What initial assessments should I perform for a patient presenting with suspected poisoning?

When assessing a patient with suspected poisoning, initial assessment should prioritise airway, breathing, and circulation (the ABCs) to identify and manage any life-threatening complications immediately NICE CG89. Assess the level of consciousness using a standard scale such as the Glasgow Coma Scale, as altered mental status is common in poisoning and guides urgency of intervention NICE CG89. Obtain a focused history if possible, including the substance(s) involved, amount, time of ingestion, and any co-ingestants or pre-existing medical conditions NICE CG89. Perform a thorough physical examination to identify signs of toxicity such as pupil size changes, skin findings, respiratory pattern abnormalities, and cardiovascular instability NICE CG89. Monitor vital signs closely including heart rate, blood pressure, respiratory rate, oxygen saturation, and temperature to detect early deterioration NICE CG89. Consider the risk of delayed toxicity or complications based on the substance ingested and clinical presentation, which may necessitate observation or further investigations Unknown 2010. Evaluate for potential psychological distress or intentional self-harm as part of the holistic assessment, referring for mental health evaluation if indicated National Collaborating Centre for Mental Health 2012. Initial investigations may include blood tests (e.g., electrolytes, renal and liver function, blood glucose), ECG, and toxicology screening guided by clinical suspicion NICE CG89. This integrated approach ensures prompt identification and management of life-threatening effects while planning for ongoing care and risk assessment NICE CG89; Unknown 2010; National Collaborating Centre for Mental Health 2012.