Signs, symptoms, and Treatment Of Specific Pediatric Poisonings Flashcards
(38 cards)
Acetaminophen – suggested laboratory studies
- serum acetaminophen level (4-24 hours after ingestion)
- serum hepatic transaminases (late increase)
- prothrombin time (increased)
Acetaminophen – clinical manifestations of poisoning
Nausea/vomiting
Anorexia
May progress over days to jaundice, abdominal pain, and liver failure
Acetaminophen – Antidote and Treatment
A. Oral N-acetyl cysteine (most effective within 8h of ingestion)
T. Gastric emptying (within 1h); activated charcoal (within 4h)
Antihistamine / anticholinergic toxicity – CLINICAL MANIFESTATIONS
Anticholinergic toxidrome: drowsiness, delirium, hallucinations, seizure, skin flushing, fused dilated pupils, fever, cardiac dysthymias, dry mouth, speech and swallowing difficulties, nausea, vomiting
Antihistamine / anticholinergic toxicity – suggested laboratory studies
- Drug screen
Antihistamine / anticholinergic toxicity – Antidote and treatment
A. Physostigmine in select cases of severe anticholinergic signs and symptoms
T. Gastric emptying (early); activated charcoal; whole bowel irrigation for sustained release preparations; cardioresporatory support; seizure control
ASPIRIN poisoning – CLINICAL MANIFESTATIONS
Hyperpnea/tachypnea; (respiratory alkalosis / metabolic acidosis), fever, nausea, vomiting, dehydration, tinnitus, agitation, seizures
ASPIRIN poisoning – suggested laboratory studies
- Blood gas (increases pH; decreased PCO2; decreased HCO3-)
- Glucose (increases)
- Electrolytes (hypokalemia)
- PT and PTT (prolonged)
- Serum salicylate level
ASPIRIN poisoning – Antidote and Treatment
A– NONE
T– Gastric emptying/activated charcoal, fluid and electrolyte management, hemodialysis in severe cases
Ethanol poisoning in children – COMMON SOURCES
Cold preparations and mouthwash
Ethanol poisoning in children – CLINICAL MANIFESTATIONS
Lethargy, CNS depression, nausea/vomiting, ataxia, respiratory depression, coma, hypotension, hypothermia (in young children)
Ethanol poisoning in children – Antidote and Treatment
A– NONE
T–
Hydrocarbon poisoning in children – COMMON SOURCES
Fuels, household cleaners, polishes, and other solvents
Hydrocarbon poisoning in children – CLINICAL MANIFESTATIONS
Tachypnea, coughing, respiratory distress, cyanosis, fever (aspiration);
nausea/vomiting, GI discomfort (oral ingestion)
mental status changes occur regardless of route
Hydrocarbon poisoning in children – Antidote and Treatment
A– NONE
T– prevent aspiration (resulting in gastric pneumonitis); avoid gastric emptying; supportive respiratory care
Iron poisoning in children – CLINICAL MANIFESTATIONS
Nausea/vomiting, diarrhea, gastrointestinal blood loss, acute liver failure, seizures, shock, coma
Iron poisoning in children – suggested laboratory studies
- Serum iron level (3-5 hr post ingestion)
- Serum pH (decreased)
- Serum glucose (increased)
- Bilirubin and liver function tests (increased)
- PT (prolonged)
- WBC (increased)
Iron poisoning in children – Antidote and Treatment
A: deferoxamine chelation
T: gastric lavage (early); whole bowel irrigation; dialysis (late, severe)
Organophosphate poisoning in children – COMMON SOURCES
Insecticides
Organophosphate poisoning in children – CLINICAL MANIFESTATIONS
"SLUDGE"
Salivation
Lacrimation
Urination
Defecation
Gastric cramping
Emesis
Also, small but reactive pupils, sweating, muscle fasciculations, confusion, and coma
Organophosphate poisoning in children – suggested laboratory studies
- Plasma OR res blood cell cholinesterase (decreased)
Organophosphate poisoning in children – Antidote and Treatment
A: atropine sulfate, followed by pralidoxime chloride
T: gastric lavage (early); activated charcoal (if ingested)
Opiate poisoning in children – CLINICAL MANIFESTATIONS
Bradycardia, hypotension, decreased RR, pinpoint pupils, somnolence, coma
Opiate poisoning in children – suggested laboratory studies
Toxicologic screen (urine AND serum)
