Emergency management of poisoning in Hong Kong

FL Lau
Accident and Emergency Department, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong

The emergency management of poisoning is important in reducing the risk of mortality and morbidity in poisoned patients. This article reviews the Hong Kong system of prehospital and emergency care of poisoning, with reference to recent advances in this field. Administering activated charcoal is recommended for the gastro-intestinal decontamination of most poisons, unless doing so is contra-indicated. Gastric lavage should be considered only in life-threatening cases of poisoning that present within the first hour. Newer antidotes that are available in Hong Kong accident and emergency departments include hydroxocobalamin, stonefish and snake antevenenes, digoxin-specific antibodies, esmolol hydrochloride, and octreotide. The 'golden hour' concept of gastro-intestinal decontamination is advocated and ways to ensure that decontamination is performed within the 'golden hour' are suggested.

Hong Kong Med J 2000;6:288-92

Key words: Antidotes/therapeutic use; Charcoal/therapeutic use; Emergency treatment; Poisoning/drug therapy; Time factors