ABSTRACT
Poisoning is one of the commonest pediatric emergencies. Most of poisonings in children below 5 years of age, are accidental and fortunately trivial, related to their exploratory nature. However a poisoned child may present as an acute emergency with or without multisystem involvement. The initial phase of management focuses on support of airways, breathing and cardiac function (ABCD of Resuscitation). The second phase includes Evaluation and Detoxification phase. The Evaluation phase involves identification and severity of toxic exposure. Recognizing a Toxidrome (constellation of the signs and symptoms seen with the ingestion of a particular poison) is particularly very helpful when the child presents with an unknown poisoning. Detoxification should proceed simultaneously. The current literature suggests that activated charcoal is the mainstay of GI decontarmination. Whole bowel Irrigation is a new addition to the armamentarium of GI decontamination. At present antidotes are available for few toxins only so the management remains supportive for most poisons.
Subject(s)
Charcoal/therapeutic use , Child , Decontamination/methods , Emergency Medical Services/methods , Emetics/therapeutic use , Gastric Lavage/methods , Humans , India , Ipecac/therapeutic use , Medical History Taking/methods , Metabolic Clearance Rate , Physical Examination/methods , Poisoning/diagnosisABSTRACT
Pediatric poisoning is a problem commonly encountered in the emergency department. After stabilization of airway, breathing, and circulation, one of the goals of treatment is decontamination in order to limit poison absorption and the resulting systemic toxicity. Decontamination modalities include gastric emptying (ipecac and gastric lavage), inhibiting absorption (activated charcoal), and catharsis (sorbital, magnesium citrate, and whole bowel irrigation). Each modality is discussed. Choice of modality by the practitioner must be individualized to each patient's situation.
Subject(s)
Adolescent , Cathartics/therapeutic use , Charcoal/therapeutic use , Child , Child, Preschool , Decontamination/methods , Emetics/therapeutic use , Gastrointestinal Diseases/therapy , Humans , Infant , Therapeutic Irrigation , Poisoning/therapyABSTRACT
Os autores comparam a eficiência de detergentes aniônicos e xarope de ipeca na induçäo de emese em 26 pacientes. Encontram melhores resultados com os detergentes e admitem sua utilizaçäo como uma forma alternativa