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PubMedDate not supplied

[Drug poisonings in childhood at a regional poisons unit].

BACKGROUND: Drug poisonings in childhood account with about one fourth for the most important group of poisonings in this age group. METHOD: From 1995 to 2004 the inquiries to a poison centre regarding drug poisonings of children < or = 6 years of age were analyzed. Additionally, a standardized questionnaire was sent for follow-up information. RESULTS: During the study period a total number of 17 553 cases of drug poisonings in childhood was determined and follow-up information was obtained for 8 590 cases (48.9 %). Boys were more likely to be affected (53.4 %) and most children were between 2 and 4 years of age (57.5 %). Mostly oral contraceptives, homeopathic drugs, nonsteroidal anti-inflammatory drugs, sodium fluoride and paracetamol were ingested. In 97.8 % of the reported cases none or minor symptoms and in 1.5 % medium or major symptoms (1 death) were observed. In the latter group of patients mostly neuroleptics, antihistaminics, nonsteroidal anti-inflammatory drugs, beta2-sympathomimetics and paracetamol were ingested. In most cases the application of fluids (47.3 %) or activated charcoal (32.0 %) was sufficient. CONCLUSIONS: Severe symptoms have rarely been observed in drug poisonings and in most children a treatment by non-professionals was sufficient. Most frequently activated charcoal was currently used for primary poison elimination. We suggest an early involvement of a poison centre in drug intoxications.

Child↗
PubMed1999

Poison center planning for mass gatherings: the Georgia Poison Center experience with the 1996 Centennial Olympic Games.

BACKGROUND: The host city for the Olympic Games needs to prepare for "the world" to visit. This article is the first published report describing the impact of an event such as the Olympics on poison center services. PLANNING AND ACTIONS: We evaluated our operations and identified potential new demands. Operational aspects reviewed included: staffing; communication with foreign language callers; knowledge of international drug products; telephone access; procedures for disaster response and recovery; poison treatment protocols; and handling of hazardous material releases. We collaborated with local, state, and federal planners to delineate the poison center role and to develop protocols for use in a poisoning, including a hazardous material's release at a densely populated site. We enhanced our capability to respond to unusual incidents by forming new alliances. Fortunately, no such events occurred; these plans were therefore not tested. CONCLUSIONS: The Georgia Poison Center developed and implemented new capabilities for the Centennial Olympic Games. Immediate access to poison center resources would have facilitated the care of poisoned patients at multiple hospitals if this had become necessary. Communities preparing for mass gatherings should capitalize on the common interests of poison centers, hazardous materials specialists, and public safety agencies. Preparations should emphasize the most likely events, while recognizing the possibility of the unexpected. Planning an integrated response allows the talents and resources of participating agencies to be maximally utilized.

Anniversaries and Special Events↗
PubMed2004

Poisoning in older adults: a 5-year experience of US poison control centers.

BACKGROUND: Poisoning in older adults has received relatively little attention. OBJECTIVE: To describe poison exposures in older adults reported to US poison centers and identify substances that pose a unique risk to this population. METHODS: A retrospective review of human exposures for patients aged >or=60 years reported to the American Association of Poison Control Center's Toxic Exposure Surveillance System from 1993 to 1997 was performed. Frequencies and cross-tabulations were used to describe the data. Hazard factor analysis was conducted to identify medications that pose risk in this population. Statistical analysis included chi(2) and Fisher's exact test for hazard factors. RESULTS: A total of 298,713 poison exposure cases were reported to US poison centers involving individuals aged >or=60 years between 1993 and 1997. The proportion of cases in this age group also steadily increased from 2.5% of all cases in 1993 to 3.4% of all cases in 1997. The mean age of the patients was 64.7 years, and 34.1% were males. Hazard factor analysis was conducted on unintentional exposures and adverse reactions to pharmaceutical agents to determine medications that posed increased risk to older adults. The substance categories that had the highest hazard factor were radiopharmaceuticals, asthma therapies, anti-coagulants, anesthetics, and antidepressants. CONCLUSIONS: Therapeutic errors and adverse reactions to medications are common reasons for major effects and fatal outcomes among older adults reported to poison centers. Understanding poisoning issues specific to this population may help direct future outreach education efforts.

Aged↗
PubMed2003

Childhood and adolescence poisoning in NSW, Australia: an analysis of age, sex, geographic, and poison types.

OBJECTIVE: This study aims to investigate whether there is any association between the types of poison substances and geographic locations for different age groups and sex. DESIGN: This is a population based epidemiological study utilising routinely collected inpatient statistics. SETTING: Data are collected as part of the routine vital health information system via all hospitals in New South Wales (NSW), Australia. PATIENTS: All patients aged between 0-19 years who were admitted to a hospital because of poisoning by the four major types of substances that were defined in the study in NSW in 2000. MAIN RESULTS: The standardised incidence ratios of poisoning related hospitalisation between metropolitan and rural areas varied across different poison types when compared with the NSW average. While there are few differences between metropolitan and rural areas for analgesic and chemical related poisoning admissions across different age groups and sex, differences in the standardised incidence ratios between geographic locations for psychotropic and venom related poisoning admissions were found. No significant difference in standardised mortality ratios were found between metropolitan and rural areas except for females in the 10-14 years age group (standardised mortality ratio 3.24, 95% confidence interval 1.69 to 6.21). CONCLUSIONS: The results obtained in this study, on the whole, provide some evidence for an association between poison types and geographic locations for psychotropic and venom related poisoning.

Adolescent↗
PubMed2003

Trends in inquiries on poisoning: a five-year report from the National Poison Centre, Malaysia.

