Azkunaga B, Mintegi S, Salmón N, Acedo Y, Del Arco L
Urgencias de Pediatría, Hospital Universitario Cruces, Barakaldo, Bizkaia, España.
An Pediatr (Barc). 2013 Jun;78(6):355-60. doi: 10.1016/j.anpedi.2012.09.016. Epub 2012 Nov 6.
To prevent acute poisoning in children we need to know in which circumstances they occur.
To analyse the circumstances of poisoning in children under 7 years-old and the management of these children in Spanish Paediatric Emergency Departments (SPED).
We perform a prospective study of charts of poisoned children less than 7 years admitted to 44 hospitals between 2008 and 2011.
A total of 400 poisoned children were recorded: 308 (77%) in children under 7 years, of whom 23 (7.5%) of them had previous episodes of poisoning in the family. More than half (230) occurred at home, mainly due to accidental ingestion (89.6%), of drugs (182, 59%), household products (75, 24.4%), and cosmetics (18, 5.8%). More than one-third (36.6%) contacted other departments before the patient reached SPED. A total of 160 (51.9%) were treated in the hospital, and 45.4% were admitted in the hospital. None of them died. Drug poisoning required complementary tests more often (48.9% vs. 32% household products, and 11.1% cosmetics, P<.05), more treatments (64.8% vs. 36% and 16.6%, P<.0001) and more admissions (54.9% vs. 37.3% and 5.5%, P=.015), and 12.1% were not due to accidental ingestion but dosage errors (vs. 2.6% and 0%, P<.05). Household product poisonings were more often related with storage in non-original packaging and being reachable by children.
The most frequent poisonings seen in SPED were caused by the accidental ingestion of drugs and household products by children less than 7 years-old at home. Drug poisoning was potentially more risky. Drug and household product storage education, proper drug dosage and administration, and good advice are the main issues to prevent these poisonings.
为预防儿童急性中毒,我们需要了解中毒发生的具体情况。
分析7岁以下儿童中毒的情况以及西班牙儿科急诊科(SPED)对这些儿童的处理方式。
我们对2008年至2011年间44家医院收治的7岁以下中毒儿童病历进行了前瞻性研究。
共记录了400例中毒儿童:其中308例(77%)为7岁以下儿童,其中23例(7.5%)家中有过中毒先例。超过半数(230例)发生在家中,主要原因是意外摄入(89.6%),涉及药物(182例,59%)、家用产品(75例,24.%)和化妆品(18例,5.8%)。超过三分之一(36.6%)的患儿在到达SPED之前联系过其他科室。共有160例(51.9%)在医院接受治疗,45.4%住院。无一例死亡。药物中毒更常需要辅助检查(48.9%,家用产品为32%,化妆品为11.1%,P<0.05),更多治疗(64.8%,家用产品为36%,化妆品为16.6%,P<0.0001)和更多住院(54.9%,家用产品为37.3%,化妆品为5.5%,P=0.015),且12.1%并非意外摄入而是用药错误(家用产品为2.6%,化妆品为0%,P<0.05)。家用产品中毒更常与非原装包装储存且儿童可触及有关。
SPED中最常见的中毒是7岁以下儿童在家中意外摄入药物和家用产品所致。药物中毒潜在风险更高。药物和家用产品储存教育、正确的药物剂量和用药方法以及良好的建议是预防这些中毒的主要问题。