scholarly journals Exotic Snakebites Reported to Pennsylvania Poison Control Centers: Lessons Learned on the Demographics, Clinical Effects, and Treatment of These Cases

Toxins ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 755
Author(s):  
Stephen W. Miller ◽  
Kevin C. Osterhoudt ◽  
Amanda S. Korenoski ◽  
Ketan Patel ◽  
Sakthivel Vaiyapuri
Keyword(s):  
Exotic Species ◽  
Native Species ◽  
Tissue Injury ◽  
Specific Treatment ◽  
Lessons Learned ◽  
Poison Control ◽  
Clinical Effects ◽  
Unique Challenge ◽  
Poison Control Centers ◽  
Medical Emergencies

Exotic snakebites (i.e. from non-native species) are a rare occurrence, but they present a unique challenge to clinicians treating these patients. Poison control centers are often contacted to assist in the management and care of these medical emergencies. In this study, we analyzed case records of the two Pennsylvania poison control centers from 2004 to 2018 to describe clinical features reported as a result of exotic snakebite envenomation. For the 15-year period reviewed, 18 exotic snakebites were reported with effects ranging from mild local tissue injury to patients who were treated with mechanical ventilation due to respiratory failure. The mean age of the patients was 35 years and males accounted for 83% of the cases. Antivenom, the only specific treatment, was administered in seven of 18 patients within an average of four h of envenomation. The procurement of antivenom against these exotic species may require substantial logistical efforts due to limited stocking of this rarely used treatment. Newer, targeted, small molecule treatments that are being currently investigated may aid in the treatment of snakebites in general. However, people should be cautious when handling these exotic species, and clinicians should be aware of these bites and relevant clinical effects in order to manage these when reported.

Pattern of ziprasidone exposures reported to Texas poison centers, 2001–2005

2008 ◽  
Vol 27 (4) ◽  
pp. 355-361 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Health Care ◽  
Age Distribution ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Clinical Effects ◽  
Poison Control Centers ◽  
Poison Centers ◽  
The Mean

Information on potentially adverse exposures to the atypical antipsychotic drug ziprasidone is limited. This study described the pattern of exposures involving only ziprasidone (isolated exposures) reported to Texas poison control centers during 2001–2005. The mean dose was 666 mg. The patient age distribution was ≤5 years (11%), 6–19 years (30%), and ≥20 years (60%). The exposures were intentional in 53% of the cases. Seventy-five percent of the exposures were managed at health care facilities. The final medical outcome was classified as no effect for 39% of the cases and minor effects for 40% of the cases. Adverse clinical effects were listed for 53% of the patients; the most frequently reported being neurological (42%), cardiovascular (13%), and gastrointestinal (5%). The most frequently listed treatment was decontamination by charcoal (34%) or cathartic (28%). Potentially adverse ziprasidone exposures reported to poison control centers are likely to involve management at a health care facility and involve some sort of adverse clinical effect. With proper treatment, the outcomes of such exposures are generally favorable.

Celecoxib exposures reported to Texas poison control centers from 1999 to 2004

2006 ◽  
Vol 25 (5) ◽  
pp. 261-266 ◽  
Author(s):  
M B Forrester
Keyword(s):  
Health Care ◽  
Age Distribution ◽  
Health Care Facilities ◽  
Poison Control ◽  
Clinical Effects ◽  
Medical Outcome ◽  
Patient Age ◽  
Poison Control Centers ◽  
Care Facilities ◽  
The Mean

Concerns have been raised about the safety of celecoxib. This study described the pattern of exposures involving only celecoxib (isolated exposures) reported to Texas poison control centers from 1999 to 2004. The mean dose was 701 mg. The patient age distribution was 5 / 5 years (48%), 6 / 19 years (8%), and 20 years (44%). In 78% of cases, exposure was unintentional. Of the exposures, 74% were managed outside of health care facilities. The final medical outcome was classified as no effect for 82% of the cases, and minor effects for 12% of the cases. Adverse clinical effects were listed for 5% of the patients, the most frequently reported being rash (3%), drowsiness (3%), pruritis (2%), and vomiting (2%). The most frequently listed treatment was decontamination by dilution (43%) or food (32%). The majority of isolated celecoxib exposures could be managed outside of health care facilities, and the outcome was generally favorable.

scholarly journals A Retrospective Study of Clinical Effects of Powdered Caffeine Exposures Reported to Three US Poison Control Centers

2016 ◽  
Vol 12 (3) ◽  
pp. 295-300 ◽  
Author(s):  
Gillian A. Beauchamp ◽  
Amberly R. Johnson ◽  
Barbara I. Crouch ◽  
Matthew Valento ◽  
B. Zane Horowitz ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Poison Control ◽  
Clinical Effects ◽  
Poison Control Centers

Cases of pediatric ingestion of celecoxib reported to Texas poison control centers in 2000–2007

2009 ◽  
Vol 28 (4) ◽  
pp. 191-194 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Abdominal Pain ◽  
Healthcare Facility ◽  
Poison Control ◽  
Minor Effect ◽  
Clinical Effects ◽  
Medical Outcome ◽  
Clinical Factors ◽  
Poison Control Centers

