Tang Dilin, Chan Wui Ling, Phua Dong Haur
Emergency Department, Tan Tock Seng Hospital, Emergency Department Level B1 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
Int J Emerg Med. 2018 Nov 16;11(1):48. doi: 10.1186/s12245-018-0210-y.
Acetaminophen is one of the most common causes of poisoning among developed countries. The emergency department observation unit (EDOU) has been increasingly used in the management of various conditions to reduce hospitalisation but its efficacy in not well studied in management of poisoned patients. In this study, we aim to study the effectiveness of our EDOU in the management of acetaminophen overdosed patients.
Medical records of patients admitted from the emergency department from 2012 to 2016 for acetaminophen overdose were reviewed. One hundred ninety-five patients presenting with acetaminophen overdose were admitted to the EDOU while 184 were admitted to the general ward. Of these, 27 patients admitted to EDOU did not meet the admission criteria for it while 71 patients who met EDOU criteria were admitted to the ward instead. For patients who fulfilled EDOU admission criteria, median length of stay for EDOU patients was 23 h (IQR 19-24) while that for those admitted to the ward was 66 h (IQR 62.5-88.3).
The EDOU is a safe alternative to hospitalisation for patients presenting with acetaminophen poisoning. It is also associated with a shorter length of stay for such patients. Further studies need to be done to assess the cost-effectiveness of EDOU for management of patients presenting with acetaminophen overdose.
对乙酰氨基酚是发达国家中毒最常见的原因之一。急诊科观察单元（EDOU）在各种病症的管理中越来越多地被用于减少住院治疗，但在中毒患者的管理中其疗效尚未得到充分研究。在本研究中，我们旨在研究我们的EDOU在对乙酰氨基酚过量患者管理中的有效性。
回顾了2012年至2016年从急诊科收治的对乙酰氨基酚过量患者的病历。195例对乙酰氨基酚过量的患者被收治到EDOU，而184例被收治到普通病房。其中，27例收治到EDOU的患者不符合其收治标准，而71例符合EDOU标准的患者却被收治到了病房。对于符合EDOU收治标准的患者，EDOU患者的中位住院时间为23小时（四分位间距19 - 24），而收治到病房的患者为66小时（四分位间距62.5 - 88.3）。
对于对乙酰氨基酚中毒的患者，EDOU是一种安全的替代住院治疗的方式。它也与这类患者较短的住院时间相关。需要进一步研究以评估EDOU对乙酰氨基酚过量患者管理的成本效益。
