Acute intoxication and poisoning in children: the experience of a tertiary-care hospital in the period 2001-2012

The frequency and distribution of acute intoxications and poisoning from non-pharmacological substances in children were evaluated in this observational-descriptive study, performed analyzing all admissions in the Emergency Room Department of our University in Rome in the period 1st January 2001-31st December 2012. We selected 249 patients aged 0-14 years, 147 males and 102 females. The highest incidence occurred in the first 4 years of life: 44.2% in the age-group of 1-2 years. Cases were mostly related to solvents (44.6%), natural products (17.7%), products for agriculture (12.9%), corrosive acids and alkaline caustics (14.8%). Most admissions occurred in the time slot 18:00 to 21:00 (23.7%). No clinical symptoms were observed in 116 children (46.6% of the total), and their physical examination was unrevealing. The remaining 133 displayed above all nausea/vomiting (22%) and pharyngeal hyperemia (18.8%). Laboratory tests and imaging studies were only performed in selected cases. In terms of consulting requests, the Poison Center was contacted 156 times (62.6% of cases), the Pediatric Intensive Care Unit 38 times (15.2%), and the surgeon-endoscopist 18 times (7.2%). A short period of observation and monitoring in the Emergency Room was warranted in 106 children (42.5%). Gastroprotective drugs were used in 75 cases (30.1%) and activated charcoal in 18 (7.2%). Children hospitalized in a pediatric department were 95 (38.2%), but no complications occurred. Targeted information programs in schools and during pediatric check-up visits should decrease the risk of ingestion of non-pharmacological substances in children and costs of its management.