Chepsy C Philip
Clinical Haematology, Christian Medical College, Ludhiana, Punjab 141008 (India); email@example.com
Key words: Poisoning; Toxidromes
Citation: Philip CC. Counselling is important in treatment of deliberate self-harm. Anaesth Pain & Intensive Care 2014;18(3):316-17
The article on poisoning with amitraz was an interesting read.1 The authors have reported a case of deliberate self-poisoning with amitraz; detailing its presentation with an approach to its management. They have rightly indicated that there are no known antidotes. In this case though there was a suspicion of the agent used, it might not always be the case. In poisoning, when the agent is unknown, the clinical syndrome of symptoms and signs may suggest one of the recognizable toxidromes, which can guide treatment; resuscitation, of course, remains an important component of the management.2,3 It should be recognized that an accurate history might not be gathered at presentation to the emergency room.4-6When etiological agent is known or is subsequently revealed, specific antidotes may be available and these offer the opportunity to reduce morbidity and mortality.2 Importantly, in cases of deliberate self poisoning, treatment should not end with decontamination and reversal of symptoms alone. A routine referral and follow up with a psychiatrist is to be encouraged.
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