This review is based on a presentation by Professor Hoffman at the RCPE’s 49th St Andrew’s Day Festival on 4 December 2009.
Despite extensive educational and preventive efforts, fatality from poisoning is a growing public health concern. While strategies to reduce fatal unintentional poisoning in children have been largely successful, growing numbers of deaths from suicidality and substance abuse present unique challenges to the public health system. This paper explores three areas where new approaches hope to mitigate major causes of poison-related fatality. Included in this discussion are bystander naloxone for opioid overdose, a reconsideration of the optimal dose of N-acetylcysteine therapy and intravenous fat emulsion (lipid rescue) therapy for cardiovascular toxins. These innovative approaches are designed to challenge dogma and provide a stimulus for individualised clinical care.
Keywords Harm reduction, intravenous fat emulsion, N-acetylcysteine, naloxone, paracetamol, poisoning
Declaration of Interests None declared.
