Toxicological Emergencies in the Resuscitation Area of a Pediatric Emergency Department: A 12-Month Review.

Abstract:

OBJECTIVE:Few studies of children with toxicological emergencies describe those undergoing acute resuscitation, and most describe exposures to single agents. We describe a 12-month sample of patients evaluated in the resuscitation area of a pediatric emergency department (ED) for a toxicological emergency. METHODS:We conducted a retrospective chart review of patients in a high-volume, academic pediatric ED. We identified patients evaluated in the ED resuscitation area for toxicological exposure and conducted structured chart reviews to collect relevant data. For all variables of interest, we calculated standard descriptive statistics. RESULTS:Of 2999 patients evaluated in the resuscitation area through 12 months (March 2009 to April 2010), we identified 80 (2.7%) whose primary ED diagnosis was toxicological. The mean age was 11.4 years. Eighty-six percent of patients were triaged to the resuscitation area for significantly altered mental status. The most frequent single exposures were ethanol (25%), clonidine (10%), and acetaminophen (5%). At least 1 laboratory test was performed for almost all patients (97%). Interventions performed in the resuscitation area included intravenous access placement (97%), activated charcoal (20%), naloxone (19%), and endotracheal intubation (12%). Eighty-two percent of patients were admitted to the hospital; 37% to the intensive care unit. No patients studied in this sample died and most received only supportive care. CONCLUSIONS:In a high-volume pediatric ED, toxicological emergencies requiring acute resuscitation were rare. Ethanol and clonidine were the most frequent single exposures. Most patients received diagnostic testing and were admitted. Further studies are needed to describe regional differences in pediatric toxicological emergencies.

journal_name

Pediatr Emerg Care

journal_title

Pediatric emergency care

authors

Beauchamp GA,Kerrey BT,Mittiga MR,Rinderknecht AS,Yin S

doi

10.1097/PEC.0000000000000858

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

670-674

issue

10

eissn

0749-5161

issn

1535-1815

journal_volume

33

pub_type

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