Most procedures in toxicology (lavage, ventilation, haemodialysis, etc.) are often partly or wholly performed by nurses. The same is true of monitoring and, in some institutions (including ours), psychiatric assessment and drug and alcohol counselling.

One advantage of running a specialist unit, where all patients in the area are admitted to one (not very large) A&E department and either one ward or the intensive care unit, is that as the number of nursing staff involved in the usual care of poisoned patients in our area may be as few as thirty. Therefore, a team approach can be fostered and educational programmes conducted. This may not be feasible across a large number of hospitals potentially involving hundreds of doctors and nurses.

The practical results of this process are a substantial reduction in negative attitudes toward patients with self-poisoning and psychiatric illness, quick effective treatment, accepted standard treatments for the majority of common poisonings, greatly shortened length of stay in hospital, very low rates of patient self-discharge and high recognition rates for psychiatric and drug and alcohol problems.

Whyte IM, Dawson AH, Buckley NA, Carter GL, Levey CM. Health care: A model for the management of self-poisoning. Med J Aust 1997; 167(3):142-146.