Evaluation of Accidental and Intentional Pediatric Poisonings: Retrospective Analysis of Emergency Medical Service Interventions in Wroclaw, Poland
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Study Population
2.3. Data Collection
2.4. Statistical Analysis
3. Results
3.1. Characteristics of the Study Group
3.2. Causes of Poisonings
3.3. Types of Substances Causing Poisonings in the Study Group
3.4. Characteristics of Groups by Cause of Poisoning
3.5. Comparison of Results Regarding Intention, Location of Incident, and Recording of Incident by Causes of Poisoning
4. Discussion
4.1. Study Limitation
4.2. Practical Implications
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Public Involvement Statement
Guidelines and Standards Statement
Use of Artificial Intelligence
Conflicts of Interest
References
- Burghardt, L.C.; Ayers, J.W.; Brownstein, J.S.; Bronstein, A.C.; Ewald, M.B.; Bourgeois, F.T. Adult prescription drug use and pediatric medication exposures and poisonings. Pediatrics 2013, 132, 18–27. [Google Scholar] [CrossRef]
- Grabska, K.; Pilarska, I. Acute poisoning among children and adolescents: A narrative review. Med. Sci. Pulse 2022, 16, 33–39. [Google Scholar] [CrossRef]
- Carpenter, D.O.; Arcaro, K.; Spink, D.C. Understanding the human health effects of chemical mixtures. Environ. Health Perspect. 2002, 110 (Suppl. S1), 25–42. [Google Scholar] [CrossRef] [PubMed]
- Pianca, T.G.; Sordi, A.O.; Hartmann, T.C.; von Diemen, L. Identification and initial management of intoxication by alcohol and other drugs in the pediatric emergency room. J. Pediatr. J Pediatr 2017, 93 (Suppl. S1), 46–52. [Google Scholar] [CrossRef] [PubMed]
- Müller, D.; Desel, H. Common Causes of Poisoning: Etiology, Diagnosis and Treatment. Dtsch. Ärzteblatt Int. 2013, 110, 690–700. [Google Scholar] [CrossRef]
- Gaw, C.E.; Osterhoudt, K.C. Ethanol Intoxication of Young Children. Pediatr. Emerg. Care 2019, 35, 722–730. [Google Scholar] [CrossRef] [PubMed]
- Kamińska, H.; Agnieszka, Z.B.; Gawlik, A.; Małecka-Tendera, E. Acute alcohol intoxication among children and adolescents admitted to the Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical University of Silesia, Katowice during 2000–2010--preliminary study. Przegl Lek 2012, 69, 777–780. [Google Scholar]
- Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, C.Y. Risk Factors for Acute Unintentional Poisoning among Children Aged 1–5 Years in the Rural Community of Sri Lanka. Int. J. Pediatr. 2017, 2017, 4375987. [Google Scholar] [CrossRef]
- Bulut, M.; Küçük Alemdar, D.; Bulut, A.; Tekin, E.; Çelikkalkan, K. Evaluation of accidental and intentional pediatric poisoning: Retrospective analysis in an emergency Department of Turkey. J. Pediatr. Nurs. 2022, 63, e44–e49. [Google Scholar] [CrossRef]
- Kosiorek, D.; Lewko, J.; Romankiewicz, E. Children Intoxicated with Psychoactive Substances: The Health Status on Admission to Hospital Based on Medical Records. J. Clin. Med. 2024, 13, 1771. [Google Scholar] [CrossRef]
- Pujo, J.M.; Simon, Y.; Lontsi Ngoulla, G.R.; Signaté, B.; Signaté, R.; Signaté, A.; Signaté, A.; Signaté, B.; Amara, I.B.; Houcke, S.; et al. Clinical and Epidemiological Characteristics of Severe Acute Adult Poisonings in French Amazonia: Urgent Need for a Toxicovigilance Monitoring Framework. Toxics 2024, 12, 200. [Google Scholar] [CrossRef] [PubMed]
- Uwumiro, F.; Okpujie, V.; Olaomi, O.A.; Abesin, O.; Madu, F.C.; Akpabio, N.N.; Otu, M.I.; Bojerenu, M.M.; Atunde, F.J.; Ilelaboye, A. Profile of Childhood Poisoning and Its Outcomes in the United States: A One-Year Nationwide Study of Emergency and Inpatient Admissions. Cureus 2023, 15, e37452. [Google Scholar] [CrossRef] [PubMed]
- Boedeker, W.; Watts, M.; Clausing, P.; Marquez, E. The global distribution of acute unintentional pesticide poisoning: Estimations based on a systematic review. BMC Public Health 2020, 20, 1875. [Google Scholar] [CrossRef] [PubMed]
- Mintegi, S.; Azkunaga, B. Poisonings in the 21st century: From cradle to adolescence. An. Pediatr. Engl. Ed. 2022, 97, 297–299. [Google Scholar] [CrossRef]
- National Poison Control Call Statistics. 2021. Available online: https://www.poison.org/poison-statistics-national (accessed on 30 June 2024).
