The first poison control center in Vietnam: Experiences of its initial years

Abstract

Poisoning is a sparsely studied but major health problem in Vietnam. In this hospital-based retrospective study, the medical records of all cases of poisoning admitted to the Poison Control Center in Hanoi from 1999 to 2003 were carefully reviewed. A total of 1,836 poisoning emergencies were recorded. The female:male ratio was approximately 1:1. The largest number of poisoned patients was found in the age-group 15-24 years. A vast majority of the toxic exposures (74.1 %) occurred at the patients' homes. Suicidal poisoning constituted about one third of all cases. The most commonly involved toxic agents consisted of the heterogeneous group "food poisoning" (35.1 %), pharmaceuticals (33.8%), toxins from poisonous animals, mostly snake bites (12.6%), and pesticides (9.1%). On admission, two thirds of the patients had mild symptoms (Poisoning Severity Score, PSS grade 1), while more than a quarter displayed pronounced clinical signs of poisoning (PSS grades 2-4). The most frequently used poisoning-specific treatments were gastric lavage (30.2%) and administration of activated charcoal (35.4%) and cathartics (34.2%). Intensive care measures, such as mechanical ventilation and dialysis, were applied less frequently, in 6.5% and 1.7%, respectively. Specific antidotes were given in 5.2% of the cases. The total number of fatalities was 21 (1.1%) and 10 patients were discharged with a neurological sequela. Hypnotic pharmaceuticals (mainly barbiturates), heroin, and pesticides were involved in a majority of the fatalities. These data provide an important basis for poisoning prevention efforts in developing countries such as Vietnam.