Pediatric Toxicology : Specialized Approach to the Poisoned Child - 25/11/13

Doi : 10.1016/j.emc.2013.09.008

Diane P. Calello, MD ^a,^b,^c,^⁎ , Fred M. Henretig, MD ^d
^a New Jersey Poison Information and Education System, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA
^b Department of Emergency Medicine, Morristown Medical Center, 100 Madison Avenue, Morristown, NJ 07960, USA
^c Emergency Medical Associates Research Foundation, Parsippany, NJ, USA
^d Section of Clinical Toxicology, Division of Emergency Medicine, The Poison Control Center, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th Street and Civic Center Boulevard, Philadelphia, PA, USA

^∗Corresponding author. Department of Emergency Medicine, Morristown Medical Center, 100 Madison Avenue, Morristown, NJ 07960.

Résumé

The poisoned child presents unique considerations in circumstances of exposure, clinical effects, diagnostic approach, and therapeutic interventions. The emergency provider must be aware of the pathophysiologic vulnerabilities of infants and children and substances that are especially toxic. Awareness is essential for situations in which the risk of morbidity and mortality is increased, such as child abuse by poisoning. Considerations in treatment include the need for attentive supportive care, pediatric implications for antidotal therapy, and extracorporeal removal methods such as hemodialysis in children. In this article, each of these issues and emerging poison hazards are discussed.

Le texte complet de cet article est disponible en PDF.

Keywords : Detergent pods, ECG, Hemodialysis, Pediatric, Poisoning, Salicylate, Supportive care