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Childhood Poisoning, A Casualty Unit Study In A Pediatric Teaching Hospital
التسمم عند الأطفال, دراسة في وحدة الطوارىء في مستشفى أطفال تعليمي

Authors: Basim H. Al-Hakeem د.باسم الحكيم --- Basil M. Hanoudi د.باسل هنودي --- Ghada F. Naji د. غادة فايق ناجي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2007 Volume: 20 Issue: 2 Pages: 331-336
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

AbstractBackground: Poisoning is an important cause of morbidity and mortality in childhood.Objective: The aim of this study is to describe the epidemiological features of acute poisoning in children less than 16 years old who were admitted to the casualty unit, to analyze various conditions and management parameters in childhood poisoning.Methods: Ninety eight cases of poisoning were admitted over a 6-month study period (2nd of May - 3rd of November 2004). Data was collected upon admission and patients were subsequently followed-up. Study was conducted in the casualty unit, in the central child teaching hospital/Baghdad, questionnaire included age and sex of patients, detailed important family history features, poison related information, clinical presentations and initial management given. All the patient's families were advised on future safety measures at home regarding the poison used.Results: Patients admitted were with the age range of 1-2years. 57% of admissions were boys with mean age of 3.07 years, while female patients were 41% with mean age of 3.98 years. Ninety four percent of poisoning was accidental, occurred indoor and the storage place of the poison was a home store or home pharmacy. Forty percent of patients ingested oral medication, while 37% ingested kerosene and the rest ingested other household products. Most patients were admitted with no complain after a history of poisoning, for observation which did not require antidotes, while vomiting was the next common presentation, gastric lavage was the next common action taken in the hospital's casualty unit. Two percent of the patients had samples taken for toxicological analysis. Thirty eight percent of patients were discharged from causality unit in good general condition, while thirty five percent were discharged on parent's responsibility. There was 3.1% fatality rate in the study period. Conclusion: Improving health education and safety measures are essential in prevention of poisoning in children. Key words: Poisoning, kerosene poisoning, Childhood poisoning, Accidental ingestions.

الملخص:خلفية الدراسة: يعتبر التسمم سبب مهم في الأعتلال والوفاة عند الأطفال.هدف الدراسة: تؤشر هذه الدراسة الميزات الوبائية في حالات التسمم الحاد عند الأطفال الذين أدخلوا وحدة الطوارى, وتحلل مختلف الظروف وعوامل العلاج.طريقة الدراسة: تم جمع المعلومات من 98 حالة تسمم للأطفال الذين أدخلوا وحدة الطوارى في مستشفى الطفل المركزي التعليمي / بغداد, للفترة من 2/5/2004 ولغاية 3/11/2004 وتمت متابعتهم لاحقا.شملت الدراسة الأطفال ذوي الأعمار دون 16 سنة, وتم جمع المعلومات فيما يتعلق بعمر الطفل و جنس الطفل و تفاصيل معلومات عن عائلة الطفل و معلومات عن المادة السمية والاعراض السريرية للحالات و خيارات العلاج المقدم وحالة المريض عند مغادرة وحدة الطوارى. النتائج: أظهرت الدراسة أن%57 من حالات التسمم للأطفال كانت لذكور, وغالبية الأعمار للأطفال كانت 1-4 سنة, وأن 48% من حالات التسمم كانت عرضية, وأن 84.7% منها كانت داخل البيت, وفي 41.8% من الحالات كانت المواد السمية مخزونة فوق الرفوف أو في صيدلية البيت, وأن 39.8% من المرضى أصيبوا لأبتلاعهم مواد دوائية, فيما كان 37.8% منهم قد تناولوا مادة النفط الأبيض والبقية قد تناولوا المستحضرات المنزلية الأخرى.لم تؤخذ نماذج للتحاليل السمية في 2% من المرضى, وكان معظم المرضى الراقدين تحت المراقبة وبعلاج تحفظي وبدون شكوى سريرية, بينما كانت شكوى التقيؤ وعلاج غسل المعدة بنسبة أقل.ان 38% من الراقدين قد تم أخراجهم متحسنين من وحدة الطوارى, بينما كان 35% منهم قد أخرجوا على مسوؤلية ذويهم. أما نسبة الوفيات فكانت 3%. الأستنتاجات: تحسين التثقيف الصحي وسبل السلامة في حفظ المواد السمية يعتبر من الامور المهمة في الوقاية من التسمم عند الاطفال.


Article
Epidemiology of Poisoning In Hospitalized Children

Author: Ahmed S Al-Naaimi
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 4 Pages: 400-406
Publisher: Baghdad University جامعة بغداد

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Abstract

Background and Objectives: Poisoning is an important cause of childhood and adolescence hospital emergency presentations and admissions and a major health problem in this population sector. The present study was designed to describe the epidemiology and pattern of poisoning in addition to its case fatality rate. Methods: A total of 1450 pediatric cases with poisoning admitted to the Central Teaching Hospital of Pediatrics, Baghdad, during the 10 years study period extending from the 1st of January 1993 to 31st of December 2002, were analyzed. Results: The peak age for poisoning cases in the present study was 1-4 years, constituting about three quarters of total pediatric admissions with poisoning. Males were more frequent than females in the present work, and this gender bias was more evident in younger ages and less evident in teenagers. Non-medicinal substances were responsible for the major part (three-quarters) of poisoning cases, especially petroleum products and pesticides. The overall case-fatality rate was 2.6%. The risk of death was higher in the more vulnerable age groups (infants and neonates). It was also higher in males and in cases with poisoning by other noxious substances eaten as food, followed by metals (mainly lead), systemic antibiotics and pesticides. However out of a total of 37 deaths attributed to poisoning that occurred during the present study period of 10 years, non-medicinal substances (especially petroleum products, pesticides and metals) were responsible for three-quarters of these deaths. Conclusion: Children under 5 years of age are the most-vulnerable group for poisoning incidents. In addition Petroleum products, insecticides and lead metal were responsible for the highest proportion of poisoning admission and fatality necessitating special steps directed towards the prevention of these problems.

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