Acute poisoning in a children's hospital: a 2-year experience

In a 2-year retrospective review, 90 patients were treated in a children's hospital for acute overdoses. In 90%, the history was the most important indicator of poisoning. On physical examination, 64% of patients were found to have altered sensorium, and 69% of cases were confirmed with a routine qualitative toxicology screening test. Accidental overdoses were most frequently due to ingestion of petroleum distillates, digoxin, carbamazepine, and theophylline. Suicidal patients ingested alcohol, barbiturates, tricyclic antidepressants, benzodiazepines, and aspirin. The majority of children with accidental overdoses received medical attention within 2 hours, but suicidal patients presented significantly later. Appropriate treatment with gastric lavage or emesis was used for 85% of patients on an emergency basis prior to admission. The inpatient therapy is based on continued gastrointestinal decontamination, basic organ system support, and monitoring for toxic effects and complications of therapy. Specific antidotes were available for only 10% of patients. In this study, 50% of patients were able to be discharged to their homes after one day of hospitalization. Pediatric patients treated in the intensive care unit incur less morbidity than adults in a similar setting. Adolescents who attempt suicide and are treated in the intensive care unit are likely to take prescription drugs in a similar manner as their adult counterparts.