ABSTRACT
School nurses may encounter a variety of poisoning and overdose scenarios in the school setting. Younger students are more likely to experience unintentional exposures that are usually lower in toxicity, with the risk for harm increasing with age for reasons including substance abuse, self-harm, and exposure to more toxic ingestants. Poison Control Centers are uniquely qualified to assist public and health professionals, including school nurses, with poisoning and overdose incidents and are available 24 hours per day. This article is Part 3 of a series of three articles and focuses on poisonings related to environmental hazards that may be found in the school setting. Information includes expected clinical effects, potential for serious injury, and a reasonable approach to manage exposures for the following substances of potential harm: disinfectants and cleaners, lab accidents and other hazardous material incidents, poisonous mushrooms, and plants differentiating between poisonous, minimally toxic, and nontoxic plants.
Subject(s)
Drug Overdose , School Nursing , Humans , Emergencies , Poison Control Centers , SchoolsABSTRACT
School nurses may encounter a variety of poisoning and overdose scenarios in the school setting. Youth have an increased risk for harm due to factors associated with substance use, self-harm, and exposure to more toxic ingestants. Poison Control Centers are uniquely qualified to assist the public and health professionals, including school nurses, with poisoning and overdose incidents and are available 24 hours per day. This article is Part 2 of a series of three articles and focuses on poisonings related to substances of abuse and addiction or as a result of social media challenges. Information includes expected clinical effects, potential for serious injury, and a reasonable approach to manage these exposures for the following substances of potential harm: alcohol, caffeine, dextromethorphan, inhalants, marijuana, tobacco, and nicotine replacement therapy. Part 3 of the series will discuss potential environmental hazards specific to the school setting.
Subject(s)
Drug Overdose , School Nursing , Smoking Cessation , Adolescent , Emergencies , Humans , Poison Control Centers , Tobacco Use Cessation DevicesABSTRACT
School nurses may encounter a variety of poisoning and overdose scenarios in the school setting. Younger students are more likely to experience unintentional exposures that are usually lower in toxicity, with the risk for harm increasing with age for reasons including substance abuse, self-harm, and exposure to more toxic ingestants. Poison control centers (PCC) are uniquely qualified to assist the public and health professionals, including school nurses, with poisoning and overdose incidents and are available 24 hours per day. This article is Part 1 of a series of three articles and introduces the management of toxicological emergencies in the school setting. In addition, this article provides information including expected clinical effects, potential for serious injury, and a reasonable approach to manage exposures for the following objects and substances of potential harm: button batteries, emergency medications, first aid products, magnets, nontoxic (inedible) products, and therapeutic error. Parts 2 and 3 of the series will continue the discussion focusing on substances of abuse and addiction, social media challenges, and environmental hazards.
Subject(s)
Drug Overdose , School Nursing , Drug Overdose/prevention & control , Emergencies , Evidence-Based Medicine , Humans , Poison Control CentersABSTRACT
Severe hepatotoxicity in acute acetaminophen overdose in children is uncommon. This apparent protection does not extend to chronic or repeated high dose acetaminophen administration. The Illinois Poison Center (IPC) was consulted on a case involving a 7 month old 17 lb infant, who had presented the day prior to an emergency department with complaint of febrile illness. Patient had been prescribed acetaminophen for symptoms, and the mother called IPC when she realized that she had been incorrectly giving the patient concentrated infant acetaminophen (80 mg per 0.8 mL) totalling 42.3 mg/kg/dose or 234 mg/kg/24 hours instead of children's acetaminophen (160 mg/5 ml). Per recently published national triage guidelines, the patient was referred to an acute care facility for evaluation. The patient presented with significantly elevated aspartate aminotransferrase (AST) and alanine aminotransferrase (ALT) levels of 1339 and 907 U/L respectively, and was initiated on i.v. n-acetylcysteine therapy. The patient responded well to therapy, with AST and ALT declining to 145 and 479 U/L respectively over the next 48 hours. This case represents one of the shortest durations of chronic acetaminophen therapy to cause hepatic injury in an infant. Further, while the level was only slightly above the national triage guideline recommended referral dose per 24 hours, significant hepatotoxicity was observed.
