Toddler Time Bombs (Poison Center Triage)

Ryan and Toxo cover some topics off the "one pill can kill" list, try breaking down the toxic mechanism of opioid induced respiratory depression in a simplistic way (but maybe fail), and walk through the triage and management of poison center case where a child was "potentially" exposed to a lethal toxin at home.

• Pediatric ingestion case study discussed at the beginning of the episode: https://pediatrics.aappublications.org/content/130/6/e1700

1. Missouri Poison Center resource guide:http://missouripoisoncenter.org/wp-content/uploads/2015/02/2011-One-Pill-Can-Kill.pdf
2. Pediatric poison prevention article:https://pubmed.ncbi.nlm.nih.gov/16419734/
3. HealthyChildren.org guide on medication safety:https://www.healthychildren.org/English/safety-prevention/at-home/medication-safety/Pages/Poison-Prevention-One-Pill-Can-Kill.aspx

• Detailed overview of the impact of drugs on respiratory centers:
• https://www.ncbi.nlm.nih.gov/books/NBK482414

1. AAPCC Annual Report on poisoning trends:https://pubmed.ncbi.nlm.nih.gov/31752545/
2. Trends in pediatric opioid exposures:https://pubmed.ncbi.nlm.nih.gov/32178937/
3. Trends in ED visits for unsupervised medication exposures:https://pubmed.ncbi.nlm.nih.gov/26347435/

1. U.S. Poison Center data on buprenorphine: https://pubmed.ncbi.nlm.nih.gov/29941678/
2. Harvard Emergency Medicine group analysis: https://pubmed.ncbi.nlm.nih.gov/27756148/
3. Maryland Poison Center/RADARS data:https://pubmed.ncbi.nlm.nih.gov/18381506/
4. ICU exposures in children:https://pubmed.ncbi.nlm.nih.gov/20921918/

• Symptoms: What are the current symptoms and their severity?
• Causative Agent & Exposure Characteristics: What substance was ingested, and in what quantity? What’s the context of the exposure?
• History: Includes past medical history, patient weight, and the time elapsed since exposure.
• Onset: When are symptoms expected to appear?
• Labs: Perform toxin-specific assessments where applicable.
• Aggravating/Remitting Factors: What interventions have already been performed,