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[How to distinguish between illness, injury or intoxication in the emergency unit?]
A K Nore1, O E Ommundsen, S Steine
1Ullevål sykehus Legevakten Storgata 40 0182 Oslo. annekatrine.nore@ulleval.no
Background:
Clinical judgement of intoxicated patients is difficult. In the emergency department of the inner city of Oslo this is done every day.
Material And Methods:
During a one-year period from 1998-99, a group of 429 first-time admitted intoxicated patients were included in a study. The patients and the method of observation are described.
Results:
75% of the patients were men; 45% reported to have consumed alcohol only, while 10% had taken a heroin overdose. The rest had used various combinations of legal and illegal drugs. Female patients were younger than male patients (29 versus 36 years, p < 0.00), and patients intoxicated only on alcohol were on the average older than patients who had taken drugs (38 versus 31 years, p < 0.00). 57 patients were hospitalized, seven of them had serious intracerebral conditions.
Interpretation:
Our study indicates that systematic observation over some hours, repeated clinical examinations, and the systematic use of a modified Glasgow Coma Scale makes it possible to sort out the seriously ill from "only" intoxicated patients.