eMedinewS Editorial

Medicine 1,945 Comments

When to admit a patient with drug overdose

Clinical assessment in the emergency department can reliably identify patients who are at high risk for complications and require ICU care.

In a retrospective analysis of data on more than 200 overdose cases, the presence of any of the following eight clinical criteria predicted a complicated hospital course that could be best managed in an ICU:

  1. PaCO2 > 45 mmHg
  2. A need for emergency intubation
  3. The presence of post ingestion seizures
  4. Unresponsiveness to verbal stimuli
  5. A non–sinus cardiac rhythm
  6. Second–or third–degree atrioventricular block
  7. Systolic blood pressure < 80 mmHg
  8. QRS duration ≥ 0.12 seconds


Brett AS, Rothschild N, Gray R, Perry, M. Predicting the clinical course in intentional drug overdose: Implications for use of the intensive care unit. Arch Intern Med 1987;147:133.

Dr KK Aggarwal
Editor in Chief