- Mottla, M.E.; Bowler, M.E.; Asgary, R. Epidemiology, risk factors, and strategies to prevent and manage poisonings due to pharmaceuticals in children in low income and low-middle income countries: A systematic review. J. Glob. Health 2023, 13, 04173. [Google Scholar] [CrossRef]
- Hemmati, M.; Tohidi, M.R.; Mohammadi, A.; Jahanpour, F.; Andayeshgar, B.; Fallah, S. Poisoning in children and adolescents in Kermanshah city, Iran. BMC Pediatr. 2024, 24, 135. [Google Scholar] [CrossRef]
- Świderska, A.; Wiśniewski, M.; Wiergowski, M.; Krakowiak, A.; Sein Anand, J. Poisonings in Poland reported to the Polish National Health Fund in the years 2009–2011. BMC Pharmacol. Toxicol. 2018, 19, 62. [Google Scholar] [CrossRef]
- Shah, M.N.; Cushman, J.T.; Davis, C.O.; Bazarian, J.J.; Auinger, P.; Friedman, B. The epidemiology of emergency medical services use by children. Prehospital Emerg. Care 2008, 12, 269–276. [Google Scholar] [CrossRef]
- American Academy of Pediatrics; Committee on Pediatric Emergency Medicine; American College of Emergency Physicians; Pediatric Committee; Emergency Nurses Association. Joint policy statement—Guidelines for care of children in the Emergency Department. J. Emerg. Nurs. 2013, 39, 116–131. [Google Scholar] [CrossRef]
- Martínez-Sánchez, L.; Ferrés-Padró, V.; Martínez-Millán, D.; Fernández-Calabria, C.; Amigó-Tadín, M.; Jiménez-Fàbrega, F.X.; Nogué-Xarau, S. Prehospital emergency care of patients exposed to poisoning: Assessment of epidemiological, clinical characteristics and quality of care. An. Pediatría Engl. Ed. 2020, 92, 37–45. [Google Scholar] [CrossRef]
- Aguilón-Leiva, J.J.; Tejada-Garrido, C.I.; Echániz-Serrano, E.; Mir-Ramos, E.; Torres-Pérez, A.M.; Lafuente-Jiménez, A.; Martínez-Soriano, M.; Santolalla-Arnedo, I.; Czapla, M.; Smereka, J.; et al. Clinical and sociodemographic profile of acute intoxications in an emergency department: A retrospective cross-sectional study. Front. Public Health 2022, 10, 990262. [Google Scholar] [CrossRef] [PubMed]
- STROBE. STROBE. Available online: https://www.strobe-statement.org/ (accessed on 15 July 2024).
