The Poison Lab

Episode #3- Toddler Time Bombs (Poison Center Triage)

Episode Summary

Ryan and Toxo cover some topics off the "one pill can kill" list, try breaking down the toxic mechanism of opioid induced respiratory depression in a simplistic way (but maybe fail), and walk through the triage and management of poison center case where a child was "potentially" exposed to a lethal toxin at home.

Episode Notes

• Case report from beginning of show
  • https://pediatrics.aappublications.org/content/130/6/e1700
• "One Pill Can Kill Resources"
  • http://missouripoisoncenter.org/wp-content/uploads/2015/02/2011-One-Pill-Can-Kill.pdf
  • https://pubmed.ncbi.nlm.nih.gov/16419734/
  • https://www.healthychildren.org/English/safety-prevention/at-home/medication-safety/Pages/Poison-Prevention-One-Pill-Can-Kill.aspx
• Respiratory centers and the effects drugs can have on them
  • https://www.ncbi.nlm.nih.gov/books/NBK482414
• Buprenorphne studies
  • Epidemology
    • AAPCC Annual report 
      • https://pubmed.ncbi.nlm.nih.gov/31752545/ 
    • Trends in opioid exposures in pediatrics
      • https://pubmed.ncbi.nlm.nih.gov/32178937/
    • Trends in ED visits for unsupervised medication exposures
      • https://pubmed.ncbi.nlm.nih.gov/26347435/
  • Exposure Studies
    • US Poison center data
      • https://pubmed.ncbi.nlm.nih.gov/29941678/
    • Harvard EM group-
      • https://pubmed.ncbi.nlm.nih.gov/27756148/
    • MD Poison center/RADARS data
      • https://pubmed.ncbi.nlm.nih.gov/18381506/
    • ICU exposures
      • https://pubmed.ncbi.nlm.nih.gov/20921918/
• Triage questions
  • Symptoms
  • Causative agent + Characteristics of exposure (qty ingested/scenario)
  • History (past medial, weight, how long ago was exposure)
  • Onset (when should we expect symptoms)
  • Labs (conduct toxin specific toxicity assessment)
  • Aggravating/Remitting factors (what has been done already that has made it better or worse?)