Pediatric emergency care
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With the increase in popularity of adult methamphetamine abuse in the state of Arizona, there has been an increase in the number of pediatric admissions from inadvertent methamphetamine poisoning. This report describes the signs and symptoms and the hospital course of pediatric patients inadvertently poisoned with methamphetamine. A nine-year retrospective chart review identified 18 pediatric patients poisoned only with methamphetamine. ⋯ Three patients received Centruroides sculpturatus antivenin intravenously. The most common complication of methamphetamine poisoning was rhabdomyolysis (two patients), and the average hospital stay for all patients was three days. This case series demonstrates that pediatric patients who ingest methamphetamine can present with signs and symptoms similar to those of an abdominal or neurologic pediatric emergency.
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Carbon monoxide (CO), a colorless, odorless gas, accounts for the majority of fatal poisonings in the United States. To date, few screening studies that evaluate pediatric exposure are available. The objectives of this study were to determine the value of a CO breath analyzer for detecting pediatric CO exposure and to identify potential CO sources. ⋯ 1.9% (9/470) of patients had elevated breath CO levels and COHb levels by cooximetry. Putative sources of CO exposure were active cigarette smoking for five patients and a faulty furnace in the home for one patient. On the basis of the history, we believe environmental tobacco smoke or automobile exhaust or both contributed to the elevated COHb levels in the other three patients. There was a good correlation between COHb by cooximetry and breath analysis (concordance correlation = 0.739) CONCLUSION: Breath analysis for CO is a convenient tool to estimate exposure and identify older children at risk.