- Gummin, D.D.; Mowry, J.B.; Beuhler, M.C.; Spyker, D.A.; Rivers, L.J.; Feldman, R.; Browng America’s Poiso, K.; Nathanielg America’s Poison Cent, P.T.P.; Bronsteinh Emergency Medica, A.C.; Weberi Missouri Poison, J.A. 2021 Annual Report of the National Poison Data System© (NPDS) from America’s Poison Centers: 39th Annual Report. Clin. Toxicol. 2022, 60, 1381–1643. [Google Scholar] [CrossRef] [PubMed]
- Yimaer, A.; Chen, G.; Zhang, M.; Zhou, L.; Fang, X.; Jiang, W. Childhood pesticide poisoning in Zhejiang, China: A retrospective analysis from 2006 to 2015. BMC Public Health 2017, 17, 602. [Google Scholar] [CrossRef] [PubMed]
- JPIC. News from the Japan Poison Information Center: 2011 annual report by JPIC. Chudoku Kenkyukai Jun Kikanshi Jpn. J. Toxicol. 2012, 25, 129–161. [Google Scholar]
- Gummin, D.D.; Mowry, J.B.; Beuhler, M.C.; Spyker, D.A.; Rivers, L.J.; Feldman, R.; Brown, K.; Pham, N.P.T.; Bronstein, A.C.; DesLauriers, C.; et al. 2022 Annual Report of the National Poison Data System® (NPDS) from America’s Poison Centers®: 40th Annual Report. Clin. Toxicol. 2023, 61, 717–939. [Google Scholar] [CrossRef] [PubMed]
- O’Connor, P.J. Differentials in poisoning rates of young Australian children according to residential location and geographical remoteness. Inj. Prev. 2005, 11, 204–206. [Google Scholar] [CrossRef]
- Agran, P.F.; Anderson, C.; Winn, D.; Trent, R.; Walton-Haynes, L.; Thayer, S. Rates of pediatric injuries by 3-month intervals for children 0 to 3 years of age. Pediatrics 2003, 111 Pt 1, e683–e692. [Google Scholar] [CrossRef]
- Li, H.; Dodd-Butera, T.; Beaman, M.L.; Pritty, M.B.; Heitritter, T.E.; Clark, R.F. Trends in Childhood Poison Exposures and Fatalities: A Retrospective Secondary Data Analysis of the 2009–2019 U.S. National Poison Data System Annual Reports. Pediatr. Rep. 2021, 13, 613. [Google Scholar] [CrossRef]
- Pawer, S.; Rajabali, F.; Zheng, A.; Smith, J.; Purssell, R.; Pike, I. Analyses of Child and Youth Self-Poisoning Hospitalizations by Substance and Socioeconomic Status. Int. J. Environ. Res. Public Health 2021, 18, 7003. [Google Scholar] [CrossRef]
- Oguche, S.; Bukbuk, D.N.; Watila, I.M. Pattern of hospital admissions of children with poisoning in the Sudano-Sahelian North eastern Nigeria. Niger. J. Clin. Pract. 2007, 10, 111–115. Available online: https://pubmed.ncbi.nlm.nih.gov/17902501/ (accessed on 6 July 2024).
- Sahin, S.; Carman, K.B.; Dinleyici, E.C. Acute Poisoning in Children; Data of a Pediatric Emergency Unit. Iran. J. Pediatr. 2011, 21, 479. [Google Scholar] [PubMed]
- Corlade-Andrei, M.; Nedelea, P.L.; Ionescu, T.D.; Rosu, T.S.; Hauta, A.; Grigorasi, G.R.; Blaga, T.; Sova, L.; Popa, O.T.; Cimpoesu, D. Pediatric Emergency Department Management in Acute Poisoning-A 2-Year Retrospective Study. J. Pers. Med. 2023, 13, 106. [Google Scholar] [CrossRef] [PubMed]
- Martínez-Sánchez, L.; Ferrés-Padró, V.; Martínez-Millán, D.; Fernández-Calabria, C.; Amigó-Tadín, M.; Jiménez-Fàbrega, F.C.; Nogué-Xarau, S. Atención prehospitalaria urgente de los pacientes pediátricos expuestos a tóxicos: Características epidemiológico-clínicas y evaluación de la calidad asistencial. An. Pediatría 2020, 92, 37–45. [Google Scholar] [CrossRef] [PubMed]
