Approach of Pediatric Poisoned Patient.pptx

Pediatric Toxicology

1. P ediatric P oisoned P atient APPROACH of……

2. APPROACH of … … … Paediatric Poisoned Patients A GENDA 1 2 3 A pproach T o P ediatric P oisoned P atient N ON -T OXIC I NGESTIONS O NE P ILL C AN K ILL 4 A SYMTOMATIC T OXIC P RESENTATION 5 P ITFALLS & T ricks

3. APPROACH of … … … Paediatric Poisoned Patients EXAMINATION: HISTORY: VITAL SIGNS: Pulse Blood Pressure Temperature Respiratory Rate & … … Pupil & …O 2 sat. ABC: As All Emergency Case Scenario. 1 st … Ensure a Patient Patent Airway, 2 nd … Ensure Intact Breathing 3 rd … Palpable Pulse Immediate Intervention … I f any one or all Are Absent . 1 5 2 3 4 T ype & Form Of Poison (S) : Type: Substance(s) …or … Drug (s) or Single …or… Multiple “Common” Form: Immediate … or … Sustained Release T ime & Amount Of Poison (S) : Time: Asymptomatic Toxicity, … Antidote Intervention & …Laboratory Analysis. Amount: Missing Pills … " All Missed Pills are … Ingested Pills " T racking The Story: Pattern : Unintentional / Intentional Exposure: Single or Group Exposure … " with friends " Conscious Level: +++ AAIICC r - - - DDDSCCC Skin: Wet … D ry … C yanotic …Flushed…P ale… Hot …C old. MM: Wet & salivating … D ry & U lcerated . Conj: Congestion … J aundice. CVS: TC … BC … ↑↓ …& ECG: QRS widened/ ↑QT RS: Tachypnea… B radypnea …W heezing …C rackles . NMS: Hyper/Hyporeflexia VALUE … Toxicity Detection … Over-Dosage Detection … Toxidromes Detection TYPE: Rapid & Concise SOURCE: Case or Parents ITEMS: 3Ts …&… Vital Signs CALL: POISON INFORMATION CENTER:

4. APPROACH of … … … Paediatric Poisoned Patients A GENDA 1 2 3 N ON -T OXIC I NGESTIONS O NE P ILL C AN K ILL 4 A SYMTOMATIC T OXIC P RESENTATION 5 P ITFALLS & T ricks A pproach T o P ediatric P oisoned P atient

5. APPROACH of … … … Paediatric Poisoned Patients - Criteria of Non Toxic Exposures: ONE PRODUCT Follow Up Available & Reliable WELL IDENTIFIED Accurate ESTIMATED AMOUNT NO WARNING SIGNS Well Determined ROUTE OF EXPOSURE Original Container Free Signs &Symptoms

6. APPROACH of … … … Paediatric Poisoned Patients the … ONLY dose " All SUBSTANCES ARE POISONS ; A Poison And A Non-poison” Differentiates THERE IS NONE THAT IS NOT A POISON,

7. APPROACH of … … … Paediatric Poisoned Patients - Households Non-Toxic Exposures: B aby Products I nk B ubble bath B ody conditioner A shes C andles C aulk C lay C harcoal C aps for toy guns C osmetics C rayons D eodorant F abric softener P encil lead P etroleum jelly S having cream H ousehold Bleach S hoe P olish S ilica gel S oaps T eething ring contents S weeteners S hampoos

8. APPROACH of … … … Paediatric Poisoned Patients - Medications of Non-Toxic Exposures: A ntacids O ral antibiotics (some exceptions) C orticosteroids C alamine lotion B irth control pills Z irconium oxide Z inc Oxide W ater-soluble vitamins (excluding iron) (if single ingestion) (if single ingestion)

9. APPROACH of … … … Paediatric Poisoned Patients A GENDA 1 2 3 O NE P ILL C AN K ILL 4 A SYMTOMATIC T OXIC P RESENTATION 5 P ITFALLS & T ricks N ON -T OXIC I NGESTIONS

10. APPROACH of … … … Paediatric Poisoned Patients DEFINITION : Drugs With Potential … Severe Toxicity …. If 1 … Or … 2 Tablets Ingested By A 10-kg Toddler . - One Pill Can Kill: A LZHEIMER DRUGS: → Cholinergic Toxidrome. A lpha 2 “ α 2 ”: Clonidine ” → BC, ↓ BP , - RC, & DCL. β - Blockers: Propranolol → Hypoglycemia, DCL, BC, Ht Block, &↓ BP, & seizures. C amphor: → GIT upset, TC, DCL, & seizures. C olchicine “Antigout & Wart Drus ” → - Mitosis , GIT upset, ↓ BP → Multisystem Organ Failure. C a C Blockers → BC, ↓ BP , & Ht block. N arcotics: “Heroin & Prescribed Narcotics” → - - - RC → Resp. Arrest. T RANSDERMAL NARCOTIC PATCHES → IF swallowed. N ICOTINE : → Severe cholinergic toxicity Transdermal Patch Ingestion. O RAL HYPOGLYCEMIC: → Fatal hypoglycemia, DCL & seizures. T RICYCLIC AntiDs : “TCAs” → Block Na channels → Intraventricular Conduction →Fatal Arrhythmias. S ALICYLATES: “OIL OF WINTERGREEN” → Un-Coupling oxidative Phos. →Severe Acidosis, Cerebral & Pulmonary Edema. Q uinine: Antimalarial Drug →Fatal ventricular arrhythmias. Q uinidine : Antiarrhythmic Drug →Fatal ventricular arrhythmias. N ICOTINE : → 4 Cigarette N arcotics: “Heroin”

11. APPROACH of … … … Paediatric Poisoned Patients A GENDA 1 2 3 4 A SYMTOMATIC T OXIC P RESENTATION 5 P ITFALLS & T ricks O NE P ILL C AN K ILL

12. - Asymptomatic Presentation: Definition: A PATIENT Expose To a LIFE-THREATENING TOXIC Exposure . I nitially A symptomatic or M inimal S ymptomatic Presentation… “ With Rapidly Improvement ” ... !!! … That M islead The Health-Care Provider.     APPROACH of … … … Paediatric Poisoned Patients

13. APPROACH of … … … Paediatric Poisoned Patients - Asymptomatic Presentation: 5 6 7 8 9 10 1 2 A NTICOAGULANT 3 4 S NAKE BITE A CETAMINOPHEN H YDROCARBONS B UTTON BATTERIES O RAL HYPOGLYCAEMIC & IRON S R TABLETS M ETHANOL N APHTHALENE Z INC PHOSPHIDE

14. APPROACH of … … … Paediatric Poisoned Patients A GENDA 1 2 3 4 5 P ITFALLS & T ricks A SYMTOMATIC T OXIC P RESENTATION

15. APPROACH of … … … Paediatric Poisoned Patients F orget CALL: PIC … HOTLINE A ccurate I dentification NON- Toxic Substance W ell K nown One Pill Can Kill LIST Premature Discharge. A symptomatic P resentation P ITFALLS & T ricks

16. APPROACH of … … … Paediatric Poisoned Patients A GENDA 1 2 3 4 5 P ITFALLS & T ricks

17. APPROACH of … … … Paediatric Poisoned Patients