What 3 things do all deliberate poisoning patient need when planning disposition?
risk assessment to determine medical disposition EARLY, social and psychiatric review
What factors affect disposition of patient?
combination of risk assessment and discussion with toxicioogy can 1. period of observation in ED, then home, 2. extended observation in EOU (emergency observation Unit) or Gen med ward 3. ICU if need organ support
What general features make EUO ideal to safely observe fox patients?
24hour availability of experienced medical staff, appropriate resources, staff and training, open plan environment that facilitates observation and ED ethos geared to assessment and disposition
What specific features do a EUO have for fox patients?
Central nurse stations, environment protecting against self harm, secure entrance, dedicated area private interview, social work, pschy, D+A outpatient liaison services, monitoring/telemetry, resus equipment, duress alarm, appropriate staff, skills and equipment, 24/7/365 senior staff, nurse
patient ratio 1:4, or 1:8
Criteria needed for EUO following poisoning
No cardiac monitoring, adequate sedation for delirium, risk assess not likely to deteriorate
Benefits of EUO for fox: Admissions in one place, experienced staff, medical staff available, security available, managed by people used to toxicology, reduced admission
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