V. Popescu *
* Prof. dr. Valeriu Popescu, Clinica de Pediatrie, Spitalul clinic de copii “Dr. V. Gomoiu”
Abstract
Children’s poisoning is one of the most important problems in pediatric practice. Because of its increasing frequency, great severity and certain difficulties of diagnosis and treatment, acute poisoning in children continues to be a great challenge for pediatricians. The great progress in science and technology and the important development of chemical and pharmaceutical industries in all countries during the last decades, led to the increase of the number and widespread of medicines easily available, often kept in the house or used without medical prescription. This explains the extensive epidemiological and social dimensions of poisonings in children nowadays and their overall increasing incidence. The article presents briefly the epidemiology, diagnosis and evaluation of severity in children’s poisoning. The determination of the degree of severity of poisoning is important (patients is unstabilized or decompensated status and patients in stabilized status) in order to make the therapeutic decision. General therapeutic measures in severe poisonings are largely discussed: • supportive therapy for mainta ining respiration, circulatio,n metabolic balance (NaHCO, KCI etc.); • removal of ingested poison (to prevent absorbtion): inducing emesis (ipeca, apomorphine), gastric lavage, activated charcoal, cathartics; • endogenous elimination of ingested poisons: forced diuresis, alakalinization or acidification; • exogenous elimination of ingested poisons: peritoneal dialysis, hemodialysis, activated charcoal hemoperfusion or cation exchange resin hemoperfusion, plasmaferesis, exchange transfusion; • aditional measures: antidotes, chelators, enzimatic blockers etc.