What follow-up care is recommended for patients discharged after treatment for poisoning or overdose?

For patients discharged after treatment for poisoning or overdose, most individuals should be seen in person ¹. However, telephone advice may be offered if a healthcare professional is confident the poisoning episode was not serious ¹.

For deliberate self-poisoning or self-harm:

Patients who have self-harmed require a further psychosocial assessment by a trained specialist, such as a mental health worker or social worker, after their physical problems have been treated ¹. The outcome of these assessments should be communicated to other healthcare professionals involved in the person's care ¹. Before discharge, follow-up support should be discussed and arranged according to the person's mental and physical health needs ⁴. This support can include contact details for a community psychiatric nurse or social worker, out-of-hours services, and plans for the first week, including practical and employment support ⁴. A follow-up appointment with the GP should be considered within 2 weeks of discharge, and the person should receive a written record of these details ⁴. The hospital psychiatrist is responsible for ensuring a discharge letter is emailed to the person's GP within 24 hours, with copies provided to the person and relevant community teams or specialist services ⁴. A copy of the latest care plan should also be sent to everyone involved in their care within 24 hours ⁴. A discharge summary, including reasons for admission and changes in condition, should be sent to the GP and others involved in care planning within a week, subject to the person's agreement ⁴. If a risk of suicide has been identified, the person should be followed up within 48 hours of discharge ⁴. Otherwise, follow-up should occur within 7 days ⁴. For adults admitted for self-harm who are not receiving community treatment after discharge, consider contacting them to provide advice on available community services for support or reassurance and how to access them ⁴. Any risk of suicide should be identified in collaboration with the person and incorporated into care planning ⁴.

For low toxicity substances:

If a person has ingested a substance considered to be of low toxicity and hospital assessment is not usually indicated for accidental poisoning, they should be advised that they may experience mild gastrointestinal upset ¹. If this occurs, they should drink a small glass of water, milk, or juice ¹. They should also be informed when to seek medical advice, for example, if gastrointestinal upset does not improve, worsens, or new symptoms develop ¹.

Safeguarding:

Safeguarding concerns should be assessed for people of all ages, including children and adults in the person's care ¹. Child maltreatment should be suspected in cases of poisoning in children if there is a report of deliberate administration of inappropriate substances, unexpected blood levels of drugs not prescribed, or repeated presentations of ingestions ³.