This report describes inquiries relating to poisoning cases which were received by the National Poison Centre of Malaysia from the years 1996 to 2000. The study utilized data from the NPC report forms. Only data relating to patient contact with a poison or chemical were included in the analysis. The poison centre received an average of 186 poisoning inquiries per year. Doctors remained the highest group of caller to the poison centre throughout the five-year period. Nearly 50% of all inquiries was regarding pesticide poisoning and this trend remained constant during the five-year period. Overall, the findings showed that poisoning inquiries relating to patient care were lower than in Japan and the United States.

Adolescent↗
PubMed2006

Gastric lavage in acute organophosphorus pesticide poisoning (GLAOP)--a randomised controlled trial of multiple vs. single gastric lavage in unselected acute organophosphorus pesticide poisoning.

BACKGROUND: Organophosphorus (OP) pesticide poisoning is the most common form of pesticide poisoning in many Asian countries. Guidelines in western countries for management of poisoning indicate that gastric lavage should be performed only if two criteria are met: within one hour of poison ingestion and substantial ingested amount. But the evidence on which these guidelines are based is from medicine overdoses in developed countries and may be irrelevant to OP poisoning in Asia. Chinese clinical experience suggests that OP remains in the stomach for several hours or even days after ingestion. Thus, there may be reasons for doing single or multiple gastric lavages for OP poisoning. There have been no randomised controlled trials (RCTs) to assess this practice of multiple lavages. Since it is currently standard therapy in China, we cannot perform a RCT of no lavage vs. a single lavage vs. multiple lavages. We will compare a single gastric lavage with three gastric lavages as the first stage to assess the role of gastric lavage in OP poisoning. METHODS/DESIGN: We have designed an RCT assessing the effectiveness of multiple gastric lavages in adult OP self-poisoning patients admitted to three Chinese hospitals within 12 hrs of ingestion. Patients will be randomised to standard treatment plus either a single gastric lavage on admission or three gastric lavages at four hour intervals. The primary outcome is in-hospital mortality. Analysis will be on an intention-to-treat basis. On the basis of the historical incidence of OP at the study sites, we expect to enroll 908 patients over three years. This projected sample size provides sufficient power to evaluate the death rate; and a variety of other exposure and outcome variables, including particular OPs and ingestion time. Changes of OP level will be analyzed in order to provide some toxic kinetic data. DISCUSSION: the GLAOP study is a novel, prospective cohort study that will explore to the toxic kinetics of OP and effects of gastric lavage on it. Given the poor information about the impact of gastric lavage on clinical outcomes for OP patients, this study can provide important information to inform clinical practice.

Journal Article↗
PubMed1993

Surveillance of poisoning and drug overdose through hospital discharge coding, poison control center reporting, and the Drug Abuse Warning Network.

There is no gold standard for determining poisoning incidence. We wished to compare four measures of poisoning incidence: International Classification of Diseases 9th Revision (ICD-9) principal (N-code) and supplemental external cause of injury (E-code) designations, poison control center (PCC) reporting, and detection by the Drug Abuse Warning Network (DAWN). We studied a case series at two urban hospitals. We assigned ICD-9 N-code and E-code classifications, determining whether these matched with medical records. We ascertained PCC and DAWN system reporting. A total of 724 subjects met entry criteria; 533 were studied (74%). We matched poisoning N-codes for 278 patients (52%), E-code by cause in 306 patients (57%), and E-code by intent in 171 patients (32%). A total of 383 patients (72%) received any poisoning N-code or any E-code. We found that PCC and DAWN reporting occurred for 123 of all patients (23%) and 399 of 487 eligible patients (82%), respectively. In multiple logistic regression, factors of age, hospital admission, suicidal intent, principal poisoning or overdose type, and mixed drug overdose were statistically significant predictors of case match or report varying by surveillance measure. Our findings indicate that common surveillance measures of poisoning and drug overdose may systematically undercount morbidity.

Adolescent↗
PubMed1980

[Suspected poisoning and actual poisons found in chemico-toxicological emergency investigations (author's transl)].

In almost half (46.5%) of 400 chemico-toxicological investigations suspected poisoning had been assumed without a specific poison being named. In 73% of these cases toxicologically important substances were demonstrated. In 19% of cases no poison could be demonstrated and in approximately 6% of cases poison ingestion could neither be ascertained nor ruled out. In 53.5% of emergency investigations suspected poisons could be named before the beginning of analysis. The information could be verified partially or completely in 78%. In 20% of these more poisonous substances were found than suspected and in 16.3% none of the suspected substances but completely different toxic ones were demonstrable. In 5.6% of cases suspected poison ingestion could not be verified.

Emergencies↗
PubMed2005

Seasonal changes in poisoning exposures reported to a regional poison center from coastal resort areas.

This study examined the role of seasonality in the reporting of poisoning exposures from geographically distinct regions, specifically from coastal resort and vacation areas. The monthly distribution of calls received by a regional poison control center from counties with popular beach and vacation resorts was compared with the monthly distribution of the overall calls to the center. A chi-square goodness-of-fit test was used to determine if there was a significant difference between the monthly distribution of calls received from the resort counties and the overall calls received by the poison center. Further, exposure and information calls from the resort counties were separately examined to determine if they were equally distributed between months. The monthly distribution of calls received from coastal resort counties was significantly different from the monthly distribution of overall calls received by the center. Significantly more calls were received from the resort counties during the months of July and August at the height of the vacation season. While there was no seasonal variation in the number of information calls from these counties, the poisoning exposure calls were not equally distributed between months, as there were more such calls during the months of July and August. Seasonality appears to play a role in the number of calls received by a regional poison center from coastal areas with popular beach resorts. Poisoning exposure calls seem to increase particularly during the months of July and August. A greater effort may have to be put into activities related to poison control and prevention into such areas during the vacation season.

Epidemiologic Studies↗