The profile of the overdose patient presenting at Paarl Hospital Emergency Department

Abstract

Background

Overdose is a common problem often seen in emergency departments in South Africa. A subjective evaluation by doctors and nurses at Paarl Hospital indicated that there was a high incidence of patients who had overdosed presenting at this hospital. They found this distressing and felt that there should be an enquiry into the phenomenon. The aim of this study was to determine the profile of the overdose patient presenting at Paarl Hospital, the number of cases per day of the week and per month of the year, which drugs were used most commonly, as well as the seriousness of the incident. The study also looked at whether the hospital's policy regarding psychiatric evaluation protocol was being followed. Finally, some recommendations were made concerning possible intervention efforts.

Methods

A review was done of cases involving all patients with overdoses presenting at Paarl Hospital during the period 1 July to 31 December 2005. Data was collected from 196 medical records using a data collection form.

Results

The frequency of overdoses at Paarl Hospital was found to be 1.13 cases per day. The results of the study showed that most patients were females with an average age of 27.3 years. Most patients were either unemployed or scholars from low socio-economic circumstances. Tricyclic antidepressants and paracetamol were the drugs used most commonly and 42.3% of the patients took more than one drug. Few cases of overdose resulted in serious morbidity, with only 8.5% admitted to high care. In most cases the attending doctors followed the policy of the hospital regarding psychiatric evaluation.

Conclusion

Possible preventative interventions should focus on educational initiatives in communities. Patients should be educated about the dangers of their medication and that all medication should be kept out of reach of children and preferably be locked away. Doctors should take note of the drugs most commonly used for overdosing and should be more cautious when prescribing these drugs. It is preferred that patients be seen by the social worker before being discharged, since there is no control over whether the patient will keep his/her appointment at the day hospital. The social worker should be adequately trained to identify patients needing psychiatric evaluation and be able to refer them to the appropriate mental healthcare practitioner.