An Overview of Pediatric Poisonings

Although the incidence of toxic exposure in children is high, the number of poison-associated deaths is extremely low. The majority of lethal pediatric poisonings are the result of intentional exposure, and fatalities are much more common in adolescents than in young children. The substances involved in adolescent toxin-related deaths mirror those found in adult poisonings. Carbon monoxide and pharmacologic agents are the toxins responsible for most deaths in children younger than 12 years. Induced emesis, gastric lavage, AC, catharsis, whole bowel irrigation, forced diuresis, extracorporeal procedures, and antidote administration have long played a part in our care of poisoned patients. Most of these interventions have been shown to have no benefit or only a limited role in the management of the toxin-exposed child. Because the overall mortality from acute poisoning is less than 1%, the challenge for clinicians is to identify children in need of aggressive interventions while relying on careful observation and symptomatic care to manage the majority of patients. © 2007, AACN.