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

Lapus, Robert M.; Slattery, Ann P.; King, William D.

doi:10.1007/s13181-010-0066-x

Cited by 6 publications

(8 citation statements)

References 7 publications

(5 reference statements)

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“…Validation of data was done by verifying the results in the medical records and contacting parents by phone. Phone calls after the toddler has been released from the hospital were very important as questioning the anxious and stressed parents during the ED visit often leads to an inaccurate history or description of the intervention [ 10 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…Hospital poison management is based on an appropriate supportive and/or toxic-specific treatment [ 5 – 9 ]. At homes, IPECAC had been recommended as a safe emetic between 1965 and 2003 [ 10 ]. However, the American Association of Poison Control Centers (AAPCC) in its 2011 report stated that IPECAC altered the child’s tolerance to orally ingest hospital poison treatments and should no longer be used at homes [ 4 , 5 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparative outcome analysis of home-initiated non-medical interventions among toddlers with orally ingested substances

Alanazi¹,

Al-Jeraisy

Salam

2015

Ital J Pediatr

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BackgroundPoison management guidelines recommend contacting or visiting poison centers directly after exposure. However, some parents initiated non-medical interventions on their children before visiting these centers. Aim was to evaluate the clinical and hospital outcomes of such practices among toddlers with orally ingested medication or chemical substances at a tertiary care facility.MethodsRetrospective cohort, based on four-arm outcome analysis. Exposures were gender, age, body mass index, arrival time to facility (hours) presented in Median [Interquartile range]. Clinical outcomes were vital signs, physical examination, diagnostic tests; Hospital outcomes were in-hospital admission, length of hospital stay (hours) presented in Median [Interquartile range], hospital cost ($US). Bivariate analysis (nonparametric tests), binary logistic/linear regression were conducted. Significance at p < 0.05.ResultsBetween 2009–2011, 165 (all previously healthy) toddlers were (Males = 58 %, females = 42 %) and had normal weights in 70 %. Witnessed incidents were in 85 %. Two control groups [Medication (control) = 72, Chemical (control) = 48] directly visited the facility after incident, while two intervention groups [Medication (intervention) = 27, Chemical (intervention) = 18] received orally administered water, salt/sugar solutes, milk/yogurt, lemon juice and/or manually induced vomiting before the visit. Abnormal clinical outcomes in total were in vital signs = 15 %, physical examination = 42 % and diagnostic tests = 26 %; hospital outcomes were admission = 16 %, length of stay range (2 hours–7.5 days), cost range (667–11,500). Bivariate analysis: Length of stay in Medication (intervention) = 9[5.4–12.0] hours significantly higher than Medication (control) = 5[2.7–7.5] hours, p = 0.003; abnormal physical examination in Chemical (intervention) = 77.8 % significantly higher than Chemical (control) = 37.5 %, p = 0.004. In regression: intervention significantly increased length of stay (t = 0.213, adj. P = 0.035); lower weight toddlers were at higher risk of admission (Beta = -0.51, adj. P = 0.018); delayed arrival time significantly increased abnormal physical examination (Beta = 0.29, adj. P = 0.003). No significant control/intervention group differences regarding abnormal vital signs (adj. P = 0.148), physical examination (adj. P = 0.781), diagnostic tests (adj. P = 0.285), admission (adj. P = 0.499), and cost (adj. P = 0.102).ConclusionHome-initiated non-medical interventions didn't improve the clinical and hospital outcomes. It has delayed the arrival time to emergency department, which added the risk of encountering abnormal physical examination, and in return increased the average length of hospital stay.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative outcome analysis of home-initiated non-medical interventions among toddlers with orally ingested substances

Alanazi¹,

Al-Jeraisy

Salam

2015

Ital J Pediatr

View full text Add to dashboard Cite

show abstract

“…The syrup induces vomiting and was used in previous years as an antidote to poisonous substances after an accidental ingestion. In the 1980s it was highly recommended by the AAP for parents to keep stored in their home in case of emergency (Bond, 2003). In 2003, the position of the AAP changed, no longer recommending storage of the syrup at all (Gutierrez, Negron, & Garcia-Fragoso, 2011).…”

Section: Syrup Of Ipecacmentioning

confidence: 99%

“…The American Association of Poison Control centers agree and advise against the use of ipecac. Bond (2003) reported that syrup of ipecac did not decrease emergency room visits or improve the child outcomes, rendering the medication ineffective. The push against ipecac has been so effective that it is essentially unavailable on the market; a recent Internet search to purchase ipecac syrup was unsuccessful.…”

Section: Syrup Of Ipecacmentioning

confidence: 99%