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International Variability in Gastrointestinal Decontamination With Acute Poisonings

Santiago Mintegi1, Stuart R Dalziel2, Beatriz Azkunaga3

  • 1Pediatric Emergency Department, Cruces University Hospital, University of the Basque Country, Bilbao, Basque Country, Spain; santiago.mintegi@osakidetza.eus.

Pediatrics
|August 4, 2017
PubMed

Insights

International pediatric poisoning management varies significantly. Gastrointestinal decontamination (GID) procedures were used in 20% of cases, but only 45.8% were appropriate, highlighting a need for better implementation of global best practices.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Toxicology
  • Global Health

Background:

  • Acute pediatric poisonings present a significant global health challenge.
  • Management strategies, including gastrointestinal decontamination (GID), vary internationally.
  • Understanding these variations is crucial for improving patient care quality.

Purpose of the Study:

  • To assess international variations in the use of GID procedures for acute pediatric poisonings.
  • To evaluate the appropriateness of GID procedures based on established clinical guidelines.
  • To identify factors influencing GID procedure performance in emergency departments worldwide.

Main Methods:

  • International, multicenter, cross-sectional prospective study.
  • Inclusion of 1688 pediatric patients (<18 years) across 105 emergency departments in 20 countries.
  • Analysis of GID appropriateness using guidelines from the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists.

Main Results:

  • GID procedures were performed in 20% of pediatric poisoning cases.
  • Activated charcoal was the most common GID (49.1%), followed by gastric lavage (13.9%).
  • Only 45.8% of GID procedures were deemed appropriate, with significant regional disparities observed.

Conclusions:

  • Substantial international differences exist in the utilization and appropriateness of GID for pediatric poisonings.
  • Current practices indicate a gap in the implementation of international best practices.
  • Further efforts are needed to standardize and improve the quality of GID in pediatric poisoning management globally.
Abstract

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