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Observation unit experience for pediatric poison exposures

Diane P Calello1, Elizabeth R Alpern, Maureen McDaniel-Yakscoe

  • 1Section of Medical Toxicology, Division of Emergency Medicine, Department of Pediatrics, Robert Wood Johnson Medical School-University of Medicine and Dentistry of New Jersey, New Brunswick, NJ 08903-0019, USA. diane.calello@umdnj.edu

Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology
|February 5, 2009
PubMed

Insights

Pediatric observation units (OU) can safely manage select poisoning exposures. Poisoned children had significantly lower unexpected hospitalization rates compared to other OU patients.

Area of Science:

  • Pediatric Emergency Medicine
  • Toxicology
  • Healthcare Management

Background:

  • Limited data exists on the care of pediatric poisoning exposures in Short-Stay Emergency Department Observation Units (OU).
  • Pediatric OUs offer an alternative to hospitalization for various conditions.

Purpose of the Study:

  • To report the experience of a pediatric OU managing children with poisoning exposures.
  • To compare hospitalization rates and outcomes of poisoned pediatric patients in the OU versus non-poisoned patients.

Main Methods:

  • Retrospective chart review of pediatric patients with poison exposure admitted to a pediatric OU over 30 months.
  • Data collected included demographics, toxicants, clinical presentation, and hospitalization rates.
  • Comparison of poisoned OU patients to non-poisoned OU patients.

Main Results:

  • 86 pediatric poisoning cases were analyzed; 82.4% were under 6 years old.
  • Common toxicants included psychoactive drugs (25%) and cardiovascular agents (19%).
  • The overall hospitalization rate was 5.4%, significantly lower than the 20.3% for non-poisoned OU patients. Unexpected hospitalization rate was 2.2%.

Conclusions:

  • Select pediatric poisoning cases are suitable for management in an OU setting.
  • Poisoned pediatric patients experienced less frequent unexpected hospitalizations from the OU compared to other diagnoses.
  • No adverse events were associated with OU placement for poisoned children.
Abstract

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