THE NATURAL HISTORY OF POISONING IN CHILDHOOD

Abstract

Clinical and epidemiological information was collected on 1033 cases of poisoning which occurred during a period of 18 months.

The ingestion of medicines accounted for 50.6 per cent of the cases of poisoning, cleaning, polishing and sanitizing agents for 19 per cent, pesticides for 10.4 per cent, petroleum distillates for 9 per cent, turpentine for 4.1 per cent, cosmetics for 1.8 per cent, a miscellaneous group of cases for 4.5 per cent and an unknown group of cases for 0.7 per cent.

Eighty-four per cent of the cases were under 5 years of age.

The poisoning resulted from an accident or error on the part of the patient in 89.8 per cent of the cases, another individual in 2.5 per cent of the cases, and a physician in 1.0 per cent of the cases.

The only fatalities occurring in individuals under 21 years of age were in 6 children, all of whom were 2 years or under. These fatalities resulted from the accidental ingestion of lighter fluid, veratrate and phenobarbital, turpentine, methyl salicylate (2 cases), and aspirin suppositories.

The kitchen was found to be the most hazardous room in the home, and the table and floor the most hazardous places to leave potentially toxic agents.

"Aspirin" accounted for 18.3 per cent of all the cases. Four-fifths of the cases of aspirin poisoning were attributed to the flavored preparation.

No correlation was observed between the severity of poisoning resulting from the ingestion of fuel oils, turpentine and furniture polish and the mechanical emptying of the stomach. It is suggested that the manner in which the stomach is emptied is of greater significance then whether or not the stomach is emptied. Although it does not seem wise to urge the induction of vomiting by the layman in these cases, the performance of gastric lavage by the physician, with the patient's head kept lower than the stomach, would seem to be indicated.

First-aid procedure in the home should be limited to the mechanical induction of vomiting and should be carried out in all cases except poisoning from strong acids and alkalis and from petroleum distillates, turpentine and furniture polish. Following this, it is urged that competent medical attention be sought immediately. Both the induction of vomiting and the performance of gastric lavage should be carried out with the patient's head lower than the stomach.