- Abhulimhen-Iyoha, B.I.; Israel-Aina, Y.T. Pattern of Accidental Childhood Poisoning at the Children Emergency Room of the University of Benin Teaching Hospital, Benin City, Nigeria. West Afr. J. Med. 2018, 35, 85–89. Available online: https://pubmed.ncbi.nlm.nih.gov/30027992/ (accessed on 6 July 2024). [PubMed]
- Kendrick, D.; Majsak-Newman, G.; Benford, P.; Coupland, C.; Timblin, C.; Hayes, M.; Goodenough, T.; Hawkins, A.; Reading, R. Poison prevention practices and medically attended poisoning in young children: Multicentre case-control study. Inj. Prev. 2017, 23, 93–101. [Google Scholar] [CrossRef]
- Azab, S.M.S.; Hirshon, J.M.; Hayes, B.D.; El-Setouhy, M.; Smith, G.S.; Sakr, M.L.; Tawfik, H.; Klein-Schwartz, W. Epidemiology of acute poisoning in children presenting to the poisoning treatment center at Ain Shams University in Cairo, Egypt, 2009–2013. Clin. Toxicol. 2016, 54, 20–26. [Google Scholar] [CrossRef]
- Johnston, L.D.; Miech, R.A.; O’Malley, P.M.; Bachman, J.G.; Schulenberg, J.E.; Patrick, M.E. Monitoring the Future National Survey Results on Drug Use, 1975–2020: Overview, Key Findings on Adolescent Drug Use; Institute for Social Research: Ann Arbor, ML, USA, 2021. Available online: https://eric.ed.gov/?id=ED611736 (accessed on 11 September 2024).
Study Group n = 484 | ||
---|---|---|
Age [years] | Mean | 13 |
Me | 15 | |
Min–Max | 0.0–17.0 | |
SD | 5.3 | |
Age [categories] | 0–6 lat | n = 87; 18%; |
7–12 lat | n = 27; 6%; | |
13–15 lat | n = 157; 32%; | |
16–18 lat | n = 213; 44%; | |
GCS [points] | Mean | 14.1 |
Me | 15 | |
Min–Max | 3.0–15.0 | |
SD | 2.1 | |
Sex | female | n = 279; 58%; |
male | n = 205; 42%; |
Variables | Study Group | ||
---|---|---|---|
n | % | ||
Cause of poisoning | Alcohol | 142 | 29.3 |
Medications | 126 | 26 | |
Intoxicants | 120 | 24.8 | |
Household chemicals | 33 | 6.8 | |
Plant toxins | 32 | 6.6 | |
Carbon monoxide | 31 | 6.4 | |
Location of incident | Home | 254 | 52.5 |
Outside home | 230 | 47.5 | |
Intention of Poisoning | Intentional | 363 | 75 |
Accidental | 115 | 23.8 | |
Destination Hospital | Hospital with pediatric department | 254 | 52.5 |
Hospital with toxicology department | 116 | 24 | |
Left at the scene, no consent for transport or handed over to police | 89 | 18.4 | |
Other hospitals, emergency room/emergency department | 25 | 5.2 |
Variables | Study Group | ||
---|---|---|---|
n | % | ||
Intoxicants | Other or unknown | 35 | 43.2 |
Designer drugs | 27 | 33.3 | |
THC | 9 | 11.1 | |
Opioids | 6 | 7.4 | |
Amphetamines | 4 | 4.9 | |
Medications | Antidepressants and sedatives | 36 | 32.7 |
Other or unknown | 33 | 30 | |
NSAIDs | 28 | 25.5 | |
Dextromethorphan | 10 | 9.1 | |
Benzodiazepines | 3 | 2.7 |
Variables | Cause of Poisoning | p-Value * | |||||||
---|---|---|---|---|---|---|---|---|---|
Carbon Monoxide | Alcohol | Intoxicants | Medications | Household Chemicals | Plant Toxins | ||||
Age [years] | 0–6 | n | 18 | 1 | 0 | 27 | 32 | 9 | <0.001 |
