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Related Experiment Videos

The poisoned child. Evolving concepts in care

G R Bond1

  • 1Division of Emergency Medicine, University of Virginia, Charlottesville, USA.

Emergency Medicine Clinics of North America
|May 1, 1995
PubMed
Summary

Pediatric poisonings are common, but most children are not harmed. Emergency physicians should focus on identifying at-risk children and providing targeted treatment, reserving aggressive interventions for severe cases.

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Area of Science:

  • Pediatric Emergency Medicine
  • Toxicology
  • Clinical Management

Background:

  • Over 1 million children in the US experience poison ingestions annually.
  • Most pediatric poisonings result in minimal or no harm.
  • Emergency physicians must differentiate between at-risk and low-risk pediatric ingestions.

Purpose of the Study:

  • To outline the appropriate evaluation and management of pediatric poisoning cases.
  • To guide emergency physicians in selecting appropriate decontamination and treatment strategies.
  • To emphasize judicious use of laboratory testing and specific therapies.

Main Methods:

  • Review of current practices in pediatric toxicology and emergency medicine.
  • Discussion of diagnostic approaches, including toxic differential diagnosis.
  • Evaluation of gastrointestinal decontamination techniques (activated charcoal, gastric emptying, whole bowel irrigation).

Main Results:

  • Activated charcoal is the preferred agent for gastrointestinal decontamination when indicated and effective.
  • Gastric emptying is reserved for specific scenarios (e.g., non-charcoal-binding substances, rapid presentation with CNS depression).
  • Laboratory testing should be targeted, avoiding broad "drug screens" unless clinically justified.

Conclusions:

  • Basic supportive care and careful patient assessment are crucial in managing pediatric poisonings.
  • Specific therapies like antidotes and enhanced elimination should be used judiciously, with clear benefit outweighing risk.
  • Management strategies for pediatric ingestions may differ from adult protocols.

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