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Poisoning in Children
Rajniti Prasad, Utpal Kant Singh, FC Layland, Shivani Singh
CHAPTER 1:
Introduction
CHAPTER 2:
General Symptoms and Signs of Poisoning
GENERAL SIGNS AND SYMPTOMS OF POISONING
Poison : Signs and Symptoms
Face and Scalp
Skin and Mucous Membrane
Gastrointestinal Tract
Nervous System
Respiratory Symptoms
Cardiovascular Symptoms
CHAPTER 3:
General Management
INITIAL RESUSCITATION STABILIZATION
Airway, Breathing, Circulation
Symptomatic and Supportive Management
Management of Hypotension or Hemodynamic Support
Management
Correction of Acid-base Disturbances
Arterial Blood Gas in Different Situations
Management of Cardiac Arrhythmia
Management of Convulsion
Management
Anticonvulsant Therapy
Management of Hypothermia
Management of Pulmonary Edema
Management of Stress Ulcers
RHABDOMYOLYSIS
Management of Pain
Nausea and Vomiting
REMOVAL OF UNABSORBED POISON
Removal of Unabsorbed Poison from GI Tract
Methods Used
Dilution
Emesis
Gastric Lavage
Adsorption
Catharsis
WHOLE BOWEL IRRIGATION
REMOVAL FROM SKIN, EYES, OTHER BODY CAVITIES
Hastening the Elimination of Absorbed Poisons
Principle
Forced Alkaline Diuresis
Forced Acid Diuresis
Dialysis
Indications for Dialysis
Toxins/Drugs where Dialysis is Employed
Complications Associated with Dialysis
Contraindications for Peritoneal Dialysis
Hemoperfusion
Hemofiltration
Antidotes
Physical Antidotes
Chemical Antidotes
Physiological or Pharmacological Antidotes
UNIVERSAL ANTIDOTE
Prevention
CHAPTER 4:
Corrosive Poisons
SITES LIKELY TO BE AFFECTED BY LOCAL EFFECT
EFFECTS OF CORROSIVES
MINERAL ACID
Pathophysiology
Clinical Features
Diagnosis
Treatment
Esophageal Dilatation
Surgery
PHENOL (CARBOLIC ACID)
Pathophysiology
Clinical Features
Diagnosis
Treatment
HYDROCYANIC ACID AND ITS SALTS
Pathophysiology
Clinical Features
Diagnosis
Treatment
CAUSTIC POTASH AND SODA
Pathophysiology
Clinical Features
Treatment
CHAPTER 5:
Metals and Non-Metals
IRON POISONING
Pathophysiology
Toxic doses
Clinical Features
Gastrointestinal Stage
Stage of Apparent Recovery (Relative Stability)
Stage of Circulatory Failure
Stage of Hepatic Necrosis
Stage of Gastric Scarring
Problems Resulting from Iron Toxicity
Diagnosis
Treatment
Decontamination (Removal of Unabsorbed Iron)
Definitive Therapy
Routes and Dosage of Desferroxamine
Preparation Available
Effectiveness and Duration of Therapy
Supportive Therapy
Other Measures
Prognosis
Prevention
LEAD POISONING
Pathophysiology
Clinical Features
Acute Lead Poisoning
Chronic Intoxication
Encephalopathy
Neuromuscular Effects and Peripheral Neuropathy
Developmental Dysfunction
Abdominal Syndrome
Hematological Manifestations
Renal Manifestations
Clinical Features of Chronic Lead Poisoning (Table 5.3)
Diagnosis of Lead Poisoning
Management
Supportive Treatment
Specific Treatment
Chelation Therapy (Table 5.5)
Indications of Chelation Therapy
MERCURY POISONING
Pathophysiology
Clinical Manifestations of Acute Mercury Poisoning
Clinical Features of Acute Mercury Poisoning
Diagnosis of Mercury Poisoning
Management
Acrodynia (Pink Disease, Dermato-polyneuritis)
Pathology
Clinical Manifestations
Laboratory Investigations
Treatment
Prevention
Minamata Disease
Pathology
Clinical Manifestations
Investigations
Treatment
ARSENIC POISONING
Pathophysiology
Clinical Features and Acute Arsenic Poisoning (Table 5.6)
Gastrointestinal