% | 20.7 | 1.1 | 0 | 31 | 36.8 | 10.3 | |||
7–12 | n | 6 | 3 | 3 | 12 | 1 | 2 | ||
% | 22.2 | 11.1 | 11.1 | 44.4 | 3.7 | 7.4 | |||
13–15 | n | 4 | 54 | 43 | 47 | 0 | 9 | ||
% | 2.5 | 34.4 | 27.4 | 29.9 | 0 | 5.7 | |||
16–18 | n | 3 | 84 | 74 | 40 | 0 | 12 | ||
% | 1.4 | 39.4 | 34.7 | 18.8 | 0 | 5.6 | |||
Sex | female | n | 8 | 68 | 67 | 33 | 18 | 11 | <0.001 |
% | 3.9 | 33.2 | 32.7 | 16.1 | 8.8 | 5.4 | |||
male | n | 23 | 74 | 53 | 93 | 15 | 21 | ||
% | 8.2 | 26.5 | 19 | 33.3 | 5.4 | 7.5 |
Variables | Cause of Poisining | p-Value * | |||||||
---|---|---|---|---|---|---|---|---|---|
Carbon Monoxide | Alcohol | Intoxicants | Medications | Household Chemicals | Plant Toxins | ||||
Location of incident | Home | n | 30 | 31 | 53 | 95 | 30 | 15 | <0.001 |
% | 11.8 | 12.2 | 20.9 | 37.4 | 11.8 | 5.9 | |||
Outside home | n | 1 | 111 | 67 | 31 | 3 | 17 | ||
% | 0.4 | 48.3 | 29.1 | 13.5 | 1.3 | 7.4 | |||
Intention of Poisoning | Intentional | n | 0 | 140 | 116 | 97 | 0 | 10 | <0.001 |
% | 0 | 38.6 | 32 | 26.7 | 0 | 2.8 | |||
Accidental | n | 31 | 1 | 2 | 28 | 33 | 20 | ||
% | 27 | 0.9 | 1.7 | 24.3 | 28.7 | 17.4 | |||
No information | n | 0 | 1 | 2 | 1 | 0 | 2 | ||
% | 0 | 16.7 | 33.3 | 16.7 | 0 | 33.3 | |||
Destination Hospital | Hospital with toxicology department | n | 2 | 35 | 49 | 25 | 1 | 4 | 0.001 |
% | 1.7 | 30.2 | 42.2 | 21.6 | 0.9 | 3.4 | |||
Hospital with pediatric department | n | 27 | 52 | 47 | 95 | 24 | 9 | ||
% | 10.6 | 20.5 | 18.5 | 37.4 | 9.4 | 3.5 | |||
Other hospitals with emergency room/emergency department | n | 2 | 5 | 10 | 2 | 1 | 5 | ||
% | 8 | 20 | 40 | 8 | 4 | 20 | |||
Left at the scene, no consent for transport, or handed over to police | n | 0 | 50 | 14 | 4 | 7 | 14 | ||
% | 0 | 56.2 | 15.7 | 4.5 | 7.9 | 15.7 |
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Wojciechowki, J.; Czapla, M.; Konop, M.; Juárez-Vela, R.; Rosińczuk, J. Evaluation of Accidental and Intentional Pediatric Poisonings: Retrospective Analysis of Emergency Medical Service Interventions in Wroclaw, Poland. Nurs. Rep. 2024, 14, 2523-2534. https://doi.org/10.3390/nursrep14030186
Wojciechowki J, Czapla M, Konop M, Juárez-Vela R, Rosińczuk J. Evaluation of Accidental and Intentional Pediatric Poisonings: Retrospective Analysis of Emergency Medical Service Interventions in Wroclaw, Poland. Nursing Reports. 2024; 14(3):2523-2534. https://doi.org/10.3390/nursrep14030186
Chicago/Turabian StyleWojciechowki, Jakub, Michał Czapla, Marek Konop, Raúl Juárez-Vela, and Joanna Rosińczuk. 2024. "Evaluation of Accidental and Intentional Pediatric Poisonings: Retrospective Analysis of Emergency Medical Service Interventions in Wroclaw, Poland" Nursing Reports 14, no. 3: 2523-2534. https://doi.org/10.3390/nursrep14030186
APA StyleWojciechowki, J., Czapla, M., Konop, M., Juárez-Vela, R., & Rosińczuk, J. (2024). Evaluation of Accidental and Intentional Pediatric Poisonings: Retrospective Analysis of Emergency Medical Service Interventions in Wroclaw, Poland. Nursing Reports, 14(3), 2523-2534. https://doi.org/10.3390/nursrep14030186