Common Poisonings in Children

00:01 In this lecture, we will review common poisonings in children.

00:06 It’s important to remember that poisonings are more likely in children with different agents.

00:13 So in children under five, typically, poisonings will be unintentional and they’ll be due to the child finding a poison and then accidentally drinking it.

00:22 Or it can be from something such as a dosing error in medication where a parent misunderestimates the degree to which they should be dosing their child and then the child gets too much medication.

00:34 Or it can be in the setting of non-accidental trauma.

00:37 Perhaps, the patient was forced to take some horrible poison.

00:42 In adolescents, more commonly, poisonings are a result of a suicide attempt.

00:47 Or they could be a result of recreational substance abuse.

00:51 So let’s go through a little bit what you want to check for when you have a patient who’s been poisoned.

00:57 It’s important to try and get a sense of the timing and the amount of the drug.

01:02 In adolescents, this can be particularly challenging.

01:06 They don’t always volunteer which drugs they were taking and they can often present with polypharmaceutical drug overdose.

01:14 Also, it’s important to calculate the range during which a patient may have taken the drug.

01:21 Let me give you an example.

01:23 If a patient was left alone at 8 p.m. in their room and then the parent came in at 11 p.m. and found them unconscious, you can assume that some time between 8 and 11, they took the drug.

01:36 And you shouldn’t assume it was 11.

01:38 And the reason for that is important because sometimes our management and treating these overdoses, especially with Tylenol have to do with knowing when the acute overdose occurred.

01:50 So this may not necessarily be an accurate estimation and also probably won’t be accurate for non-accidental trauma situations.

01:59 It’s important to do vital signs and do a thorough physical exam.

02:02 Assess the mental status and also check pupillary size because pupillary size may give you some clues as to what the agent was that’s causing altered mental status.