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Four-year review of cigarette ingestions in children
D McGee1, T Brabson, J McCarthy
1Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, PA 19141, USA.
Insights
Ingesting cigarette products is rare and rarely causes significant toxicity in children under six. Vomiting within 20 minutes is the most common symptom, and its absence indicates a favorable outcome.
Area of Science:
- Pediatrics
- Toxicology
- Emergency Medicine
Background:
- Cigarette product ingestion is a common pediatric poisoning exposure.
- Understanding the associated symptoms and outcomes is crucial for clinical management.
Purpose of the Study:
- To evaluate the demographics, incidence, symptoms, and outcomes of cigarette product ingestions in children under six years of age.
- To identify predictors of significant toxicity following pediatric cigarette ingestion.
Main Methods:
- Retrospective review of a Poison Control Center database.
- Analysis of 700 cases of children under six ingesting cigarettes or cigarette butts between 1988 and 1991.
Main Results:
- 143 children (20.4%) experienced symptoms, predominantly vomiting (98.6%) within 20 minutes (74.3%).
- Five patients had transient lethargy or irritability; no seizures were reported.
- 44 children ingested potentially toxic amounts and were referred to the emergency department.
Conclusions:
- Significant toxicity from pediatric cigarette product ingestion is rare.
- Vomiting within 20 minutes is the most common symptom; its absence predicts a favorable outcome.
- Asymptomatic children did not develop delayed symptoms, and symptomatic children recovered without sequelae.
Abstract:
The objective of our study was to assess the demographics, incidence, types of symptoms, and outcomes of cigarette product ingestions in children. The study was a retrospective database review. Seven hundred children under six years of age ingesting cigarettes or cigarette butts reported to a Poison Control Center between 1988 and 1991. Among 143 patients (20.4%) with symptoms, vomiting was the only symptom in 138 (98.6%) and occurred in less than 20 minutes in 104 (74.3%). The five remaining patients (two with vomiting, three without) developed transient lethargy or irritability that completely resolved. Forty-four of 700 patients ingested potentially toxic amounts and were referred to the emergency department; three were lost to follow-up. Initially asymptomatic patients never developed symptoms. Symptomatic patients improved without sequelae. No patient developed seizures. We concluded that significant toxicity from the ingestion of cigarette products in children is rare. Vomiting within 20 minutes is the most common symptom. Its absence predicts a favorable outcome, even when large amounts are suspected to have been ingested.