Manny: Pediatric patients made up 45.2% of the 2.6 million toxic exposure calls to US poison control centers in 2017. Although most of these reports represent minor ingestions, there are at least 8 different classes of substances that can lead to severe toxicity or even death with even small ingestions in children.
The 2017 data from the American Association of Poison Control Centers reported 25 deaths in children less than 6 years of age. With the development of new pharmaceuticals and the expanded treatment indications for others, the availability of deadly drugs is only increasing. It is imperative for physicians to be familiar with the presenting signs and symptoms of potentially toxic ingestions in the pediatric population in order to be able to quickly initiate therapeutic and life-saving interventions.
Brit: Why don’t we take this medication by medication?
Manny: Sure! Let's do it!
Brit: The first one is sulfonylureas - mechanism, signs/sxs, treatment, observation time if asymptomatic
Manny: Calcium channel blockers
Brit: Toxic alcohols
Manny: clonidine
Brit: TCAs
Manny: Salicylates
Brit: Opioids
Manny: Local anesthetics
Brit: Antimalarials
Some takehomes from this post:
If you have a child that presents concerning for toxic ingestion, contact the poison control center immediately.Identification of children with clinical toxidromes concerning for ingestion requires vigilance on the part of the clinician.Careful questioning of the family/caretakers is required to identify potential exposuresIn pediatric exposures with known time of ingestion and early presentation, activated charcoal may be considered for early decontamination in the asymptomatic patient who is protecting his/her airway.Manny: That was an awesome high-yield review Brit. Well that rounds out our summary of the key emDocs post. Thanks for joining us on the podcast, and stay tuned for our next episode. Feel free to comment on our site and let us know if you have any feedback. Stay safe and healthy everyone!