[Suicide and attempted suicide with rodenticides from 1968 to 2000].

INTRODUCTION: The paper reviews rodenticides in use in Yugoslavia, their mechanism of action, typical clinical picture as well as general and specific treatment of poisoning.

OBJECTIVES: Our aim was to present interventions performed in urgent treatment considering the fact that the mortality rate in rodenticide poisoning, especially with zinc phosphide is really small.

MATERIAL AND METHODS: The study included history data of patients who attempted and committed suicide with rodenticides. Data analysis was done in regard to the poison, sex, qualification, marital status, motives, underlying disease and interventions performed. RESULTS OF INVESTIGATION: The total number of attempts was 88, out of which 85 were attempted and 3 committed suicides, mostly with zinc phosphide: 34 attempted (40%) and 3 committed (100%). There were 66 (75%) patients with elementary school, 61 (69%) patients were married, 36% were workers and 35% housewives, while marital or family conflicts were motives for suicide in 52 (59%) patients. There were 30 (34%) patients with depression, 28 (32%) were alcoholics and 23 (26%) patients suffered from neurosis. In 17 patients (19%) ambulatory gastric lavage was done, while in 56 (64%) patients it was done in the hospital.

DISCUSSION: Attempted and committed suicides were most commonly done with zinc phosphide, and then come rat poisons. A considerably small number of interventions were recorded in the surrounding outpatient clinics, but it is only natural, because the furthest outpatient clinic is about 40 km away, so patients can make it to the hospital within 20 minutes and get adequate medical care. Although gastric lavage was excessive with activated charcoal and laxans, most lavages were inadequate and performed with water, not solution of sodium-bicarbonate.

CONCLUSIONS: Suicides with rodenticides are still actual in medicine. Women attempt and commit suicide with rodenticides more often. Zinc phosphide is the most frequently used poison. These patients must be admitted to hospital and observed for at least three days. Zinc phosphide poisoning requires excessive gastric lavage with sodium bicarbonate solution, application of charcoal, laxanes, calcium preparations with excessive osmotic diuresis, whereas in poisoning with coumarin preparations, apart from gastric lavage, application of charcoal and laxanes as well as excessive osmotic diuresis, vitamin K and Dicynone are necessary.