ABSTRACT
Table 23.3 Substances Most Frequently Involved in Human Exposure Table 23.4 Categories with Largest Numbers of Deaths Table 23.5 Distribution of Route of Exposure for Human Poison Exposure
Cases and 764 Fatalities Table 23.6 Distribution of Reason for Exposure by Age Table 23.7 Distribution of Reason for Exposure and Age for 764
Fatalities Table 23.8 Number of Substances Involved in Human Poison Exposure
Cases B. Pediatric Poisonings
Table 23.9 Reported Poison Exposures in Children Younger than 6 years of Age, 1985 through 1989
Table 23.10 Pediatric Pharmaceutical Ingestion Fatalities: 1983-1990 Table 23.11 Pediatric Nonpharmaceutical Ingestion Fatalities: 1983-1990 Table 23.12 Ingestions of Solid Prescription Drugs, by Age of Victim Table 23.13 Ingestions of Solid Prescription Drugs, by Container Type Table 23.14 Leading Solid Prescription Drugs Ingested, Resulting
in Hospitalization Table 23.15 Owner of Medication Ingested Table 23.16 Container Type and Ownership of Medication Table 23.17 Risk Factors Involved in Drug Poisoning in Children 0 to
17 Years C. Adolescent Toxic Exposures
Table 23.18 Drug-Related Fatalities by Drug Class among Adolescents 11 to 17 Years Old Reported to the American Association of Poison Control Centers in 1989, 1990, and 1991
D. Poisoning in the Elderly Table 23.19 Distribution of Age and Sex for 764 Fatalities Table 23.20 Annualized Poisoning Hospitalization Rates and Relative
Risks, Massachusetts 1982-1985 Table 23.21 Annualized Poisoning-Related Death Rates and Relative Risks,
Massachusetts 1983-1985
Section 4. Management Trends Table 23.23 Therapy Provided in Human Exposure Cases Table 23.24 Ipecac Administration by Site and Age Table 23.25 Decontamination Trends
Section 5. Role of the Toxicology Laboratory Table 23.26 Common Drugs Included on Most Toxicology Screens Table 23.27 Types of Medical and Toxicological Test Situations Table 23.28 Some Common Clinical Presentations and Differential
Diagnoses in Overdose Table 23.29 Toxicological Syndromes by Class of Drugs Table 23.30 Useful Laboratory Tests in Toxicological Diagnosis Table 23.31 Comparison of Generic Toxicological Methods Table 23.32 Potential Interferences for Quantitative Serum Drug Tests
Used in Emergency Toxicology Section 6. Role of the Poison Control Center
Table 23.33 Site of Caller and Site of Exposure to Human Poison Exposure Cases
Table 23.34 Symptom Assessment at the Time of Initial Call to Poison Center
Table 23.35 Management Site of Human Poison Exposure Cases Table 23.36 Medical Outcome of Human Poison Exposure Cases by
Patient Age Table 23.37 Distribution of Medical Outcome by Reason for Exposure for
Human Poison Exposure Victims Section 7. Contemporary Issues
Table 23.38 Nationwide Poison Control Centers — Directory References
Nearly two million human poisonings are reported to poison information centers each year; however, there are an estimated 2 to 3 million additional unreported exposures.1 The purpose of this chapter is to review the epidemiological characteristics of human poisoning, clinical toxicology research designs, and general management techniques of the acutely poisoned patient. In addition, the role of the poison control centers in managing these patients and several contemporary issues in clinical toxicology are discussed.
