Inappropriate management and transfer of cases with acute poisoning referred to poisoning treatment center – Ain Shams University – Cairo

ince patients with acute poisoning may present as emergency cases, delayed transfer or inappropriate management may lead to serious deterioration of cases.The objective of the studyTo assess the performed basic management and transportation of poisoned patients, and their impacts on the outcome of the referred patients to the Poisoning Treatment Center (PTC), Ain Shams University Hospitals, in Cairo in 2008.MethodsThe medical files of all referred cases to the PTC, in 2008 were reviewed. Inappropriate management or transfer was recognized according to the basics of standards of care and principles of medical ethics in emergencies and on the basis of the Guideline of College of Physicians & Surgeons of Manitoba for interfacility emergency transportation. Correlation coefficients and Chi square tests were used for statistical comparison of frequency between the different groups.ResultsSeventy-nine cases (13.5% of the referred cases) were designated as inappropriate transfer which included inappropriately managed cases either with incorrect medications (50.6%) or with faulty measures for resuscitation or decontamination (15.2%), referred cases after unjustified long delay time (>6h) (22.8%), cases that did not receive first aid measures (21.5%), inappropriately transported cases (86.1%), referred cases while risks of transfer outweighed its benefits(3.8%), and referred cases without sufficient documentation of the received management in the referring hospital (87.3%).ConclusionThe several defects encountered in this study are related to poorly designed emergency care systems including ignored continued medical education and training, negligent emergency medicine practice and unsuccessful scientific communications with the PTC