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poisoning, burns, and injury prevention > Signs, symptoms, and Treatment Of Specific Pediatric Poisonings > Flashcards

Signs, symptoms, and Treatment Of Specific Pediatric Poisonings Flashcards

0
Q

Acetaminophen – suggested laboratory studies

A
  1. serum acetaminophen level (4-24 hours after ingestion)
  2. serum hepatic transaminases (late increase)
  3. prothrombin time (increased)
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1
Q

Acetaminophen – clinical manifestations of poisoning

A

Nausea/vomiting
Anorexia

May progress over days to jaundice, abdominal pain, and liver failure

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2
Q

Acetaminophen – Antidote and Treatment

A

A. Oral N-acetyl cysteine (most effective within 8h of ingestion)
T. Gastric emptying (within 1h); activated charcoal (within 4h)

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3
Q

Antihistamine / anticholinergic toxicity – CLINICAL MANIFESTATIONS

A

Anticholinergic toxidrome: drowsiness, delirium, hallucinations, seizure, skin flushing, fused dilated pupils, fever, cardiac dysthymias, dry mouth, speech and swallowing difficulties, nausea, vomiting

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4
Q

Antihistamine / anticholinergic toxicity – suggested laboratory studies

A
  1. Drug screen
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5
Q

Antihistamine / anticholinergic toxicity – Antidote and treatment

A

A. Physostigmine in select cases of severe anticholinergic signs and symptoms
T. Gastric emptying (early); activated charcoal; whole bowel irrigation for sustained release preparations; cardioresporatory support; seizure control

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6
Q

ASPIRIN poisoning – CLINICAL MANIFESTATIONS

A

Hyperpnea/tachypnea; (respiratory alkalosis / metabolic acidosis), fever, nausea, vomiting, dehydration, tinnitus, agitation, seizures

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7
Q

ASPIRIN poisoning – suggested laboratory studies

A
  1. Blood gas (increases pH; decreased PCO2; decreased HCO3-)
  2. Glucose (increases)
  3. Electrolytes (hypokalemia)
  4. PT and PTT (prolonged)
  5. Serum salicylate level
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8
Q

ASPIRIN poisoning – Antidote and Treatment

A

A– NONE

T– Gastric emptying/activated charcoal, fluid and electrolyte management, hemodialysis in severe cases

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9
Q

Ethanol poisoning in children – COMMON SOURCES

A

Cold preparations and mouthwash

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10
Q

Ethanol poisoning in children – CLINICAL MANIFESTATIONS

A

Lethargy, CNS depression, nausea/vomiting, ataxia, respiratory depression, coma, hypotension, hypothermia (in young children)

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11
Q

Ethanol poisoning in children – Antidote and Treatment

A

A– NONE

T–

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12
Q

Hydrocarbon poisoning in children – COMMON SOURCES

A

Fuels, household cleaners, polishes, and other solvents

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13
Q

Hydrocarbon poisoning in children – CLINICAL MANIFESTATIONS

A

Tachypnea, coughing, respiratory distress, cyanosis, fever (aspiration);

nausea/vomiting, GI discomfort (oral ingestion)

mental status changes occur regardless of route

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14
Q

Hydrocarbon poisoning in children – Antidote and Treatment

A

A– NONE

T– prevent aspiration (resulting in gastric pneumonitis); avoid gastric emptying; supportive respiratory care

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15
Q

Iron poisoning in children – CLINICAL MANIFESTATIONS

A

Nausea/vomiting, diarrhea, gastrointestinal blood loss, acute liver failure, seizures, shock, coma

16
Q

Iron poisoning in children – suggested laboratory studies

A
  1. Serum iron level (3-5 hr post ingestion)
  2. Serum pH (decreased)
  3. Serum glucose (increased)
  4. Bilirubin and liver function tests (increased)
  5. PT (prolonged)
  6. WBC (increased)
17
Q

Iron poisoning in children – Antidote and Treatment

A

A: deferoxamine chelation
T: gastric lavage (early); whole bowel irrigation; dialysis (late, severe)

18
Q

Organophosphate poisoning in children – COMMON SOURCES

A

Insecticides

19
Q

Organophosphate poisoning in children – CLINICAL MANIFESTATIONS

A 
"SLUDGE" 
      Salivation
      Lacrimation
      Urination
      Defecation
      Gastric cramping
      Emesis

Also, small but reactive pupils, sweating, muscle fasciculations, confusion, and coma

20
Q

Organophosphate poisoning in children – suggested laboratory studies

A
  1. Plasma OR res blood cell cholinesterase (decreased)
21
Q

Organophosphate poisoning in children – Antidote and Treatment

A

A: atropine sulfate, followed by pralidoxime chloride

T: gastric lavage (early); activated charcoal (if ingested)

22
Q

Opiate poisoning in children – CLINICAL MANIFESTATIONS

A

Bradycardia, hypotension, decreased RR, pinpoint pupils, somnolence, coma

23
Q

Opiate poisoning in children – suggested laboratory studies

A

Toxicologic screen (urine AND serum)

24
Q

Opiate poisoning in children – Antidote and Treatment

A

A: naloxone

T: gastrointestinal decontamination if appropriate; respiratory support

25
Q

Sympathomimetic poisoning in children – COMMON SOURCES

A

Decongestants, amphetamines, cocaine

26
Q

Sympathomimetic poisoning in children – CLINICAL MANIFESTATIONS

A

Tachycardia, hypertension, fever, large but reactive pupils, sweating, agitation, delirium/psychosis, seizures

27
Q

Sympathomimetic poisoning in children – suggested laboratory studies

A
  1. Electrolytes (hypokalemia)
  2. Blood glucose (decreased)
  3. ECG
28
Q

Sympathomimetic poisoning in children – Antidote and Treatment

A

A– NONE

T: gastric lavage/activated charcoal/ cathartics, sedatives for severe agitation, cardiorespiratory support

29
Q

Theophylline poisoning in children – CLINICAL MANIFESTATIONS

A

Tachycardia, hypotension, tachypnea, vomiting, agitation, seizures

30
Q

Theophylline poisoning in children – CLINICAL MANIFESTATIONS

A

Tachycardia, hypotension, tachypnea, vomiting, agitation, seizures

31
Q

Theophylline poisoning in children – suggested laboratory studies

A
  1. Serum theophylline level (q2-4h),
  2. Blood glucose (increased)
  3. Hypokalemia
  4. Acidemia
  5. Hypercalcemia
  6. Hypophosphatemia
  7. ECG
32
Q

Theophylline poisoning in children – Antidote and Treatment

A

A– NONE

T– activated charcoal/ whole bowel decontamination , hemodialysis in severe ingestion

33
Q

Tricyclic antidepressant poisoning in children – CLINICAL MANIFESTATIONS

A

Tachycardia, hypertension progressing to hypotension, confusion, drowsiness, dry mucous membranes, dilated but responsive pupils, agitation, seizures, coma, dysrhythmias

34
Q

Tricyclic antidepressant poisoning in children – suggested laboratory studies

A

ECG (widened QRS complex, ventricular arrhythmias)

35
Q

Tricyclic antidepressant poisoning in children – Antidote and Treatment

A

A– NONE

T– gastric lavage/activated charcoal, sodium bicarbonate (blood alkylization) for conduction abnormalities.

36
Q

Ethanol poisoning in children – suggested laboratory studies

A

Serum

37
Q

Hydrocarbon poisoning in children – suggested laboratory studies

A
  1. Arterial blood gas monitoring

2. Chest radiograph (initial and 4-6h after exposure)

poisoning, burns, and injury prevention (1 decks)

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