Pediatric Ingestions: New High-Risk Household Hazards

David C. Sheridan; Adrienne Hughes; B. Zane Horowitz

doi:10.1542/pir.2019-0309

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David C. Sheridan, MD, MCR*
Adrienne Hughes, MD*,^†
B. Zane Horowitz, MD*,^†

^*Department of Emergency Medicine, Oregon Health & Science University, Portland, OR
^†Oregon Poison Center, Portland, OR

AUTHOR DISCLOSURE
Drs Sheridan, Hughes, and Horowitz have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Practice Gaps

Most poisoning events in preschool-aged children continue to be accidental ingestions in the home, ranging from medications to toys and common household products.
Knowledge of these common ingestions is important to properly diagnose, treat, and refer to emergent care as needed.
Pediatricians and emergency physicians should be familiar with new exposures and treatment options that have been recommended for some novel agents.

Objectives

After completing this article, readers should be able to:

Explain the general epidemiology and emerging trends for pediatric poisonings and exposures.
Become familiar with several new products that have emerged as high-risk exposures in preschool-age children.
Describe the potential serious clinical complications and treatment options for these new high-risk agents.

Introduction

There is good news and bad news when it comes to pediatric poisoning and exposures. The last full year that the American Association of Poison Control Centers reported data was 2017. (1) There were 2,115,186 human exposures called in to poison centers in the 50 states and US territories, of which children represented the largest percentages. Children younger than 6 years were the concern in 45% of calls, those 6 to 12 years of age represented 6% of calls, and adolescents 13 to 19 years of age 8% of calls. (1) Although no death of a child is considered a positive outcome, the trend in fatalities from poison exposure for toddlers has been decreasing. The good news is that of 956,871 calls to poison centers regarding preschool-age children (<6 years old), there were only 19 fatal outcomes. The bad news is that the data identify room for improvement in adolescent poison prevention. In adolescents, ages 13 to …