Little data exist regarding pediatric celecoxib ingestions. This study described the pattern of pediatric celecoxib ingestions reported to poison control centers. Cases were isolated celecoxib ingestions by patients aged 0–5 years during 2000–2007 reported to Texas poison control centers. The distribution of cases was described with respect to demographic and clinical factors. Of the 177 total patients, dose ingested in milligrams was reported for 92 patients. Mean reported dose was 305.5 mg (range 10–2300 mg). Of those 92 cases, distribution by management site was 89.1% on site, 6.5% already at/en route to healthcare facility and 4.3% referred to healthcare facility. Final medical outcome was no effect for 95.7% cases and minor effect for 4.3% cases. Specific clinical effects reported (in only one case each) were rash, abdominal pain, vomiting, agitation/irritability, and drowsiness. All of the pediatric celecoxib ingestions reported to Texas poison control centers resulted in no or minor effect.

Poison Control Centers' Role in Glow Product-Related Outbreak Detection: Implications for Comprehensive Surveillance System

2009 ◽  
Vol 24 (1) ◽  
pp. 68-72 ◽  
Author(s):  
Alvin F. Chu ◽  
Steven M. Marcus ◽  
Bruce Ruck
Keyword(s):  
Surveillance System ◽  
Emerging Infectious Diseases ◽  
The United States ◽  
Outbreak Detection ◽  
Poison Control ◽  
Surveillance Systems ◽  
Clinical Effects ◽  
Code Number ◽  
Poison Control Centers ◽  
Comprehensive Surveillance

AbstractIntroduction:The development of syndromic surveillance systems to detect bioterrorist attacks and emerging infectious diseases has become an important and challenging goal to many governmental agencies and healthcare authorities. This study utilized the sharp increase of glow product-related calls to demonstrate the utility of poison ontrol data for early detection of potential outbreaks during the week of Halloween in 2007.Methods:A review was conducted of the electronic records of exposures reported to the New Jersey Poison Information and Education System NJPIES) Poison Control Hotline from 2002 through 2007 with generic code number 0201027 (glow products) set by the American Association of Poison Control Centers (AAPCC). Key information such as age, gender, time of the call, exposure reason, clinical effects, and medical outcomes along with telephone number, zip code, and county location were used in the analyses to determine the extent of the outbreak.Results:Analyses included a total of 139 glow product-related calls during the week of Halloween in 2007 with a single-day high of 59 calls on Halloween Day. More than 90% of the glow product exposures were in children 1–10 years of age. The glow product-related calls on Halloween Day increased from 14 calls in 2002 to 59 calls in 2007, a 321% increase during a six-year period.Conclusions:Poison control centers in the United States are equipped with a unique and uniform input data collection system—the National Poison Data System—that provides an important data source in the development of a comprehensive surveillance system for early outbreak detection.

Adult metaxalone ingestions reported to Texas poison control centers, 2000-2006

2009 ◽  
Vol 29 (1) ◽  
pp. 55-62 ◽  
Author(s):  
Mathias B Forrester
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Minor Effect ◽  
Clinical Effects ◽  
Medical Outcome ◽  
Poison Control Centers ◽  
Few Data

Few data exist on potentially adverse metaxalone (Skelaxin®) ingestions in adults. All metaxalone ingestions involving patients aged ≥20 years during 2000-2006 were retrieved from Texas poison control centers. Exclusion criteria were lack of follow-up or multiple substance ingestion. Cases were analyzed for selected demographic and clinical factors. Of the 142 patients, 66.2% were female. Dose ingested was reported for 61 patients. Of those cases with a reported dose, distribution by management site was 29.5% on-site, 59.0% already at/en route to health care facility, and 11.5% referred to health care facility. Final medical outcome was ‘no effect’ for 50.8% cases, ‘minor effect’ for 31.1%, and ‘moderate effect’ for 18.0%. The more common adverse clinical effects reported were drowsiness (27.9%), tachycardia (6.6%), agitation (6.6%), nausea (4.9%), dizziness (4.9%), slurred speech (4.9%), and tremor (4.9%). A moderate medical outcome occurred in 13.6% of ingestions of ≤2400 mg and 20.5% of ingestions of >2400 mg. Management involved a health care facility in 18.2% of ingestions of ≤2400 mg and 100.0% of ingestions of >2400 mg. This study found that adult ingestions of higher doses of metaxalone, particularly >2400 mg, were associated with more serious medical outcomes and were managed at health care facilities. This study also proposes triage guidelines for when ingestions can be safely managed at home.

