[Management of self poisoning at an emergency medical center]

We examined the response given to calls for acute self-poisonings in a French department (Vienne) in order to determine current management practices.

We reviewed retrospectively all calls to the Vienne pre-hospital emergency care center between January 1997 and December 1999 that concerned acute self-poisoning. There were 2,057 calls for 1,312 women and 708 men (mean age 35.3 +/- 13.7 years, age range 8-99 years).

The call was made by a private person in 72.1% of the cases, by a physician in 14.4% and by a first-aid worker in 8.4%. The annual incidence was 1.83 calls per 1000 inhabitants. Self-poisoning led to death in 1% of the cases (mean age 40.8 +/- 10.8 years, age range 27-70 years). A total of 3,225 toxic agents were identified, i.e. 1.56 +/- 1 agent per poisoning (range 1-10). Psychotrops predominated and were found in 74.8% of the suicide attempts with drugs. Non-drug poisonings accounted for 2.5% of the cases. The emergency center responded to the call by dispatching an ambulance (56.4%) or a medicalized emergency care unit (22.4%), providing counsel (18.2%), or calling in a physician (1.1%). A mobile hospital unit was dispatched in 58% of the cases judged to involve a life-threatening situation.

Self-poisoning is one of the most common situations managed by pre-hospital emergency care centers. The response given to emergency calls would appear to be insufficiently medicalized.