2002 annual report of the American association of poison control centers toxic exposure surveillance system

Watson, William A.; Litovitz, T. A.; Rodgers, George C.; Klein‐Schwartz, Wendy; Youniss, Jessica; Rose, S. Rutherfoord; Borys, Douglas J.; May, Mary E.

doi:10.1016/s0735-6757(03)00088-3

Cited by 431 publications

(268 citation statements)

References 19 publications

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“…A great variety of the scenarios from these two categories have been reported [5][6][7][9][10][11] which all share one characteristic -a lack of knowledge, information and attention among the adult users of the fentanyl patch. These include the accidental transfer of the patch from another person while hugging the child [5], placement of the patch on the child skin in order to relieve pain [6,9], improper disposal of the used fentanyl patch which resulted in ingestion of the patch by the child in one case [10] and with self-application of the discarded patch to the skin by the child in another [7]. The inadvertent users of the fentanyl patches in these incidents were most often grandparents [5][6][7]9].…”

Section: Discussionmentioning

confidence: 99%

“…These include the accidental transfer of the patch from another person while hugging the child [5], placement of the patch on the child skin in order to relieve pain [6,9], improper disposal of the used fentanyl patch which resulted in ingestion of the patch by the child in one case [10] and with self-application of the discarded patch to the skin by the child in another [7]. The inadvertent users of the fentanyl patches in these incidents were most often grandparents [5][6][7]9]. The contact of the fentanyl patch and the child was either completely accidental [5,7,10] or the patch was applied to the child skin in order to relieve acute pain [6,9].…”

Section: Discussionmentioning

confidence: 99%

“…The inadvertent users of the fentanyl patches in these incidents were most often grandparents [5][6][7]9]. The contact of the fentanyl patch and the child was either completely accidental [5,7,10] or the patch was applied to the child skin in order to relieve acute pain [6,9].…”

Section: Discussionmentioning

confidence: 99%

“…Adverse reactions in the form of life threatening conditions due to improper use of the fentanyl transdermal patch in children have been reported [5][6][7][8], as well as fatalities [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Death by band-aid: fatal misuse of transdermal fentanyl patch

2015

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We present a case of fatal intoxication by the application of a transdermal fentanyl patch upon a superficial bleeding abrasion of a 2-year-old girl. The grandmother discovered the body of the child in bed at approximately 7 a.m. External examination revealed a properly developed, nourished and hydrated child, with some vomit in the nostrils and inside the mouth. There was no evidence of trauma besides small contusions and abrasions on knees, with a patch placed over the largest abrasion. Closer inspection revealed that this was transdermal fentanyl patch.Internal examination and microscopic analysis revealed regurgitation of stomach content, cerebral and pulmonary edema and liver congestion. Toxicology analysis revealed trace levels of fentanyl in the blood just above the limit of detection (2 ng/mL), while concentrations in the urine, liver and kidney were approximately 102, 28 and 10 ng/mL, respectively. Investigation discovered that the child injured her knee while playing the evening before. The grandmother applied the patch to cover the injury, unaware that she had used a fentanyl transdermal patch instead of simple band-aid.Although fatal intoxications are uncommon among young children in high-income countries, it is of major interest to raise awareness of such events especially since a great majority of these are preventable. The presented case points at the need for more thorough education of users and more strict rules in prescribing and handling of this potent medicine. As well, we find this case to be a useful contribution to the evaluation of postmortem fentanyl concentrations in fatal intoxication in a small child.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Death by band-aid: fatal misuse of transdermal fentanyl patch

2015

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“…In the years subsequent to the policy statement change in 2003, there has been no observed significant increase in morbidity or mortality associated with accidental ingestions [4,5]. However, not much is reported as far as what impact the policy change had on poison center triage responses.…”

Section: Introductionmentioning

confidence: 99%

Effects on a Poison Center’s (PC) Triage and Follow-up After Implementing the No Ipecac Use Policy

2010

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Unit-Dose Packaging of Iron Supplements and Reduction of Iron Poisoning in Young Children

Tenenbein¹

2005

Arch Pediatr Adolesc Med

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These are the first data that show a decrease in the incidence of nonintentional ingestion of a specific drug by young children and a decrease in mortality from poisoning by this drug after the introduction of unit-dose packaging. There was a decrease in the incidence of iron ingestion and a dramatic decrease in the number of deaths due to iron poisoning. This validates unit-dose packaging as an effective strategy for the prevention of iron poisoning and iron poisoning deaths in young children. This highly effective intervention should be considered for other medications with a high hazard for morbidity and mortality when taken as an overdose.

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2002 annual report of the American association of poison control centers toxic exposure surveillance system

Cited by 431 publications

References 19 publications

Death by band-aid: fatal misuse of transdermal fentanyl patch

Death by band-aid: fatal misuse of transdermal fentanyl patch

Effects on a Poison Center’s (PC) Triage and Follow-up After Implementing the No Ipecac Use Policy

Unit-Dose Packaging of Iron Supplements and Reduction of Iron Poisoning in Young Children

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