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from Subsection 4O - Clinical – Toxicology
Published online by Cambridge University Press: 27 June 2025
Poisoned patients who present to the emergency department often require a period of observation to determine their ultimate disposition. Most poisoned patients are able to be discharged within 24 hours, which makes them good candidates for observation unit (OU) admission. Data suggests that clinicians using well-defined protocols can safely manage poisoned patients in the OU. Benefits of OU care for this patient population include earlier involvement of multidisciplinary teams, shorter length of stay, conservation of resources and potential cost-savings. Pediatric poisoned patients in particular are excellent candidates for OU protocols. Multiple agents have been managed in the OU, such as acetaminophen, benzodiazepine, carbon monoxide, stimulants, opioids and various envenomations. OU protocols are not limited to single agent ingestions. OUs may also be used for buprenorphine initiation for the opioid addicted patient. The most effective protocols utilize the expertise of medical toxicologists to help risk stratify appropriate patients for OU care. With well-designed protocols, the poisoned patient can be effectively and safely managed in the ED OU.
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