Clinical Toxicology

Clinical toxicology involves the research, prevention and treatment of diseases caused by chemicals, drugs and toxins. Special attention is paid to levels of chemical exposure and to the effects that exposure can have on people.

The Trust has very well developed toxicological facilities which are the Birmingham Unit of the National Poisons Information Service (, a specialist level treatment unit (West Midlands Poisons Unit), a dedicated toxicological laboratory and an Alcohol Care Team.

National Poisons Information Service

The National Poisons Information Service is commissioned by the UK Health Protection Agency (formerly Public Health England) and provides advice to health professionals and to Government and non-governmental organisations on all aspects of clinical toxicology, via a database (TOXBASE®), by telephone and in correspondence. The unit at City Hospital provides a year-round 24-hour a day service by rotation for health care staff on the diagnosis, treatment and management of patients who may have been poisoned. The NPIS is staffed by scientists and by physicians who are clinical toxicologists.

The Alcohol Care Team

The SWB Alcohol Care Team (ACT) is nationally recognised and at the forefront of care for those with serious alcohol use disorders (AUD). The ACT assesses patients in our A&E departments and on wards, providing treatment and support for people with complex alcohol related issues. This can range from advising on and managing symptoms of alcohol withdrawal, to offering brief interventions and referrals into community alcohol services.

The ACT also provides an elective alcohol detoxification pathway, creating a holistic care package for patients (Please note that referrals into the ACT elective detox pathway are from professionals only).

Staff across the Trust are given training on the clinical management of alcohol dependency and addiction to challenge the stigma often associated with alcohol use disorders.

The ACT consists of clinical toxicologists, alcohol specialist nurses, alcohol practitioners, a Fibroscan alcohol nurse and a drug specialist nurse, all of whom have clinical and addiction experience.


A Fibroscan is a non-invasive ultrasound which is used to look for signs of scarring to the liver. The Fibroscan nurse scans patients who meet the referral criteria and can give immediate results. Depending on the result the nurse provides the patient with information about the health of their liver and will make necessary referrals to the gastroenterology specialists. The Fibroscan nurse assesses patients in our A&E departments, wards and in outpatient clinics. Referrals to the Fibroscan nurse are from the ACT only.

Drug Specialist treatment

The ACT also has a full-time drug specialist nurse, who assesses patients in our A&E departments and wards with complex drug related issues. The drug specialist nurse provides clinical advice on the assessment and management of drug intoxication or withdrawal and has excellent links with community drug services to ensure that patients continue to receive the care they need when they are discharged from hospital. Referrals to the drug specialist nurse are from healthcare professionals working at the Trust.

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