Self-Poisoning With Ibuprofen in Youth: A What, When and Why Clinical Framework

Deliberate self-poisoning (DSP) among children and adolescents has been steadily increasing over the past decade worldwide with paracetamol and ibuprofen the most common medications used. Assessment and management often fall to Emergency Department (ED) staff with varied psychiatric experience. We outline an easy-to-use psychiatry framework for ED clinicians to guide them in assessing and managing young people who present with DSP with Ibuprofen. A "what, when and why" framework derived from the authors' clinical experience in child and adolescent liaison psychiatry and emergency care, is outlined. This may guide ED clinicians in the assessment of what medication is ingested, when DSP occurred on as well as when to initiate treatment and how to explore why the DSP episode took place. DSP with Ibuprofen has the potential to cause severe physical sequelae ranging from renal and liver impairment to severe gastro-intestinal bleeds and thrombocytopaenia. Establishing what was used in the DSP episode and when it occurred is therefore crucial to allow for timely treatment and management. Establishing reasons why the young person took the overdose, along with thorough risk assessment is crucial in aiding safe discharge planning. Given the importance of timely intervention, the suggested framework provides an easy-to-remember method for assessment, informing management and discharge planning.