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An Overview of the Pediatric Toxidromes and Poisoning Management
Wun F Hui1, Kam L Hon1, Alexander K C Leung2
1Department of Pediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong.
Insights
Recognizing pediatric toxidromes is crucial for prompt poisoning diagnosis and treatment. This review covers common toxidromes, their management, and advanced interventions like extracorporeal toxin removal.
Area of Science:
- Pediatric Toxicology
- Emergency Medicine
- Clinical Pharmacology
Background:
- Poisoning is a significant global cause of childhood illness and death.
- Clinical toxidrome recognition remains essential for managing pediatric poisoning cases, complementing modern diagnostics.
Purpose of the Study:
- To review common pediatric toxidromes and poisoning management strategies.
- To emphasize the importance of clinical assessment in pediatric toxicology.
Main Methods:
- A literature search was performed on PubMed using keywords: "toxidrome," "poisoning," "intoxication," "children," and "pediatric."
- The search was filtered for relevance to pediatric poisoning and management.
Main Results:
- Toxidrome recognition facilitates rapid diagnosis and timely antidote administration.
- The review details common pediatric toxidromes, including symptomatology, exposure sources, and management.
- Extracorporeal toxin removal is discussed as an advanced treatment for severe, refractory cases.
Conclusions:
- Familiarity with pediatric toxidromes and poisoning management is vital for physicians.
- Prompt recognition and appropriate intervention are key to improving outcomes in pediatric poisoning.
Background:
Poisoning is one of the leading causes of childhood morbidity and mortality worldwide. Despite the advancement of poison detection by modern investigation methods, the clinical skill of toxidrome recognition by combining the findings from a detailed history, thorough physical examination, and the results of basic investigations is still indispensable for the management of children with suspected poisoning.
Objective:
The aim was to review pediatric toxidromes and poisoning management.
Methods:
A literature search was conducted on PubMed (between February 1 and 15, 2020) with keywords "toxidrome" "poisoning" "intoxication" "children" and "pediatric". The search was customized by applying the appropriate filters so as to get the most relevant articles to meet the objective of this review article.
Results:
Toxidrome recognition may offer a quick guide to possible toxicology diagnosis so that specific antidote can be administered in a timely manner. This article discusses a few commonly encountered toxidromes in pediatric poisoning, with an emphasis on the symptomatology and source of exposure. The antidote and specific management for each toxidrome are also discussed. Although most patients with intoxication can be managed with close observation, supportive measures and antidote treatment, it is unfortunate that antidotes are only available for a limited number of poisons responsible for intoxication. Extracorporeal toxin removal is being increasingly recognized as a mode of treatment for patients with rapid deterioration who are unresponsive to conventional management. The decision to apply such technique and the choice of modality are frequently individualized due to the paucity of high-level evidence. The various patient and toxin/medication factors involved in the decision- making process are discussed.
Conclusion:
Poisoning is a common cause of pediatric accidents and injuries. Physicians should be familiar with common toxidromes and poisoning management.
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