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Handbook of Common Poisonings in Children. INSTITUTION Food and Drug Administration (DREW), Washington, D.C

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O DOCUMENT BESUME ED 144 708 PS 099 577 $ ...,, / 1.- . ,TITLE - Handbook of CommOn Poisonings in Children. INSTITUTION Food and Drug Administration (DREW), Washington, D.C. " fEPORT NO , HEW-FDA-707004 pus DATE /6, ' NOTE -114p. ,.. 1 AyAILABLEFRO!! Superintendent of Documents, U.S. Government Printing ..... Office, Washington, D.C. 20402 (Stock No. 017-C12-0024074, $1.50) . EDRS PRICE NF -$0.83 HC-$6.01. Pins Postage. DESCRtPTORS Accident Prevention;*Children;Emergency'SqUad Personnel; *Governm'ent Publications; icGuidaS; Hospital Pe onnel; Pharmacists;- Physicians;_ *Reference Bo ks IDENTtFIERS, *Poisoning ABSTRACT This handbook for physicians, emergency room. personhel and pharmacists lists- the manufacturer, descriptiOn, / toxiaity, symptoms and findings, treatment, and references.for-73 . / poison substances considered by the Subcommittee on 1Ccidental 1 Poisoning of the American-Academi% of'Pediatrics to be most significant in terms of accidental poisoning of.ehildFen.' (BF) 1 *****************************f**************,************************** * .DOcuments acquirNd by ERIC inclUde many inforMal unpublished *. * materials not available from other-sources. ERIC makes every effort * * to obtain the'best copy available. Nevertheless, items of marginal * * reproducibility are often encountered and this affects the quality * *sof the 'microfiche and hardcopy reproddctions ERIC makes available * via the ERIC Document (reproduction Service (EDRS) .EDRS is not . * * responsible for the quality bf the original document. Reproductions * . *.supplied by EDRS, are the best that can beemade from the 'original. ******************41********r****************************************** U.S. DEPARTtAENT OF HEALTH, EDUCATION, AND WELFARE Public vice/Fo©d and Drug Administration 5600Fi Rockville, Maryland 20857 HEW (FDA) 16-7004 , , , Handbook of # ,. Common Poisonings in Children 1976,. 0 r FDA 4,1 . For we by the 044rorinlyndsrot el Deoumenes. UAL GoesnmentPr Irdine 0111a4 Waal linglon. 0 C. 20502- Pr10. $1 50 Stock No. 017-012-00010-4 FOREWORD' One of the basic missions of the Foodand Drug Ackninistra- tion is preventive medicine. The Agency seeks to prevent injury and illness from harmful substances in the foods we eat; from drugs that may produce more risk than benefit; from unsafe med- lel devices; from dangerous sources of 'radiation; and from im- pure vaccines and blood destined for transfusion. All these pro. grams are designed to protect the consumer against products that. are supposed to be safe but Sometimes are not due to laws in design and development, manufacture, or processing. All these programs wotect children as well as adults. There is, however, another clasf.13f.--,hazard involving children concerning which even our t efforts at preyention are insufficient. This class consists of ucts that are either not intended to be con- sumed, or arei ended to be consumed in small amounts, but which, nonetheless, are consumed by children hundreds of thou- sands of times a yearfar too often with fatal results. When a child's natural Curiosity, his desire to eat, and his lack of a well developed, protective sense of taste'and snnil lead to ingestion of a chemical 'ftlastante,itis of vital importance- thaiinformation concerning toxicology of such chemicalsbe readily available tophysitian, pharmaci/.st, and parent alike. Recognizing that a"child's desire to explore every facet of his or her universe has too often led to tragedy, the Food and Drug Administration has published this Handbook of Acute.Common Poisonings in Children from materals provided by the American Academy of Pediatrics. -Although limited to 73 toxic substances out of the thousands of potential hazards, these 73 are by far the nika significant in terms of accidental poigoning of children. Therefore, the avail- ability of the data in this book can materially speed the- proper response when a child' is exposed to a toxic chemical, at a time when speed is of basic importance. , . Alexander M. Schmidt Commissioner of Food and 1Drugs s 4 /c 1 American Academy of Pediatrict SUBCOMMITTEE ON ACCIDENTAL POISONING "1973 -1976 Lorne K. Garrettson; Chairman, 1975 . ,Editor Paul A. Palmisano, M.D., Chairman, 1973-1975, Robert G. Scherz, M.D., Chairman, 1971=1973, ,Henri J. 'Breault, M.D. Virginia G. tfarris, M.D. Elizabh-S. Hillman, M.D. Francis X. Lieb, M.D. Raymond Chi Wing Ng, M.D. Hugo Dunlap Smith, M.D. Sorrell Wolfson, M.D1 LiaisOn John J. Crotty, M.D., National Clearinghouse for Poison' Control Centers. 