Clinical Spectrum and Severity of Poisoning in the Paediatric Intensive Care Unit of a Tertiary Care Centre in Uttarakhand: A Retrospective Cohort Study
Correspondence Address :
Dr. Kunal Das,
B 9/6, HIHT Campus, Swami Rama Nagar, Dehradun, Uttarakhand, India.
E-mail: drkunaloncology@gmail.com
Introduction: Acute poisoning causes significant mortality and morbidity among children worldwide. However, the pattern of poisoning and causative substances varies significantly in geo-demographic areas.
Aim: To describe admissions due to acute poisoning in the Paediatric Intensive Care Unit (PICU) of a tertiary care centre in terms of demographics, clinical profile, specific agents involved and severity of poisoning.
Materials and Methods: This was a retrospective cohort study conducted in PICU of a tertiary care level teaching institute of Uttarakhand, India over a period of three years on subjects of age group from one month to 18 years. Data was collected and analysed for demography, clinical presentation, substance, management, complications, and outcome. Poison Severity Score (PSS) was used to assess the severity of poisoning. Data was analysed using Statistical Package for the Social sciences (SPSS) software version 21.0.
Results: During the study period, out of total 751 PICU admissions, 45 were due to poisoning. Organophosphates {20 (44%)} and aluminium phosphide {12 (26%)} were the most common substances used. Accidental poisoning was common {6 (46%)} among less than five years of age. However, suicidal attempts were noted more frequently {20 (64%)} among >15 years of age group. Vomiting 31(69%), altered sensorium 23 (51%), and pain abdomen 16 (35%) were the most common presentations. Nine (20%) patients required ventilatory support as well. Three (6.6%) patients died; all associated with aluminium phosphide poisoning.
Conclusion: The most common poison consumed is organophosphate. Aluminium phosphide is the most lethal poison, accounting for all the deaths in the study. Accidental poisoning is common in children less than five years of age. Suicidal poisoning is common among adolescents which must be prevented by early detection of stress. Primary health care facility hesitates to intervene even for basic poisoning care before referring.
Aluminium phosphide, Organophosphate, Suicide
DOI: 10.7860/JCDR/2021/49611.15440
Date of Submission: Mar 25, 2021
Date of Peer Review: Apr 29, 2021
Date of Acceptance: Jul 03, 2021
Date of Publishing: Sep 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? No
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Mar 27, 2021
• Manual Googling: Jun 29, 2021
• iThenticate Software: Jul 31, 2021 (8%)
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