needle tracks, pressure marks, bullous lesions and soft tissue swelling, may also be present. reduced respiratory rate and airway reflexes), and neurological (loss of consciousness, convulsions, corneal and pupillary reflexes, and spinal reflexes) functions. hypotension, hypertension, dysrrhythmias), respiratory (e.g. The patient who has taken an overdose often exhibits varying clinical signs, with alteration in cardiovascular (e.g. The general appearance of the patient, including vital signs, skin color and lesions, skin and breath odor, may give important diagnostic features. Physical examination: Findings on physical examination are of great clinical value. The patient's medical or psychiatric history, current medications used by patient or family members, obtained from family or friends if the patient is unable to relate the information, may imply a likely cause of poisoning.

In an unsupervised child, circumstances often suggest that the substance in the mouth or on the skin has been swallowed. carbon monoxide poisoning in the bathroom with gas water heater or in the garage). The surrounding circumstances and the place of discovery may suggest poisoning with a specific agent (e.g. Suicide notes, sent SMS or e-mails will support the assumption of self-poisoning. When unconscious patients are found with empty drug packages, alcoholic beverages, household product containers, it is reasonable to suspect that these agents may be the cause of coma. In previously healthy young adults, self-poisoning is probably the reason for unexpected coma. If the patient is unable to provide accurate information (very young, unconscious, demented) circumstantial evidence may be important in establishing the diagnosis.

History: In many cases, it is not difficult to make the correct diagnosis because a history of drug overdose or exposure to the toxic agent is provided by the patient, family members, witnesses or emergency services staff. Poisoning should be suspected in all cases of sudden, severe, and unexpected illness and in any patient who presents with multisystemic involvement.

Diagnosis is based on the history, circumstantial evidence, a cluster of symptoms and signs, on the results of biochemical and toxicological analyses and ECG or X-ray abnormalities. Investigation of the Poisoned Patient - History Taking and Physical Examinationĭepartment of Clinical Toxicology, Jagiellonian University, Kraków, Polandīackground: Assessment of an acutely poisoned patient involves the taking of an appropriate history, assessment of the vital signs, level of consciousness, a physical examination, and requesting appropriate toxicological and non-toxicological investigations.

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