Journal Information
Vol. 56. Issue 1.
Pages 23-29 (1 January 2002)
Share
Share
Download PDF
More article options
Vol. 56. Issue 1.
Pages 23-29 (1 January 2002)
Full text access
Intoxicaciones en urgencias: cambios epidemiológicos en los últimos 10 años
Emergency Department Visits for Poisoning: Epidemiological Changes in the Last 10 Years
Visits
7466
S. Mintegui Raso
Corresponding author
smintegui@hcru.osakidetza.net

Correspondencia: Dr. S. Mintegui Raso. Urgencias de Pediatría. Departamento de Pediatría. Hospital de Cruces. Pl. de Cruces, s/n. 48903 Baracaldo. Bilbao
, J. Benito Fernández, M.A. Vázquez Ronco, A. Fernández Landaluce, P. Gortázar Arias, G. Grau Bolado
Urgencias de Pediatría. Departamento de Pediatría. Hospital de Cruces. Bilbao
This item has received
Article information
Objetivo

Estudiar los aspectos epidemiológicos de las intoxicaciones atendidas en urgencias de pediatría entre 1988 y 1999

Pacientes y métodos

Estudio descriptivo, observacional, desarrollado en tres fases de 12 meses (años 1988, 1993 y 1999). Se registraron las circunstancias que rodearon la consulta, el tratamiento en urgencias y la evolución clínica

Resultados

Las consultas por posible intoxicación han descendido entre 1988 y 1999 (279 frente a 161, p 5 0), tanto las debidas a productos del hogar (IPH) (91 frente a 48, D 5 -47%) como las medicamentosas (IM) (112 frente a 87, D 5 -22%)

Los antitérmicos constituyen un tercio de las IM y los psicofármacos alrededor del 11 %. El paracetamol es actualmente el fármaco más implicado

Los álcalis-cáusticos constituyen la IPH más frecuente, aunque su número se ha reducido (48 en 1988 y 18 en 1999). Los hidrocarburos suponen la 2.a IPH (número estable, 12-16/año)

La intoxicación suele darse en el hogar propio. El tóxico estaba guardado en un recipiente no original en cerca del 5% en 1988 y en el 13,7 % en 1999, básicamente productos del hogar

El número de pacientes que recibe tratamiento en urgencias ha descendido entre 1988 y 1993 y permanece estable entre 1993 y 1999 (62 % en 1988 y alrededor del 35% en 1993 y 1999; p 5 0,000003). El número de ingresos ha descendido de 17 (6,0 %) a 6 (3,7 %, p 5 0,39)

No se registraron fallecimientos

Conclusiones

En los últimos 10 años han descendido las consultas por posible intoxicación en niños basándose en las intoxicaciones menores, principalmente por productos del hogar. El paracetamol ha desbancado al ácido acetilsalicílico como fármaco más frecuentemente implicado

Palabras clave:
Intoxicación
Niños
Urgencias de pediatría
Objective

To study the epidemiological changes observed in pediatric poisonings treated in our Emergency Department between 1988 and 1999

Patients and methods

Descriptive, observational study performed in three 12-month periods (1988, 1993 and 1999). The circumstances surrounding the visit, treatment in the Emergency Department and clinical evolution were registered

Results

Consultations for possible poisoning decreased between 1988 and 1999 (279 vs. 161, p 5 0). This decrease was noted both in poisonings caused by household products (91 vs. 48, D 5 -47 %) and those caused by drugs (112 vs. 87, D 5 -22 %). Antipyretics caused one-third of drug poisonings and psychotropics caused approximately 11 %. The most commonly implicated agent is currently paracetamol. Caustic alkali were the most common household products causing poisoning although the number of such poisonings decreased (48 episodes in 1988 and 18 in 1999). Hydrocarbons were the second most frequent cause of household product poisoning (12-16/year). Most episodes occurred at home. The poison, mainly household products, was kept in a container other than the original in nearly 5% of episodes in 1988 and in 13.7 % in 1999. The number of children receiving treatment in the Emergency Department decreased between 1988 and 1993 and remained stable between 1993 and 1999 (62 % in 1988 and approximately 35 % in 1993 and 1999; p 5 0.000003). The number of admissions also decreased from 17 children in 1989 (6.0 %) to six in 1999 (3.7 %, p 5 0.39). No deaths were recorded

