The Hospital Management of Fatal Self-Poisoning in Industrialized Countries: An Opportunity for Suicide Prevention?

Autor/inn/en	Kapur, Navneet; Turnbull, Pauline; Hawton, Keith; Simkin, Sue; Mackway-Jones, Kevin; Gunnell, David
Titel	The Hospital Management of Fatal Self-Poisoning in Industrialized Countries: An Opportunity for Suicide Prevention?
Quelle	In: Suicide and Life-Threatening Behavior, 36 (2006) 3, S.302-312 (11 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0363-0234
DOI	10.1521/suli.2006.36.3.302
Schlagwörter	Hospitals; Risk Management; Poisoning; Suicide; Prevention; Developed Nations; Opportunities; Medical Services; Literature Reviews; Patients; Intervention; Mortality Rate; Self Destructive Behavior + Suchen Sie Ihr Suchwort? Krankengymnast; Krankenhaus; Risikomanagement; Selbstmord; Prävention; Vorbeugung; Developed countries; Industriestaat; Industrieland; Möglichkeit; Arzt; Patient; Mortalitätsrate; Self destrucive behaviour; Selbstzerstörung
Abstract	Suicide by self-poisoning is a prevalent cause of death worldwide. A substantial proportion of individuals who poison themselves come into contact with medical services before they die. Our focus in the current study was the medical management of drug self-poisoning in industrialized countries and its possible contribution to suicide prevention. We reviewed the literature to determine the proportion of self-poisoning suicides who reach hospital alive, the sociodemographic and clinical characteristics of in-hospital overdose deaths, the in-hospital management this group of patients receives, and whether there are specific aspects of pre-hospital care and in-hospital management that have the potential to improve survival. Between 11% and 28% of individuals who died following deliberate ingestion of drugs reached hospital alive. The substances which were most frequently implicated in death were paracetamol (acetaminophen) and paracetamol compounds, tricyclic antidepressants, and benzodiazepines. Most patients received fairly intensive treatment, yet death may have been preventable in a small proportion of cases. Only one intervention (the administration of acetylcysteine) was shown to reduce mortality and this was in a highly selected group of patients (those who had ingested paracetamol and developed fulminant hepatic failure). It is possible that other interventions such as better airway management, the prompt administration of activated charcoal, and improved pre-hospital care may improve outcomes but their potential contribution to suicide prevention needs to be investigated in future studies. (Author).
Anmerkungen	Guilford Press. 72 Spring Street, New York, NY 10012. Tel: 800-365-7006; Tel: 212-431-9800; Fax: 212-966-6708; e-mail: info@guilford.com; Web site: http://www.guilford.com.
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10