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One poison center's experience with "snake" firework ingestions.
Matthew S Correia1,2, Adrienne Hughes1,2, Robert G Hendrickson1,2
1Oregon Poison Center, Portland, OR, USA.
Clinical Toxicology (Philadelphia, Pa.)
|March 12, 2025
Summary
Ingesting snake fireworks, containing barium salts, rarely causes severe toxicity. Most children experienced only mild gastrointestinal issues, with few developing hypokalemia, indicating low risk for serious barium poisoning.
Area of Science:
- Toxicology
- Emergency Medicine
- Pediatrics
Background:
- Snake fireworks contain barium salts, which can cause toxicity if ingested.
- Barium toxicity symptoms include hypokalemia, weakness, dysrhythmias, and respiratory distress.
Purpose of the Study:
- To evaluate firework-related cases involving oral exposure to snake fireworks.
- To assess the incidence and severity of barium toxicity following ingestion of snake fireworks.
Main Methods:
- Retrospective analysis of poison center cases (2009-2023) involving oral snake firework exposure.
- Inclusion criteria: suspected or confirmed oral exposure; exclusion criteria: no oral exposure, firework retrieval, or insufficient follow-up.
- Data extraction focused on exposure details and barium toxicity indicators.
Main Results:
- Sixty-four cases met inclusion criteria; no deaths or severe toxicity reported.
- Nine percent of cases (6 children) were symptomatic, primarily with gastrointestinal complaints.
- Hypokalemia occurred in 2 symptomatic patients and 4 asymptomatic patients, with mild severity and short latency.
Conclusions:
- Oral exposure to snake fireworks infrequently leads to significant toxicity.
- Symptoms do not reliably predict hypokalemia development.
- While severe toxicity is rare, monitoring is advised for symptomatic children after ingestion.
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