Cardiovascular
Neurological
Respiratory
Renal
Hematological
Ophthalmological
Dermatological
Clinical Manifestations of Chronic Arsenic Poisoning
Investigations
Treatment
PHOSPHORUS POISONING
Pathophysiology
Clinical Features
Treatment
Chronic Phosphorus Poisoning
Iodine
Clinical Features
Treatment
ALUMINIUM TOXICITY
Pathophysiology
Clinical Manifestations
Investigations
Treatment
Prognosis
CHAPTER 6:
Animal Poisoning
SCORPION STING
Pathophysiology
Clinical Manifestations
Neurological
Autonomic Nervous System
Central Nervous System
Cardiovascular
Respiratory
Gastrointestinal
Metabolic
Renal
Hematological
Hepatobiliary
Miscellaneous
Grading of Severity of Scorpion Sting Envenomation
DIAGNOSIS
Management of Scorpion Sting
Local Management
Systemic Management
Prevention
SNAKE BITE
Classification (Table 6.2)
Morphology of Some Important Snakes
Poison Gland
Fangs
Venom
Absorption of venom
Pathophysiology
Factors Affecting Severity of Snake Bite
Clinical Manifestations
Venom Ophthalmia
Hydrophiidae (Sea Snake)
Viperidae (Pit Vipers, Russel’s Viper, Rattle Snakes)
Laboratory Findings
Treatment
First Aid
Controversial First Aid Methods
Immediate Management
Specific Therapy
Indications of Antivenom
Reconstitution of Antivenom
Dosage guidelines for Antivenom
Antivenom Reactions
Contraindications to Antivenom Therapy
Supportive Management
Prevention
BEE AND WASP STING
Clinical Features
Treatment
SPIDER BITES
Clinical Features
Treatment
LIZARD BITE
CATERPILLAR
CHAPTER 7:
Insecticide Poisoning
CLASSIFICATION OF INSECTICIDES
Inorganic Chemical Insecticides
Organic Chemical Insecticides
ORGANOPHOSPHORUS POISONING
Pathophysiology
Muscarine-like Effect
Nicotine-like Effect
Action on CNS
Clinical Manifestations (Table 7.1)
Intermediate Syndrome
Chronic Effects
Diagnosis
Management
Management of Airways
Management of Seizure
Atropine Sulfate
Cholinesterase Regeneration Compounds
Monitoring of Patient
Prophylaxis
CARBAMATES
PYRETHRINS
ROTENONE
DDT (DICHLORO-DIPHENYL TRICHLOROETHANE)
Pathophysiology
Clinical Features
Treatment
Prognosis
ENDRIN
Clinical Manifestations
Treatment
GAMMEXANE
Zinc Phosphide
Clinical Features
Treatment
SODIUM FLUOROACETATE
Clinical Manifestations
Management
NICOTINE
Clinical Features
Treatment
Fluorides
Clinical Features
Treatment
PYRETHROID
Pathophysiology
Clinical Manifestations
Diagnosis
Treatment
CHAPTER 8:
Salicylate Poisoning
PATHOPHYSIOLOGY
Clinical Features
General Features
Metabolic Disturbances
Complications of Salicylate Intoxication
Laboratory Investigations (Table 8.1)
Treatment
Indications for Hemodialysis or Hemoperfusion
CHAPTER 9:
Acetaminophen (Paracetamol)
PATHOPHYSIOLOGY
Clinical Features
Management
Specific Measures
Prognosis
CHAPTER 10:
Barbiturate Poisoning
PATHOPHYSIOLOGY
Lethal Blood Levels
Clinical Features of Acute Barbiturate Intoxication
Mild Poisoning
Moderate Poisoning
Severe Poisoning
Diagnosis
Investigations
Mild Intoxication
Severe Intoxication
Treatment
CHAPTER 11:
Hydrocarbons
CLASSIFICATION
Pathophysiology of Hydrocarbon Poisoning
Clinical Presentations
Admission Criteria following Hydrocarbon Ingestion
General Principles of Emergency Management of Hydrocarbon
KEROSENE OIL POISONING
Clinical Features
Radiological Findings
Management
Complications
Prevention
SOLVENT SNIFFING
Diagnosis
Management
PETROLEUM AND DERIVATIVES
Management
CHAPTER 12:
Dhatura
PATHOPHYSIOLOGY
