Patients with Altered Mental Status May Benefit from Medical Toxicology Consultation

Background: Presentation of intoxicated patients to hospitals is frequent, varied, and increasing. Medical toxicology expertise could lead to important changes in diagnosis and treatment, especially in patients presenting with altered mental status. Objectives: To describe and analyze clinical scenarios of intoxicated patients with altered mental status presenting to a medical toxicology service during a 1 -year period soon after its establishment. Methods: Medical records of all individuals for whom a toxicology consultation was requested during the study period were reviewed. Patients who presented with altered mental status with the most significant changes in diagnosis and management due to a medical toxicology consult were described in detail. Results: Of 973 toxicology consultations performed during the study period, bedside consultation was provided for 413 (42%) patients. Of these 413, 88 (21%) presented with some level of altered mental status. We described 10 patients in whom medical toxicology consultation resulted in significant changes in diagnosis and management. Conclusions: Medical toxicology consultations, especially bedside consultation, can significantly improve the clinical care of intoxicated patients, particularly those with altered mental status. Medical toxicology specialists are well positioned to provide high value and expedited patient care.