Psychiatric Issues in the Critically Poisoned Patient

Rasimas, Joseph J.

doi:10.1007/978-3-319-20790-2_44-1

Cited by 2 publications

(3 citation statements)

References 230 publications

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“…Further, repetition of intentional self‐poisoning could be associated with underlying mental health concerns. 32 Those with mental illnesses are more likely to misuse drugs, 33 which could account for a large portion of the poisoning injuries.…”

Section: Discussionmentioning

confidence: 99%

Rates of injury according to a single or comorbid mental illness identified in a large employee database

Merrill

Ashton

2023

Journal of Occupational Health

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Objective To identify associations between specific types of mental illness (occurring alone or in combination with other mental illness) and (specific and all types) of injury. Methods Analyses involve 21 027 employees aged 18–64 insured by Deseret Mutual Benefit Administrator (DMBA), 2020. Nine classifications of mental illness and 12 classifications of injury are considered. Rate ratios are adjusted for age, sex, and marital status. Results The rate of injuries is 13.6%. A positive association exists between any mental illness and injury (rate ratio [RR] = 1.74, 95% CI 1.62–1.87). The positive association is consistent across all types of injury, except burns. While having a mental illness tends to positively associate with having an injury (vs. none), it more strongly associates with having two or more types of injury (vs. none). Injury rates are significantly greater when comorbid mental illness is involved (vs. one type of mental illness), more so for multiple types of injuries. Specifically, there is a positive association between having a mental illness (vs. none) and a single type of injury (vs. none) (RR = 1.58, 95% CI 1.42–1.75) or two or more types of injuries (vs. none) (RR = 1.94, 95% CI 1.70–2.23). Corresponding estimates where comorbid mental illnesses exist (vs. none) are (RR = 2.07, 95% CI 1.70–2.51) and (RR = 3.32, 95% CI 2.64–4.17), respectively. The most common combinations of mental illness that positively associate with injury tend to involve comorbid mental illness. Conclusions Several types of mental illness positively associate with injury and are more strongly associated when there is comorbid mental illness.

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Section: Discussionmentioning

confidence: 99%

Rates of injury according to a single or comorbid mental illness identified in a large employee database

Merrill

Ashton

2023

Journal of Occupational Health

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“…Other supportive and symptomatic treatment that may be administered on an individual basis may include correction of hypoglycemia with glucose (dextrose) infusion, use of specific antidotes in cases of coingestants for which they are available, and so on. Also, psychosocial assessment and the role of a psychiatrist in the management of patients presenting with intentional overdose is important and may have an impact on repetition rates of self-harm, particularly considering that patients who deliberately overdose have a high prevalence of suicidal ideation and pre-existing psychiatric disorders that may impact medical management 71,72 . Psychiatric aftercare should be arranged according to the patient's needs and risk 73 …”

Section: Discussionmentioning

confidence: 99%

“…Also, psychosocial assessment and the role of a psychiatrist in the management of patients presenting with intentional overdose is important and may have an impact on repetition rates of self-harm, particularly considering that patients who deliberately overdose have a high prevalence of suicidal ideation and pre-existing psychiatric disorders that may impact medical management. 71,72 Psychiatric aftercare should be arranged according to the patient's needs and risk. 73 Figure 3 summarizes the key takeaway messages for the management of pediatric patients with acute hydroxychloroquine overdose based on the author's evaluation of the available published data, which had the strength of evidence less than that provided by well-controlled prospective pediatric studies.…”

Section: Discussionmentioning

confidence: 99%

Acute Hydroxychloroquine Overdose

Pejčić¹

2021

Pediatr Emer Care

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Objectives: This review aimed to explore and summarize information from available cases of pediatric acute hydroxychloroquine overdose with confirmed hydroxychloroquine exposure to give the clinicians a helpful perspective for its better recognition and management.Methods: Electronic searches were conducted in PubMed/MEDLINE, Web of Science, Scopus, EBSCO and Serbian Citation Index. The abstracts from 2 toxicology conferences were manually checked for additional relevant publications, as well as reference lists of the retrieved publications. Descriptive statistics, narrative summation, and tabulation of the extracted data were made.Results: Nine publications and a total of 9 patients were included in the review. Reported age of the patients varied from 2.5 to 16 years (median, 16 years). There were more female patients (77.8%). Estimated total ingested hydroxychloroquine dose was reported in 7 cases (77.8%), and it ranged from 4.0 to 20.0 g (median: 12.0 g). Four patients (44.4%) ingested hydroxychloroquine with a coingestant. Altered mental status (100.0%), cardiotoxicity (88.9%), hypotension (77.8%), and hypokalemia (55.6%) were the most commonly reported clinical manifestations. The majority of the patients were hospitalized (88.9%). More than half of the patients (55.6%) were reported to be treated in the intensive care unit. Most frequently reported therapeutic measures were the following: administration of intravenous fluids/infusions (77.8%), vasopressors (77.8%), bicarbonate therapy-sodium bicarbonate (66.7%), potassium replacement (55.6%), and intubation/ventilation (55.6%). Three patients (33.3%) died.Conclusions: Management of acute hydroxychloroquine overdose in children should be symptomatic and tailored to observed clinical manifestations. There is a need for additional investigations to better understand the impact and effectiveness of various treatment options.

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Psychiatric Issues in the Critically Poisoned Patient

Cited by 2 publications

References 230 publications

Rates of injury according to a single or comorbid mental illness identified in a large employee database

Rates of injury according to a single or comorbid mental illness identified in a large employee database

Acute Hydroxychloroquine Overdose

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