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25-03-2013 | Paediatrics | Article

Acute-poisoning admissions common, non-serious in under 6s


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medwireNews: Acute poisoning events requiring hospital admission are fairly common in children under the age of 6 years, but are usually resolved quickly with no loss of life or significant period of illness, show results from a Finnish study.

The most common sources of poisoning were terbutaline (12.3%), used in Finland as a bronchodilator for obstructive bronchitis; benzodiazepines (12.0%), used as sedatives, anticonvulsants, and muscle relaxants; and dishwasher powder (9.3%).

Although pharmaceuticals were the most common cause of poisoning in the study (64%), it should be noted that the toxic effects of carbon monoxide and other gases or fumes were excluded, as well as the effects of venomous animals.

"If they had been included, then non-pharmaceutical poisonings may have accounted for a higher percentage of poisoning cases," write study author Marko Hoikka (Kainuu Central Hospital, Kajaani) and colleagues in Acta Paediatrica.

Notably, paracetamol (acetaminophen) poisoning, reported to be the most frequent pharmaceutical agent involved in child poisoning in several studies from Europe and the USA, was the causative agent in only 3.6% of cases in this study.

The researchers evaluated data on all children (n=334) admitted to the Oulu University Hospital between 1991 and 2010.

They calculated that the overall incidence rate during the period was 5.2 cases per 10,000 children per year, with a small decrease observed from 6.7 per 10,000 children per year during 1991-1995 to 4.5 per 10,000 children per year during 2006-2010.

The team found that the mean age when admitted to hospital was 2.34 years, and 46.4% of the children were admitted to the pediatric intensive care unit (PICU). Slightly more boys (56.9%) than girls were admitted.

Activated charcoal was given to 65% of the patients as a treatment and 16 (5%) were given specific antidotes. Induced vomiting and gastric lavage were also used to treat the patients.

Despite a relatively high rate of PICU admission, this was for observation purposes in most cases and the mean length of overall hospital stay was 1.2 days. Three children had aspiration pneumonia as a complication, but no children died as a result of poisoning.

Based on their results, "pharmaceutical products should also be designed and packaged with greater safety in mind, to reduce the risk of accidental poisoning," suggest the authors.

By Helen Albert, Senior medwireNews Reporter

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