Poisonings in Poland reported to the Polish National Health Fund in the years 2009-2011

Evaluation of Accidental and Intentional Pediatric Poisonings: Retrospective Analysis of Emergency Medical Service Interventions in Wroclaw, Poland

Background/Objectives: Poisonings among children are a major cause of morbidity and mortality worldwide and present a significant challenge for emergency medical services (EMS). The aim of this study was to analyze the types of substances causing poisonings and the intention of poisonings in children, providing detailed information on the most common causes of poisonings in different age groups. Methods: A retrospective study was conducted analyzing medical records of pediatric patients under the care of emergency medical services (EMS) in Wroclaw, Poland, between 2015 and 2017. The study included all patients under 18 years old diagnosed with poisoning. Data collected included age, sex, cause of poisoning, location of the incident, neurological status (GCS), and the type of healthcare facility. Results: The study included 484 patients, with a mean age of 13 years. The largest age group was 16-18 years (44%), and the majority were female (58%). The most common causes of poisonings were alcohol (29.3%), medications (26%), and intoxicants (24.8%). Over half of the incidents occurred at home (52.5%). Intentional poisonings constituted 75% of cases, particularly involving alcohol (38.6%), intoxicants (32%), and medications (26.7%). Accidental poisonings were mainly due to household chemicals (28.7%) and carbon monoxide (27%). The differences in causes and locations of poisonings were statistically significant (p < 0.001). Conclusions: Our study showed that the most common causes of poisonings among children were alcohol, medications, and intoxicants. Poisonings most frequently occurred at home, especially with medications, while outside the home, alcohol and intoxicants were predominant. This study was not registered.

Availability of Antidotes for Management of Acute Toxicity Cases at Emergency Departments in Qassim Hospitals: A Retrospective Study

Background: Drug overdose is a medico-social issue worldwide that may occur intentionally or unintentionally. It is one of the most common reasons for emergency department visits, and it is also a frequent cause of morbidity and mortality globally. This study aims to determine the occurrence of acute toxicity cases and their management outcomes at the emergency departments in Qassim Province hospitals in Saudi Arabia. In addition, the study aims to investigate the antidote availabilities at those medical centers.

Methods: A retrospective hospital record-based study of acute toxicity cases admitted to the emergency department in hospitals in Qassim during the period from January 1, 2020, to December 31, 2020, was conducted. Data were collected based on hospital resources such as gastrointestinal decontamination, stabilization, elimination enhancement resources, and antidotes from Qassim hospitals, and the availability of antidotes as well as the clinical data of the patients with the management outcome.

Results: A total of 264 patients with acute toxicity were admitted to the emergency departments of 14 hospitals in Qassim Province in 2020. Of the 264 cases, 179 (68%) were males, and 85 (32%) cases were females. Ninety-five percent of the cases were admitted to public hospitals, whereas 5% were admitted to private hospitals. The largest group by age of admitted cases were aged 11-20 years (19.3%). This study showed that 99% received appropriate treatment for their cause of toxicity, whereas 1% did not. The most common causes of toxicity in Qassim were found to be food poisoning (20.5%), followed by intentional suicide attempts with warfarin/enoxaparin/aspirin overdoses (15.9%) and acetaminophen (paracetamol) overdosage seen in 15.5% of admitted cases. Flagyl, in addition to fluids, was used in the management of 16.7% of cases, N-acetyl cysteine was used for 16.3%, and vitamins K and B6 were used for 14.0% of cases. Activated charcoal, atropine, calcium chloride, calcium gluconate, flumazenil, insulin, magnesium, sodium bicarbonate, and vitamin K were available at all the studied hospitals. However, all the hospitals lacked both ethylenediaminetetraacetic acid (EDTA) and a cyanide kit. Methylene blue and leucovorin were available in only one of the studied hospitals.

