poisonings-lecture_slides-Week1Part2.pdf

7/27/2019 poisonings-lecture_slides-Week1Part2.pdf

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Why does a poisoning happen ?

National Poison Data System (2011)

Reason for Exposures

Unintentional 80.0%

Intentional 16.0%

Adverse Reaction 2.6%

Other 1.4%


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Unintent ional Exposures

o Curious toddlero Medication error

o Bites & stings

o Environmental

o On the job


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Intent ional Exposures

o Suicideso Misuse

o Abuse


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Adverse react ions

o Allergic reactionso Medications

o Foods


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Potent ia l Routes o f Exposure

o Inhalationo Skin and Eyes

o Ingestion

o Injection


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Summary Statements

o Most poisonings are: acute

accidental/unintentional

occur in the home

involve children less than 5 years of age

o Intentional exposures are more likely to be

associated with worse outcomes.


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Top Five List NPDS

Chi ldren


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Look-al ike Products


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Case Fol low-up - Under the s ink

o 22 month oldo Window cleaner contains dilute ammonia (


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Case Fol low-up In the Bathroom

o 18 month oldo Solid deodorant contains antiperspirant with

aluminum salt

o Assessment: potential for minor surfaceirritation rare foreign body obstruction risk


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Case Fol low-up In the Shoe Box

o 17 month oldo Silica gel is a commonly used desiccant

designed to minimize moisture when placed inhousehold products and medications. It is notabsorbed and is a minor irritant.


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Non- or minimal ly toxic product examples

o Antiperspirantso Bar soap

o Crayons

o Eye makeup

o Pencils

o Playdoh

o Zinc Oxide ointment


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Top Five List NPDS

Chi ldren < 6 years o ld , Phar maceut ica ls

1. Analgesics (9.7%)2. Topicals (6.9%)

3. Vitamins (4.1%)

4. Antihistamines (3.6%)

5. Cough and cold preparations (2.9%)


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Top Five List NPDS

Adul ts

1. Analgesics (10%)2. Cleaning Substances (7.7%)

3. Bites & Stings (6.3%)

4. Sedatives/antipsychotics (6.1%)

5. Pesticides (5.3%)


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Case Fol low-up The Unrelent ing

Headache

17 year oldThe Unrelenting Headache

The patient was hospitalized with progressive

neurologic deterioration & liver failure andthen pronounced with brain death. Later, the8 year old sister admitted to seeing her take awhole bottle of Tylenol, but was sworn to

secrecy (by the older sister).


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Pop Quiz #1

Which case is at greatest risk forlife-threatening toxicity?

A. 18 month old with deodorant(In the Bathroom)

B. 22 month old with windowcleaner (Under the Sink)

C. 17 month old with desiccant(In the Shoe Box)

D. 17 year old treating herself fora migraine (The UnrelentingHeadache)

poisonings-lecture_slides-Week1Part2.pdf

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