Why does a poi soni ng happen?

National Poison Data System (2011)

Reason for Exposures
Unintentional 80.0%
Intentional 16.0%
Adverse Reaction 2.6%
Other 1.4%
Uni nt ent i onal Exposur es
o Curious toddler
o Medication error
o Bites & stings
o Environmental
o On the job

Int ent i onal Exposur es
o Suicides
o Misuse
o Abuse

Adver se r eact i ons
o Allergic reactions
o Medications
o Foods
Pot ent i al Rout es of Exposur e
o Inhalation
o Skin and Eyes
o Ingestion
o Injection

Summar y St at ement s
o Most poisonings are:
acute
accidental/unintentional
occur in the home
involve children less than 5 years of age
o Intentional exposures are more likely to be
associated with worse outcomes.


Top Fi ve Li st NPDS
Chi l dr en <6 year s ol d, Non- phar maceut i cal s

1. Cosmetics and personal care products (14.6%)
2. Cleaning substances (9.5%)
3. Foreign bodies (7.2%)
4. Pesticides (3.4%)
5. Plants (2.6%)



Look- al i ke Pr oduct s
Case Fol l ow- up - Under t he si nk
o 22 month old
o Window cleaner contains dilute ammonia ( <1
%), surfactant, isopropyl alcohol 3%
o Assessment: potential for minor surface
irritation

Case Fol l ow- up In t he Bat hr oom
o 18 month old
o Solid deodorant contains antiperspirant with
aluminum salt
o Assessment: potential for minor surface
irritation rare foreign body obstruction risk

Case Fol l ow- up In t he Shoe Box
o 17 month old
o Silica gel is a commonly used desiccant
designed to minimize moisture when placed in
household products and medications. It is not
absorbed and is a minor irritant.

Non- or mi ni mal l y t oxi c pr oduct exampl es
o Antiperspirants
o Bar soap
o Crayons
o Eye makeup
o Pencils
o Playdoh
o Zinc Oxide ointment

Top Fi ve Li st NPDS
Chi l dr en < 6 year s ol d, Phar maceut i cal s

1. Analgesics (9.7%)
2. Topicals (6.9%)
3. Vitamins (4.1%)
4. Antihistamines (3.6%)
5. Cough and cold preparations (2.9%)




Top Fi ve Li st NPDS
Adul t s

1. Analgesics (10%)
2. Cleaning Substances (7.7%)
3. Bites & Stings (6.3%)
4. Sedatives/antipsychotics (6.1%)
5. Pesticides (5.3%)




Case Fol l ow- up The Unr el ent i ng
Headache
17 year old The Unrelenting Headache

The patient was hospitalized with progressive
neurologic deterioration & liver failure and
then pronounced with brain death. Later, the
8 year old sister admitted to seeing her take a
whole bottle of Tylenol, but was sworn to
secrecy (by the older sister).

Pop Quiz #1
Which case is at greatest risk for
life-threatening toxicity?

A. 18 month old with deodorant
(In the Bathroom)
B. 22 month old with window
cleaner (Under the Sink)
C. 17 month old with desiccant
(In the Shoe Box)
D. 17 year old treating herself for
a migraine (The Unrelenting
Headache)