[Present condition of the poisoning reason substance analysis in an advanced critical care center]

We investigated the significance of analyzing substances causing intoxication in emergency centers. The poison analysis room was established 6 years before this study. We analyzed a total of 504 patients with intoxication (203 males and 301 females). Concerning the prognosis, 23 patients died; 16 patients (10 males, 6 females) died of paraquat/diquat intoxication, 3 patients (3 males) died of intoxication with organic phosphate agents, 1 patient (male) died of intoxication with a phenoxy agent, and 3 patients (1 male, 2 females) died of intoxication with antipsychotic agents. The other 481 patients were discharged after improvement or referred to another department. Furthermore, we examined the presence or absence of information on intoxication at consultation in the patients with intoxication. In 69 (71.9%) of 96 episodes of intoxication with pesticides, the results of analysis were consistent with the information. In 27episodes (28.1%), there was no information at consultation, or the results of analysis were not consistent with the information. In 299 (79.9%) of 374 episodes of drug poisoning, the results of analysis were consistent with the information. In 75 episodes (20.1%), there was no information at consultation, or the results of analysis were not consistent with the information. These results suggest that the analysis of substances causing intoxication is essential in 20% of patients. We investigated the serum cholinesterase (ChE) level on the initial consultation in the patients with intoxication with pesticides. Ingestion of organic phosphate agents markedly reduced the serum ChE level. However, our results suggest that the serum ChE level depends on the type/amount of pesticides and the interval after ingestion. In addition, many patients took several types of pesticides or drugs, suggesting the importance of analyzing substances causing intoxication.