Lamireau T, Llanas B, Kennedy A, Fayon M, Penouil F, Favarell-Garrigues J C, Demarquez J L
Paediatric Emergency Care Unit, Children's Hospital, Bordeaux, France.
Eur J Emerg Med. 2002 Mar;9(1):9-14. doi: 10.1097/00063110-200203000-00004.
Acute poisoning in children is still a major public health problem, and represents a frequent cause of admission in emergency departments. We carried out an epidemiological study of poisonings leading to admission to a paediatric emergency care unit (PECU). We analysed data from 2988 children who were admitted to the PECU of Bordeaux, France with acute poisoning from 1989 through 1995. During the 7-year period, the poison exposure numbers decreased slightly from 490 to 382 (6% vs. 3% of total medical emergencies). This represented a mean annual incidence of 1.4 poison exposures per 1000 children younger than 18 years of age and living in Bordeaux and its surroundings. Characteristics of the study population, circumstances of poisoning and substances involved were similar to those previously described. Eighty per cent of children were younger than 5 years of age, presented with a benign course. Forty per cent were not treated and 75% were discharged home either immediately or within 24 hours of admission. Only 1.5% of cases, mainly adolescent girls who attempted suicide, were admitted to a paediatric intensive care unit. Overall mortality rate was 0.33/1000. In children, most cases of acute poisoning are accidental, benign, and mainly attributed to the ingestion of a non-toxic substance. This points to the need for better information of the population on availability of poison control centre calling facilities, in order to decrease the number of admissions to the PECU. Patients suspected of having ingested a potentially dangerous substance can be managed in short-stay observation units, thus avoiding unnecessarily prolonged hospitalization. Acute poisoning in children remains a frequent problem, highlighting the need to develop an education programme on primary prevention in our region.
儿童急性中毒仍是一个重大的公共卫生问题，也是急诊部门常见的入院原因。我们对导致儿童急诊护理单元（PECU）收治的中毒情况进行了一项流行病学研究。我们分析了1989年至1995年期间因急性中毒入住法国波尔多PECU的2988名儿童的数据。在这7年期间，中毒暴露人数略有下降，从490例降至382例（占医疗急诊总数的比例分别为6%和3%）。这代表每1000名居住在波尔多及其周边地区的18岁以下儿童中，每年平均有1.4次中毒暴露。研究人群的特征、中毒情况和所涉及的物质与先前描述的相似。80%的儿童年龄小于5岁，病情呈良性。40%的儿童未接受治疗，75%的儿童在入院后立即或24小时内出院回家。只有1.5%的病例，主要是企图自杀的青春期女孩，被收入儿科重症监护病房。总体死亡率为0.33/1000。在儿童中，大多数急性中毒病例是意外、良性的，主要归因于摄入了无毒物质。这表明需要让公众更好地了解毒物控制中心的呼叫设施，以减少入住PECU的人数。怀疑摄入潜在危险物质的患者可在短期观察病房进行处理，从而避免不必要的长期住院。儿童急性中毒仍然是一个常见问题，凸显了在我们地区开展初级预防教育计划的必要性。