1 COLLABORATORS The Subcommittee on Accidental Pdisoning of the Amj can Academy of P'ediatrics acknowledges with sincere gratit s the collaboratdrs/consultants who gave freely of their time effort iu reviewingand revising the data in this booklet., Carol R. Angle, M.D., Omaha, Nebraska Jay M. Arena, m.o.., Durham, North Carolina . Narvel Black, R.Ph., Birmingham, Alab a J. Julian Chisolm, M.D., Baltimore, M RobertEl Clark,R.Ph., Birmingham, ama Sanford N. Cohen; M.D.,, Detroit, Michin Joel H..Dobbs, R.Ph.,-Birminghani, bania Nortriarr Eade, Ph.D.,/ M.D., Mont , Quebec Eharles A. Green,'Jr7, R.A., Birm'gham, Alabama Thomas W. R.Ph.,'rmingham, Alabama Joseph Greesher/n .D., East eadoW, New York Matilda S. McI tire,IM.D., aha, Nebraska Marshall Me ell. h., Binghani, Alabama Howard C. ofenso ., Mineola, New York Julia F.orton, M Florida Jame! R. Reed, Pl". Biymingham,;Alabarna Thomai E. Reic fer; M.D., Annapolis, Maryland Barry/H. RumackM.D., Denver, Colorado a"' Hayiy C. ShirkeyM.D.., New Orleans, Louisiana vnOtany,.Ph.,,Richmond, Virginia James L. Talbert, M.D., Gainesville, Florida ,L.H.S.Van ,Mierop, kD., Gainesville,' Florida Ther.Subdornmittee also wishes to thank ,Sandra A. Anderson, Baal°, New York', for assistance with the bibliography andRo- ben M. Smith, Birmingham, Alabama, for technical assistance. 7 i ... a 4 CONTENTS Introduction vii i General Management of Acute Poisonings ,. 1. Acetone '3 Alkali ) 5 Amphetanine 6 Arsenic 8 Atropine , 1r 9 Barbiturates / 111 s Ben Oay Ointment , ' 13 BetiChlor * .. r 14 Campho-Phenique 15 Camphor 16 Chlordane 17 Chlorine Gas 18 Clorox, . 29 Cologne 21 Congesprin 21 Contac Dalmane (Flurazepam HCI) 113 Dp-von Products 24 dCON Rat Poisorf 26. DDT 27 Demerol 28 Detergent, Dishwasher 29 - Diazinon , 30 Digitalis and Digitalis Glycosides. 32 r Dilantin N. 35 Diphenhydramine Hydrochloride (Benadryl) 36 Donnatal Products 38 Doriden , , 40 Drano Granules 41 Elavil ., 4,2 Ethyl Alcohol , . 44 Ethylene Glycol 45 Etrafon 46 Hydrogen Peroxide , 47 Iron Salts 48 Isoniazid 50 Isopropyl Alcohol 51 Kerosene and kelated Petroleum Distillates 52 Lead . _ 54 Librium - .1 4 57 Lomotil . - - 58 '7 1. 4 ,'/.t A, . LSX., LSD-25 59, Lysol' Liquid Disinfectant Toilet Boit,1 Cleaner 4, 60 Malathion I 61 Meprobamate 62 Mercury, Mercury Salts #4 64 Mescaline 66 Methadone 67 e Methaqualone 68 4 Methyl Alcohol 69 Multivitamins with nerals 71 Naphthalene 73 No Doz . k 74 Noludar - 74 Nytol\ \.: 75 Old English Furniture and Scratch Cover Polish " 76 / Paradichlorobenzene 76 Phenothiazine Tranquilizers 77 Philodendron , 79 Pine-Sol 80 Placidyl 81 Preludin , .82 Salicylates 82 Serax 85 Sinequan 85 Sominex . -77. ......... f 87 Talwin . 89 Testor Cements for Models 9,0 Thyroid, Dessicattel 91 Tofranil, 92 Toluene 94 Turpentine . I . 95 Valium 96 / 8 1 A INTRODUCTION Several years ago the Commktee on Accident Preventio9, of the .1merican Academy Of Pediatrics began to .explore the pos- sibility of -producini'a practical hanclYriok on acute poisoning in 4 children. The Subcommittee on Accidellital Poisoning was assigned the task of preparing the handbook. A number of formats were studied. TheSubconmittee decided that is was not necessary td, compete with several good/ current handbooks and texts' on clini- cal toxicology- and poisoning, despite -the absence of a book ex- clusively concerned with children.- Eventually,thishandbook emerged. ' .- Through the cooperation of theNational Clearinghouse for , Poison Control Centers, a list of the 200, most commonly reported toxic substances was provided. The Subcommittee added a few' other common poisons to this list then chose the 73 iternetvon- tained in this handbook. For more than 15 sears the National Clearinghouse for Poison Control Centers has provided Poisons Control Centersinthe United States with file cards containing brief descriptions, toxicity data, clinical signs and symptoms, and treatment for intoxications caused. by most drug's and many other chemical agerits. Using the basic text of these cards, 'the Subcommittee, with the magtani- vtmous assistance of many experts throughout this country and Ca- nada, produced this handbook. All of the cards were reviewed and most were extensively edited; some were entirely rewritten. Many new literature references were added and, wherever possible, spe- cial emphasis en treating the pediatric patient was made. The Subcommittee belie's/es that, in many areas, 70 to 80% at the calls regarding toxic episodes in children will be reflected by the items listed in this handbook. In a sense this handbook is a "pocket poison information center," and itis designed to help, pediatricians, other primary physicians, emergency room' perion- nel, and pharmacist it is not 'intended to be used in a vacuum. The individual confronted with a poisoned patient should employ all necessary resources available: basic clinical judgment, other texts, poison information centers, and appropriate consultants. This handbook puts 73 of the most commonly consulted index cards in poison' information
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