Title:An Overview of the Pediatric Toxidromes and Poisoning Management
Volume: 16
Issue: 4
Author(s): Wun F. Hui, Kam L. Hon*Alexander K.C. Leung
Affiliation:
- Department of Pediatrics and Adolescent Medicine, The Hong Kong Children’s Hospital,Hong Kong
Keywords:
Pediatric poisoning, intoxication, toxidrome, antidote, extracorporeal treatment.
Abstract:
Background: Poisoning is one of the leading causes of childhood morbidity and mortality
worldwide. Despite the advancement of poison detection by modern investigation methods, the clinical
skill of toxidrome recognition by combining the findings from a detailed history, thorough physical
examination, and the results of basic investigations is still indispensable for the management of
children with suspected poisoning.
Objective: The aim was to review pediatric toxidromes and poisoning management.
Methods: A literature search was conducted on PubMed (between February 1 and 15, 2020) with
keywords "toxidrome" "poisoning" "intoxication” “children” and "pediatric". The search was customized
by applying the appropriate filters so as to get the most relevant articles to meet the objective of
this review article.
Results: Toxidrome recognition may offer a quick guide to possible toxicology diagnosis so that specific
antidote can be administered in a timely manner. This article discusses a few commonly encountered
toxidromes in pediatric poisoning, with an emphasis on the symptomatology and source of exposure.
The antidote and specific management for each toxidrome are also discussed. Although most patients
with intoxication can be managed with close observation, supportive measures and antidote
treatment, it is unfortunate that antidotes are only available for a limited number of poisons responsible
for intoxication. Extracorporeal toxin removal is being increasingly recognized as a mode of
treatment for patients with rapid deterioration who are unresponsive to conventional management. The
decision to apply such technique and the choice of modality are frequently individualized due to the
paucity of high-level evidence. The various patient and toxin/medication factors involved in the decision-
making process are discussed.
Conclusion: Poisoning is a common cause of pediatric accidents and injuries. Physicians should be
familiar with common toxidromes and poisoning management.