Immediate- and controlled-release zolpidem ingestions reported to Texas poison centers

2009 ◽  
Vol 28 (8) ◽  
pp. 505-509 ◽  
Author(s):  
Mathias B Forrester
Keyword(s):  
Controlled Release ◽  
Care Facility ◽  
Health Care Facility ◽  
Immediate Release ◽  
Poison Control ◽  
Clinical Effects ◽  
Control Center ◽  
Poison Control Centers ◽  
Poison Centers ◽  
The Mean

Zolpidem is available in immediate-release (IR) and controlled-release (CR) formulations. This investigation examined whether there were differences in zolpidem IR and CR ingestions reported to poison control centers. Zolpidem ingestions that did not involve coingestants reported to Texas poison control centers during 2005-2008 were identified. The ingestions were grouped by IR and CR formulations and compared with respect to demographic and clinical factors. There were 734 IR and 163 CR ingestions. The mean dose ingested was 92.9 mg and 104.6 mg, respectively. IR and CR cases were, respectively, 56.9% and 58.3% male, 54.6% and 49.7% age >19 years, 65.0% and 65.0% already at or en route to a health care facility when the poison control center was contacted, and 30.1% and 39.3% involved no effect. The most frequently reported adverse clinical effects were, for IR and CR, respectively, drowsiness (54.4% vs 42.3%), tachycardia (10.6% vs 11.7%), ataxia (6.3% vs 11.7%), slurred speech (6.3% vs 6.7%), vomiting (5.0% vs 5.5%) and hallucinations/delusions (4.9% vs 3.1%). The distribution of zolpidem IR and CR ingestions reported to Texas poison control centers were similar. However, zolpidem CR ingestions appeared less likely to result in drowsiness and hallucinations but more likely to result in ataxia.

Toxicity of Polysaccharide–Iron Complex Exposures Reported to Poison Control Centers

2000 ◽  
Vol 34 (2) ◽  
pp. 165-169 ◽  
Author(s):  
Wendy Klein-Schwartz
Keyword(s):  
Healthcare Facility ◽  
Iron Complex ◽  
Facility Management ◽  
Poison Control ◽  
Minor Effect ◽  
Poison Center ◽  
Clinical Effects ◽  
Serious Adverse Events ◽  
Poison Control Centers ◽  
Toxic Exposures

OBJECTIVE: To evaluate the toxicity of polysaccharide–iron complex (PIC) exposures reported to poison centers in the US. DESIGN: A retrospective analysis of potentially toxic exposures to PIC without concomitant substances reported to the American Association of Poison Control Centers (AAPCC) Toxic Exposure Surveillance System from 1990 to 1998 was performed. RESULTS: Of 810 potentially toxic exposures to PIC, 55.9% occurred in females, 43.8% in males; in 0.3%, gender was unknown. The majority of exposures (74.4%) involved children under six years of age. The reasons for exposure were: 86.7% unintentional, 11.6% intentional, and 1.6% adverse reaction. The most frequently reported clinical effects attributed to PIC were vomiting (n = 23), diarrhea (10), nausea (11), abdominal pain (10), and lethargy/drowsiness (7). While the majority of exposures were managed outside a healthcare facility, management site varied depending on age (management in non-healthcare facility in 71.8% of exposures in children under six years of age vs. 44.9% in adolescents and adults). The majority of outcomes (95.6%) were no effect, minor effect, unrelated effect, not followed since nontoxic, or not followed since only minimal toxicity possible. Of two cases coded as moderate effect, it could not be determined whether the symptoms were related to PIC in one, and in the second case inspection of the poison center record revealed that the actual outcome was minor effect. There were no major effects or deaths. CONCLUSIONS: There were no serious adverse events following PIC exposure reported to the AAPCC. Although more data are needed, these findings suggest reduced toxicity for PIC relative to other forms of iron.

Human Exposures to N, N-diethyl-m-toluamide Insect Repellents Reported to the American Association of Poison Control Centers 1993–1997

2002 ◽  
Vol 21 (5) ◽  
pp. 341-352 ◽  
Author(s):  
John W. Bell ◽  
Joseph C. Veltri ◽  
Brent C. Page
Keyword(s):  
Adverse Effects ◽  
American Association ◽  
Clear Relationship ◽  
Poison Control ◽  
Clinical Effects ◽  
Multiple Exposure ◽  
Poison Control Centers ◽  
Insect Repellents ◽  
Route Of Exposure ◽  
Exposure Routes

This study analyzed 20,764 exposures involving insect repellants containing N, N-diethyl- m-toluamide (DEET) that were reported to poison control centers from 1993 to 1997. Nearly 70% of the cases reported no symptoms related to the exposure. The occurrence of symptoms was related to the route of exposure, with the highest rates associated with ocular exposures, followed by inhalation, multiple exposure routes, dermal, andingestion. Two deaths were reported, one in a 26-year-old male and one in a 34-year-old female, both following a dermal exposure. Twenty-six subjects experienced major effects. The greatest number of reported exposures involved infants and children, but this group experienced lower rates of adverse effects than teens or adults. There was no clear relationship between DEET concentration and presence or severity of clinical effects. For the cases reported to poison control centers and included in this analysis, the risk of serious medical effects for labeled use of insect repellants containing N, N-diethyl- m-toluamide appears to be low.

scholarly journals Snakebites Reported to the Kentucky Regional Poison Control Centers for the Years 2012-2016

2021 ◽  
Author(s):  
James Buchanan ◽  
Jeffrey Thurman ◽  
Charles Hargis ◽  
Lauren Kirkpatrick ◽  
Martin Huecker
Keyword(s):  
Poison Control ◽  
Poison Control Centers
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