CLINICAL FEATURES
PERIPHERAL ANTI-MUSCARINIC EFFECTS
CENTRAL ANTI-MUSCARINIC EFFECTS
INVESTIGATIONS
Diagnosis
Treatment
Gastrointestinal Decontamination
Supportive Care
Antidote
CHAPTER 13:
Cocaine
PATHOPHYSIOLOGY
Clinical Features
Management
CHAPTER 14:
Opioids
CLASSIFICATION OF OPIOIDS
PATHOPHYSIOLOGY
CLINICAL MANIFESTATIONS OF OPIOIDS
Central Nervous System
Adulterants
Smooth Muscle of Various System
GI Tract
Biliary Tract
Respiratory Tract
Urinary Tract
Cardiovascular
Miscellaneous
Opioid Overdose
Opioid Withdrawal
Opioid Withdrawal in Newborn
Complications of Opioid Abuse
Management of Opioid Overdose
General Management
Specific Management
Management of Opioid Withdrawal
CHAPTER 15:
Phenothiazines and Related Neuroleptics
CLASSIFICATION OF PHENOTHIAZINES AND RELATED NEUROLEPTICS
PATHOPHYSIOLOGY
CLINICAL FEATURES
Cardiovascular
Central Nervous System
Extrapyramidal Symptoms
Autonomic Nervous System
Pulmonary
Gastrointestinal
Eye
Skin
Allergic and Idiosyncratic
ECG
Specific Treatment
CHAPTER 16:
Cyclic Antidepressant
CYCLIC ANTIDEPRESSANT
PATHOPHYSIOLOGY
Clinical Manifestations
Diagnosis
Management
Sodium Bicarbonate
Respiratory Depression
Choreoathetosis and Myoclonus
Seizures
Arrhythmias
Hypertension and Hypotension
CHAPTER 17:
Carbon Monoxide
PATHOPHYSIOLOGY
Clinical Manifestations
Chemical Method
Spectroscopic Method
Treatment
CHAPTER 18:
Ethylene Glycol
PATHOPHYSIOLOGY
Clinical Manifestations
Stage I (30 Minutes–12 Hours)
Stage II (12–24 Hours)
Stage III (24–72 Hours)
Treatment
CHAPTER 19:
Epidemic Dropsy
EPIDEMIOLOGY
PATHOPHYSIOLOGY
Clinical Features
Diagnosis
Treatment
CHAPTER 20:
Mustard Gas
PATHOGENESIS
Clinical Features
Treatment
First Aid
Therapeutic Measures
CHAPTER 21:
Methanol (Methyl Alcohol)
PATHOPHYSIOLOGY
Clinical Manifestations
Treatment
CHAPTER 22:
Oleander Poisoning
PATHOPHYSIOLOGY
Clinical Features
Diagnosis
Management
CHAPTER 23:
Dapsone Poisoning
PATHOPHYSIOLOGY
Clinical Presentation
Management
CHAPTER 24:
Aluminium Phosphide (Celphos)
PROPERTIES OF PHOSPHINE
pathophysiology
Pathology
Clinical Features
Inhalation Intoxication
Ingestional Intoxication
Mild Toxicity
Moderate-to-Severe Toxicity
Shock in Aluminium Phosphide Poisoning
Adult Respiratory Distress Syndrome
Diagnosis
Laboratory and Other Investigation Parameters
Management
Preventive Measures
CHAPTER 25:
Mushroom Poisoning
PATHOPHYSIOLOGY
Clinical Manifestations
Laboratory Diagnosis
Treatment
CHAPTER 26:
Naphthalene
PATHOPHYSIOLOGY
Clinical Features
Investigations
Treatment
CHAPTER 27:
Theophylline
CLINICAL MANIFESTATIONS
Diagnosis
Treatment
CHAPTER 28:
Calcium Channel Blocker
PATHOPHYSIOLOGY
CLINICAL MANIFESTATIONS
LABORATORY INVESTIGATIONS
Treatment
CHAPTER 29:
Benzodiazepines
CLINICAL FEATURES
Laboratory Investigations
Treatment
CHAPTER 30:
Fluoride Toxicity
CLINICAL MANIFESTATIONS
Laboratory Findings
Treatment
CHAPTER 31:
Radioactive Hazards
PATHOPHYSIOLOGY
CLINICAL MANIFESTATIONS
Management
Prevention
CHAPTER 32:
Miscellaneous
DIGITALIS
Clinical Features of Toxicity
Extra Cardiac
Cardiac
ECG Manifestations
Treatment of Digitalis Toxicity
COWDUNG POWDER POISONING
Clinical Features
Investigations
Management
PODOPHYLLIN
Clinical Manifestations
Treatment
BACLOFEN POISONING
Clinical Manifestations
Treatment
JATROPHA POISONING
Pathophysiology
Clinical Manifestations
Treatment
INDEX
TOC
Index
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