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Handbook of common poisonings in children
rhe Joma/ of Emergency Med/one, Vol 5, pp 581-582, 1987
Pmted in the USA
:I HANDBOOK OF COMMON POISONINGS IN CHILDREN, 2nd edition. American Academy of Pediatrics. 175 pp. Evanston, Illinois, 1983, $22.50.
ful tables listing nontoxic products and botanicals. Of less use is a discussion of categories of warning labels. The text is followed by a formulary of drugs used in the treatment of poisoned patients that is well organized and benefits from notations of contraindications and adverse reactions associated with each drug. The second edition of this handbook is now four years old but we found that in large part the individual discussions remain fairly current as to management of various poisonings. There are, however, some sections that are in need of updating. For example, oral N-acetyl-cysteine is no longer under experimental protocol, and is now the accepted agent for treatment of significant acetaminophen overdose, and methionine no longer has a place in management of this form of poisoning. The use of acid diuresis in phencyclidine overdose, too, is outmoded. Physostigmine is recommended in the text both for diagnostic trial and therapeutic use in severe manifestations of atropine, tricyclic antidepressant, and other anticholinergic poisonings. Insufficient notation is made of the significant side effects of this drug, including seizures, bradycardia, bronchospasm, and cardiac arrest, which have led to its more restricted and cautious use. Many sections are well written including those on alkali ingestions, the alcohols, and iron poisoning. The section on plants includes an excellent table of poisonous plants with their toxic symptoms
This handbook was prepared by the American Academy of Pediatrics (AAP) Committee on Accident and Poison Prevention and was designed to provide a “quick” reference to management of the hundred or so most common poisonings in the pediatric age group. The core of the text is a series of discussions of each poison, arranged in alphabetical order. Each discussion follows the same general format, describing first the types of products commonly involved, and detailing available concentrations and dosages. A description of the pathophysiology of the poison is followed by symptoms and recommended management. The descriptions are generally succinct, allowing the essential information to be rapidly accessed. Each discussion is followed by a brief list of references. In addition, there is a general introductory section that describes the basics of management of toxic exposures, including details on emesis and gastric lavage, use of charcoal and cathartics, and the acute management of epidermal and eye exposures. This section also includes a brief discussion of pertinent laboratory tests, such as toxic screens and formulas for calculating anion gap, osmolar gap, and for estimating blood ethanol levels. The section concludes with a discussion of nontoxic ingestions that contains several useBook Reviews, which keeps readers gency medicine field, is coordinated
:B i-------
Copyright :) 1987 Pergarnon Journals Ltd
??
informed of important publications in the emerby Edward J. Otten, MD Associate Professor and
Director of Pre Hospital Care, Department Cincinnati College of Medicine.
of Emergency Medicine, University of 0736-4679/87
581
$3.00 + .OO
582 and treatment. A few of the poisons chosen for inclusion in the handbook, such as meprobamate and methyprylon, are less commonly seen today in pediatric poisonings. The text would benefit from inclusion of discussions of antidysrhythmic drugs, clonidine, and other antihypertensives and cocaine toxicity. This handbook would be a useful adjunct to the references on poisonings in any emergency department or ambulatory center that sees children. (It is invaluable
The Journal of Emergency Medicine
for pediatricians’ and family physicians’ offices.) A major asset of the text is its brevity and the ease of accessing relevant information. We hope that a newly revised edition may be forthcoming but believe there is much in the current handbook to recommend its wider usage. Patrick Fennell, MD Susan Wason, MD Children’s Hospital Medical Center 3350 Elland Avenue Cincinnati, OH 45229
Pmted in the USA
:I HANDBOOK OF COMMON POISONINGS IN CHILDREN, 2nd edition. American Academy of Pediatrics. 175 pp. Evanston, Illinois, 1983, $22.50.
ful tables listing nontoxic products and botanicals. Of less use is a discussion of categories of warning labels. The text is followed by a formulary of drugs used in the treatment of poisoned patients that is well organized and benefits from notations of contraindications and adverse reactions associated with each drug. The second edition of this handbook is now four years old but we found that in large part the individual discussions remain fairly current as to management of various poisonings. There are, however, some sections that are in need of updating. For example, oral N-acetyl-cysteine is no longer under experimental protocol, and is now the accepted agent for treatment of significant acetaminophen overdose, and methionine no longer has a place in management of this form of poisoning. The use of acid diuresis in phencyclidine overdose, too, is outmoded. Physostigmine is recommended in the text both for diagnostic trial and therapeutic use in severe manifestations of atropine, tricyclic antidepressant, and other anticholinergic poisonings. Insufficient notation is made of the significant side effects of this drug, including seizures, bradycardia, bronchospasm, and cardiac arrest, which have led to its more restricted and cautious use. Many sections are well written including those on alkali ingestions, the alcohols, and iron poisoning. The section on plants includes an excellent table of poisonous plants with their toxic symptoms
This handbook was prepared by the American Academy of Pediatrics (AAP) Committee on Accident and Poison Prevention and was designed to provide a “quick” reference to management of the hundred or so most common poisonings in the pediatric age group. The core of the text is a series of discussions of each poison, arranged in alphabetical order. Each discussion follows the same general format, describing first the types of products commonly involved, and detailing available concentrations and dosages. A description of the pathophysiology of the poison is followed by symptoms and recommended management. The descriptions are generally succinct, allowing the essential information to be rapidly accessed. Each discussion is followed by a brief list of references. In addition, there is a general introductory section that describes the basics of management of toxic exposures, including details on emesis and gastric lavage, use of charcoal and cathartics, and the acute management of epidermal and eye exposures. This section also includes a brief discussion of pertinent laboratory tests, such as toxic screens and formulas for calculating anion gap, osmolar gap, and for estimating blood ethanol levels. The section concludes with a discussion of nontoxic ingestions that contains several useBook Reviews, which keeps readers gency medicine field, is coordinated
:B i-------
Copyright :) 1987 Pergarnon Journals Ltd
??
informed of important publications in the emerby Edward J. Otten, MD Associate Professor and
Director of Pre Hospital Care, Department Cincinnati College of Medicine.
of Emergency Medicine, University of 0736-4679/87
581
$3.00 + .OO
582 and treatment. A few of the poisons chosen for inclusion in the handbook, such as meprobamate and methyprylon, are less commonly seen today in pediatric poisonings. The text would benefit from inclusion of discussions of antidysrhythmic drugs, clonidine, and other antihypertensives and cocaine toxicity. This handbook would be a useful adjunct to the references on poisonings in any emergency department or ambulatory center that sees children. (It is invaluable
The Journal of Emergency Medicine
for pediatricians’ and family physicians’ offices.) A major asset of the text is its brevity and the ease of accessing relevant information. We hope that a newly revised edition may be forthcoming but believe there is much in the current handbook to recommend its wider usage. Patrick Fennell, MD Susan Wason, MD Children’s Hospital Medical Center 3350 Elland Avenue Cincinnati, OH 45229