Conclusions

In the last ten years, visits for possible episodes of pediatric poisoning have decreased, mainly those due to mild poisoning caused by household products. Paracetamol has replaced acetyl-salicylic acid as the most frequently implicated drug

Key words:
Poisoning
Children
Pediatric emergency
Full text is only aviable in PDF
Bibliografía
[1.]
T.L. Litovitz, W. Klein-Schwartz, S. White, D.J. Cobaugh, J. Youniss, A. Drab, B.E. Benson.
1999 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System..
Am J Emerg Med, 18 (2000), pp. 517-574
[2.]
M. Shannon.
Ingestion of toxic substances by children..
[3.]
S. Mintegui, J.V. Velasco, A. Villate, F. Escudero, I. Pocheville, I. Mendia.
Valoración sobre aspectos epidemiológicos de las intoxicaciones en un servicio de urgencias pediátrico..
An Esp Pediatr, 33 (1990), pp. 528-530
[4.]
E. Blanco, B. Azúa, R. Rodríguez, S. Mintegui, J. Sánchez, J. Benito.
Intoxicaciones en la infancia: aspectos epidemiológicos y manejo hospitalario..
An Esp Pediatr, 42 (1995), pp. 265-268
[5.]
T. Litovitz, A. Manoguerra.
Comparison of pediatric poisoning hazards: An analysis of 3.8 million exposure incidents: A report from the American Association of Poison Control Centers..
Pediatrics, 89 (1992), pp. 999-1006
[6.]
C. Calvo, E. Onís, M.A. Vázquez, M.J. Martínez, J. Benito, S. Mintegui.
Hábitos poblacionales en el uso pediátrico de antitérmicos..
An Esp Pediatr, 54 (2001), pp. 607
[7.]
A.D. Woolf, F.H. Lovejoy.
Prevention of childhood poisonings..
Clinical management of poisoning and drug overdose, pp. 300-306
[8.]
G.B. Rodgers.
The safety of child-resistant packaging for oral prescription drugs: two decades of experience..
Jama, 275 (1996), pp. 1661-1665
[9.]
C. Chafee-Bahamon, F.H. Lovejoy.
Effectiveness of a regional poison center in reducing excess emergency room visits for children's poisonings..
Pediatrics, 72 (1983), pp. 164-169
[10.]
M. Tenenbein.
Recent advancements in pediatric toxicology..
Ped Clin North Am, 46 (1999), pp. 1179-1188
[11.]
A.S. Manoguerra.
Gastrointestinal decontamination after poisoning..
Where is the scienceα Crit Care Clin, 13 (1997), pp. 709-745
[12.]
K. Kulig, D. Bar-Or, S.V. Cantrill, P. Rosen, B.H. Rumack.
Management of acutely poisoned patients without gastric emptying..
Ann Emerg Med, 14 (1985), pp. 562-567
[13.]
K.S. Merigian, J.R. Hedges, L.A. Kaplan, J.R. Roberts, R.C. Stuebing, A. Pesce.
Plasma catecholamine levels in cyclic antidepressant overdose..
J Tox-Clin Tox, 29 (1991), pp. 177-190
[14.]
S.M. Pond, D.J. Lewis-Driver, G.M. Williams, A.C. Green, N.W. Stevenson.
Gastric emptying in acute overdose: A prospective randomized controlled trial..
Med J Austr, 163 (1995), pp. 345-349
[15.]
American College of Emergency Physicians: Clinical policy for the initial approach to patients presenting. with acute toxic or dermal or inhalation exposure..
Ann Emerg Med, 25 (1995), pp. 570-585
[16.]
G.R. Bond.
poisoned child. Evolving concepts in care..
Emerg Med Clin North Am, 13 (1995), pp. 343-355
[17.]
K. Kulig.
The last word on gastric emptyingα AACT Update., 9 (1996), pp. 1-2
[18.]
M.G. Belson, H.K. Simon.
Utility of comprehensive toxicologic screens in children..
Am J Emerg Med, 17 (1999), pp. 221-224
Copyright © 2002. Asociación Española de Pediatría
Download PDF
Idiomas
Anales de Pediatría (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?