Profile of childhood poisoning at a tertiary care centre in North India

To determine the profile and outcome (discharge from emergency room after observation, admission or death) of pediatric patients presenting with acute poisoning to a tertiary care centre in north India.

We retrospectively reviewed the last 2 year (July, 2004 to July, 2006) hospital records of pediatric emergency room to profile all cases of pediatric poisoning during that period and noted their outcome. All cases age < or = 12 years with definite history of poisoning were included.

111 patients presented to the pediatric emergency during the study period. Mean age of our patients was 3.12 +/- 2.04 yrs (SD). Majority of our patients (63.9%) was in the 1-3 yr age group. Males outnumbered females by a factor of two; majority of our patients resided in urban areas. Kerosene (27.9%), drugs (19.8%) and insecticides (11.7%) were the agents most frequently implicated. Almost all (96.9%) ingestions were accidental in nature. Thirty six patients (32.4%) were asymptomatic after 6 hr of observation in the emergency ward; 75 patients (67.6%) developed symptoms related to toxic ingestion. The common serious symptoms included altered sensorium, respiratory distress, seizures, ataxia, hypotension, cyanosis and burns; three patients required intubation and mechanical ventilation. Almost one third of our patients underwent gastric lavage; no patient with kerosene poisoning or any other inappropriate indication underwent the same.

The trends for pediatric poisoning noted at our centre are not very different from those observed in hospital-based studies conducted more than a decade ago, despite the rapid socioeconomic development in our country. In sharp contrast to developing countries, where majority of poisonings are due to common non-toxic household products, most of our patients require hospitalization because of severe symptoms related to dangerous nature of toxins ingested. Consultation with the poison cell results in improved patient management.