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Course Image Major Intoxication

Major Intoxication

ACE
Trauma and Emergency Medicine

Summary

Acute poisoning is a common medical emergency accounting for about 10% of the workload in the emergency department. A poison is a substance which, when introduced into or absorbed by a living organism, destroys life or injures health. Side effects of therapeutic doses of drugs are also manifestations of poisoning.

Poisoning episodes may be classified as:

  • Accidental (unintentional)
  • Intentional
  • Homicidal

Accidental poisoning with household products occurs most often in children as a result of mishaps such as inhaling or ingesting chemical agents. Accidental poisoning may also occur in the elderly particularly when prescribed large
numbers of medications.


Intentional self-poisoning is most frequent in adults and accounts for the majority of poisonings admitted to hospital. Intentional poisoning may result from misuse, abuse or a suicide attempt. Intentional poisoning may also involve
the deliberate administration of a toxin to a child and may be regarded as a form of child abuse.


Acute poisoning as a means of homicide is very uncommon. Evidence-based information in poisoning management is minimal because of the variety of drugs and doses involved and the difficulty of conducting high quality clinical trials.


General Information

Enrolled trainees 2412

Open 27.12.2017

Available for ESICM members

Student effort 2

Last Updated April 19, 2024

Intended Learning Outcomes

After studying this module on Major Intoxication, you should be able to:

  • Determine the likely cause of acute poisoning based on a directed history and physical examination with selected laboratory testing
  • Describe how to concurrently initiate treatment to maintain vital functions, limit absorption or enhance elimination of toxins, and utilise antidotes or specific interventions when appropriate
  • List the available resources to access further information or experts to assist in management of the critically ill poisoned patient
  • Describe how to manage specific poisonings that may be encountered in ICU patients

Relevant competencies in CoBaTrICE

  • 1.1 Adopts a structured and timely approach to the recognition, assessment and stabilisation of the acutely ill patient with disordered physiology
  • 1.2 Manages cardiopulmonary resuscitation
  • 1.3 Manages the patient post-resuscitation
  • 1.4 Triages and prioritises patients appropriately, including timely admission to ICU
  • 2.1 Obtains a history and performs an accurate clinical examination
  • 2.6 Obtains and interprets the results from blood gas samples
  • 2.7 Interprets chest x-rays
  • 2.9 Monitors and responds to trends in physiological variables
  • 2.10 Integrates clinical findings with laboratory investigations to form a differential diagnosis
  • 3.1 Manages the care of the critically ill patient with specific acute medical conditions
  • 3.2 Identifies the implications of chronic and co-morbid disease in the acutely ill patient
  • 3.3 Recognises and manages the patient with circulatory failure
  • 3.4 Recognises and manages the patient with, or at risk of, acute renal failure
  • 3.5 Recognises and manages the patient with, or at risk of, acute liver failure
  • 3.6 Recognises and manages the patient with neurological impairment
  • 3.7 Recognises and manages the patient with acute gastrointestinal failure
  • 3.10 Recognises and manages the patient following intoxication with drugs or environmental toxins
  • 4.1 Prescribes drugs and therapies safely
  • 4.8 Recognises and manages electrolyte, glucose and acid-base disturbances

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