Intoxication grave de l'adulte : épidémiologie, définition, critères d'admission en réanimation

Acute poisonings represent a frequent reason of admission in emergency rooms or intensive care units. Mortality of poisoned patients remains generally lower than 1% but may reach 10% and more for some cardiotropic toxicants. The prognosis has changed over the last years. Evaluation of intoxication severity should rely on a rigorous approach based on analysis of the prognostic factors and the criteria of established severity, which seems specific to each psychotropic, cardiotropic or analgesic toxicant. It is possible to evaluate the individual patient prognosis, to decide his admission to an intensive care unit, and to indicate, if necessary, the administration of any onerous or risky treatment. The existing polyvalent physiologic scores are inappropriate to establish an individual prognosis or to take clinical decisions in drug-induced poisonings.