Although poisoning is a common cause of admisson to the pedaitric intensive care unit, the drugs

and their symptoms and respective treatments are too varied to cover in a single review. Because of
space limitations, only a brief overview of the drugs involved in common serious poisonings in
childhood (table 22.1) and sure elements in the differential diagnoses (table 22.2) are covered.

Toxidromes or classes of drugs involved with a constellationof symptoms (table.22.3) and classic
laboratory tests used in the differential diagnosis of toxicologic emergencies (table 22.4) are also
covered.

A table for specific intoxicants and their antidotes (table 22.5) is included. Next, there is a brief
review of general approaches to the treatment of the poisoned child and a discussion of selected
specific poisonings and the choice of thecniques used in their removal(table 22.6)

Table 22.1 drugs involved in serious childhood poisonings

Drugs others
Acetaminophen Alcohols(ethyl,isopropyl,methyl)
Antiarrthytmics Ethylene Glycol
Anticonvulsants Caustics
Antihistamines Herbicides
Antihypertensives Organophosphates
Aminophyline Petroleum distillates
Aspirin
Beta-blocker
Digoxin
Hallocinogens
Iron
Opiods
Theophyline
Tricylic antidepressants

Table 22.2 Clinical menifestations of poisonings

Sign or symptom Poison

Odor
Bitter almond Cyanide
Aceton Isopropyl alcohol, methanol, acetylsalicylic acid
Coal gas Carbon monoxide
Pungent aromatic Ethclorvynol
Oil of wintergreen Methyl salicylate
Pear Chloral hydrate
Garlic Arsenic,thallium,phosphorus
Alcohol Ethanol,methanol
Petroleum Petroleum distillates
Skin
Cyanosis
Red flush
Sweating
Dry
Bullae
Jaundice
Purpura
Temperature
Hypertension
Hypotension
Pulse rate
Bradycardia
Tachycardia
Arrhytmias
Mucous membranes
Dry
Salivation
Oral lessions
Lacrimation
Respiration
Depressed
Tachypnea
Kussmaul
Wheezing
Pneumonia
Pulmonary edema
Central nervous system
Seizure
Pupils,miosis
Mydrasis
Blindness, optic atrophy
Fasciculation
Nystagmus
Hypertonus
Myoclonus,rigidity
Delirium
Coma
Weakness,paralysis
Gastrointestinal system
Vomiting,diarrhea,abdominal pain