Acute poisoning among children and adolescents: a narrative review

Background: Acute poisoning is a frequent emergency and a significant health concern in the pediatric population. The pattern of acute intoxication differs between countries and within each country. Poisoning depends on many factors. It can be divided into two categories (accidental and intentional), and each one has its own characteristics. Aim of the study: This study aimed to analyze and discuss the overall patterns of accidental and intentional poisoning among children and adolescents. Material and methods: A systematic literature search was conducted using Google Scholar, Elsevier, and the PubMed database. The following keywords were used: “acute poisoning”, “pediatric poisoning”, “intentional poisonings”, “unintentional poisonings”, and “suicide attempts”. Results: A total of 38 articles were included in the review. Half had been published in the last five years. The analysis focused on the characteristics of the materials and methods, results, and conclusions sections of each study. Conclusions: Unintentional poisonings dominate among younger children, with a slight male predominance. They usually occur at home and occasionally lead to severe harm or even death. The most common causes of intoxication in this population are medications and household products. The majority of poisonings among adolescents are intentional suicide attempts. Among older children, over-the-counter analgesics are the most common cause of acute poisoning. Accidental poisoning can be avoided by providing preventive educational programs to guardians and replacing potentially toxic household products with safer ones. The prevention of intentional poisoning should be based on a community support system and behavioral programs. Healthcare professionals should be familiar with poisoning and be aware of the different patterns of intoxication according to age and gender.

The trend of top five types of poisonings in hospitalized patients based on ICD‐10 in the northeast of Iran during 2012–2018: A cross‐sectional study

Background and Aims

Poisoning remains a major health issue in developing countries with high morbidity and mortality rates; also it is one of the most common causes of admission to hospitals. This study aimed to investigate the trend of the top five types of poisonings in hospitalized patients according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD‐10) in Imam Reza hospital, Mashhad, Iran.

Methods

This was a cross‐sectional study performed from March 20, 2012, until September 22, 2018. We collected data from all patients hospitalized for poisoning admitted to the poisoning center at Imam Reza hospital in northeast Iran. ICD‐10 was adopted to categorize all types of poisonings (T36‐T65). The results obtained were analyzed by SPSS 16.

Results

Thirty‐four thousand eight hundred and ten cases were included. The mean age of the patients was 29.64 ± 14.69 years, of them, 50.7% were males. Benzodiazepine poisoning (T42.4) has the highest frequency among other subcategories and it was more common among females (60.5%). Opium poisoning (T40.0) has the highest mortality rate (5.4%) among other subcategories that is more common in males (72.0%). The mortality associated with narcotics was the highest frequency (2.7%). Suicide (83.6%) was the most common cause of poisoning. Most poisonings occurred in summer (27.4%).

Conclusion

These findings could help health care managers and policymakers develop prevention and educational programs to reduce these poisonings and limit people's easy access to drugs and substances.

Poisoning and associated factors to death from pesticides: case-control study, Brazil, 2017

BACKGROUND

Pesticide poisoning causes high morbidity and mortality. Surveillance is required for post-marketing monitoring of these products.

AIM

To assess poisonings and associated factors with lethality by pesticides.

METHOD

This is a case-control study based on the cases of pesticide poisoning assisted in 2017 by Brazilian Poison Control Centers. Patients who died were the cases and the survivors, the control. The odds ratio (OR) of death and 95% confidence interval (CI) were calculated. From the regression model, a predictive model of death was developed, stratified by age, gender and occupational context to investigate the risk of agricultural workers poisoned by extremely hazardous agents.

RESULTS

3,826 patients poisoned by pesticides were identified, of which 146 died. Older people (OR = 4.94; 95%CI 2.49 - 9.80), males (OR = 1.68; 95%CI 1.15 - 2.46), agricultural workers (OR = 2.20; 95%CI 1.15 - 4.24), suicide attempts (OR = 13.27; 95%CI 6.48 - 27.19) and exposure to extremely hazardous products (OR = 2.77; 95%CI 1.84 - 4.16) odds of death from pesticide poisoning.

CONCLUSION

Out of 100 pesticides poisoning, four died. Elderly, males, working in the agricultural sector, suicide attempts and extremely hazardous products had a higher risk of death.