Pediatric Emergency Department Management in Acute Poisoning-A 2-Year Retrospective Study.

(1) Background: Poisonings in children are common reasons for addressing ED and can potentially have serious complications. Our research aims to review risk factors leading to poisoning in children. (2) Methods: A retrospective review of all pediatric poisoning cases addressing the Children's emergency department of St Mary Hospital over a two-year period was performed. (3) Results: We collected data on 797 children admitted for acute poisoning. The highest incidence identified was in the 12-18 and 1-3-year-old age groups. The distribution of voluntary versus unintentional poisonings was relatively balanced: 50.19% versus 47.43% (for some cases the type of intoxication remained unknown). Exposure to the toxic substance by ingestion was significant compared to the other routes, with an incidence of 87.1%. Acute poisoning happened at home in 70.4% of cases. A known risk factor before reaching the ED was present in 13.04%. (4) Conclusions: Our study showed a greater risk for acute poisoning in children between 1-3 years of age, and adolescents over 12 years. Identifying and documenting epidemiological aspects and other variables is important for establishing preventive measures and for therapeutic conduct. Adequate risk stratification and preventive measures involving closer supervision of minors or cognitive-behavioral programs can prevent voluntary intoxication.

The Use of Clinical Scores in the Management of Immune Thrombocytopenic Purpura in Children.

While the majority of children with recently diagnosed ITP have a benign, self-limiting condition, most often with a spontaneously recovery, 40% of children with ITP progress toward persistent ITP and 10-20% goes toward chronicity. Several clinical scores have been developed with the aim to perform a better monitoring outcome or to differentiate transient vs. persistent ITP (e.g., Donato score). Our paper aims to describe and to compare the most important scores used in the management of ITP in children: bleeding severity scores and chronicity prediction scores. These scores include a combination of different already known risk factors: age, gender, presence of a previous infections or vaccination, bleeding grade, type of onset, platelet count at diagnosis. The real utility of these scores has been a matter of debate and no consensus has been reached so far as to their necessity to be implemented as compulsory tool in the care of children with ITP.

[Soliciting a model of a child emergency care unit in road accidents in the year 2005]. / Model de solicitare al unei unitati primire urgente copii în cazul accidentelor rutiere in anul 2005.

This paper describes the specific model of burden due to child road traffic injuries upon the emergency care unit from a university paediatric hospital during 2005 year. A total number of 193 road trauma cases required emergency care to this hospital. Distribution by seasons pointed out the highest number in summer (31.1%) and comparing the observed repartition by seasons with an expected symmetrical repartition there have been obtained significant differences between seasons (p < 0.02). The regular number of cases was 1-2 daily. The burden of road trauma was unequal, more boys (58.5%) being injured than girls and children living in urban areas recorded similar rates of injuries with those from rural areas. The median age of injured children was nine years, approximately one third of cases being included in 5-9 years age group. The leading non-fatal injuries requiring emergency care as a result of road traffic collisions have been: multiple trauma--166, intracranial injury--128, fractured lower limbs--31, fractured upper limbs--20 cases. Approximately one third of these cases required admission in hospital for complex care, one third have been referred to another hospital (neurosurgery and maxillo-facial clinic) and one third have been discharged after 24 hours of hospitalized monitoring. In conclusion, more road traffic injuries arrived in the emergency care unit of the studied university paediatric hospital during summer without a specific distribution by weekdays, but with a higher probability of being a boy aged 5-9 years, presenting multiple trauma especially intracranial injury and requiring specialised hospital care.

[The ecological accident on the Siret River. A possible cyanide intoxication of children]. / Accidentul ecologic de pe râul Siret. Un episod de intoxicatie cu cianuri la copii.

THE PURPOSE: Of our study is to assess the gravity of cyanide intoxication of children, in the ecological accident in January 2001. MATERIAL AND METHODS: We included in our study 127 children aged between 2 months and 17 years. They were hospitalized in January and February 2001, in the "Sf. Maria" Children's Hospital. Case analysis was based on data of the emergency unit and units where the children were sent after primary care. We evaluated the patients from clinical and paraclinical point of view and we took samples of biological products in order to confirm the diagnosis. RESULTS: Age distribution was 0-1 year (4%), 1-3 years (7.8%), 3-6 years (9.4%), 6-12 years (33.8%), and 12-18 years (42.5%). The lapse of time between the ingestion of contaminated fish and symptomatology was variable. Measures were taken: removal from toxic contact, hospitalization, antidote administration, and treatment of complications. DISCUSSIONS: Although literature data shows that this intoxication appears after the age of three, we found that mother ingestion of contaminated fish, determined intoxication in nursings. Symptoms appeared at 3-12 hours after fish ingestion from the contaminated river and it was suggestive for the diagnosis. First aid measurements were necessary in specialized emergency unit and antidote administration sometimes only in clinical suspicion of intoxication. Correlation between clinical findings and toxic concentrations in urine samples confirm the diagnosis. CONCLUSIONS: Our study tries to highlight those ecological accidents with cyanides present important consequences on people and animal's health. The therapeutic intervention must be fast in order to stop blood distribution of the toxic.