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2018 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 36Th Annual Report

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2018 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 36Th Annual Report Clinical Toxicology ISSN: 1556-3650 (Print) 1556-9519 (Online) Journal homepage: https://www.tandfonline.com/loi/ictx20 2018 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 36th Annual Report David D. Gummin, James B. Mowry, Daniel A. Spyker, Daniel E. Brooks, Michael C. Beuhler, Laura J. Rivers, Heba A. Hashem & Mark L. Ryan To cite this article: David D. Gummin, James B. Mowry, Daniel A. Spyker, Daniel E. Brooks, Michael C. Beuhler, Laura J. Rivers, Heba A. Hashem & Mark L. Ryan (2019) 2018 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 36th Annual Report, Clinical Toxicology, 57:12, 1220-1413, DOI: 10.1080/15563650.2019.1677022 To link to this article: https://doi.org/10.1080/15563650.2019.1677022 Published online: 21 Nov 2019. Submit your article to this journal Article views: 278 View related articles View Crossmark data Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=ictx20 CLINICAL TOXICOLOGY 2019, VOL. 57, NO. 12, 1220–1413 https://doi.org/10.1080/15563650.2019.1677022 NPDS REPORT 2018 2018 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 36th Annual Report David D. Gummin MDa, James B. Mowry PharmDb, Daniel A. Spyker PhD, MDc, Daniel E. Brooks MDd, Michael C. Beuhler MDe, Laura J. Rivers BSf, Heba A. Hashem MSg and Mark L. Ryan PharmDh aWisconsin Poison Center, Department of Emergency Medicine, Section of Medical Toxicology, Medical College of Wisconsin, Milwaukee, WI, USA; bIndiana Poison Center, Indianapolis, IN, USA; cDepartment of Emergency Medicine, Oregon Poison Center, Oregon Health & Science University, Portland, OR, USA; dDepartment of Medical Toxicology, Banner University Medical Center - Phoenix, Phoenix, AZ, USA; eNorth Carolina Poison Control, Atrium Health, Charlotte, NC,USA; fCiber Global, Troy, MI, USA; gAmerican Association of Poison Control Centers, Alexandria, VA, USA; hDepartment of Emergency Medicine, Section of Clinical Toxicology, Louisiana State University Health Sciences Center, Shreveport, LA, USA Table of contents Introduction . 1224 What’s new in this year’s report? .......................................................................................1224 The NPDS products database...........................................................................................1224 Methods................................................................................................................1224 Characterization of participating poison centers and population served .....................................................1224 Encounter management – specialized poison exposure emergency providers ................................................1224 NPDS – near real-time data capture ....................................................................................1225 Annual report case inclusion criteria ....................................................................................1225 Statistical methods ....................................................................................................1225 NPDS surveillance .....................................................................................................1225 Emerging trends ......................................................................................................1226 Fatality case review and abstract selection ..............................................................................1228 Pediatric fatality case review ...........................................................................................1229 Results .................................................................................................................1230 Information requests to poison centers ..................................................................................1230 Exposure cases logged at poison centers ................................................................................1231 Age and gender distributions ...........................................................................................1233 Caller site and exposure site ...........................................................................................1233 Exposures in pregnancy................................................................................................1233 Chronicity ............................................................................................................1234 Reason for exposure...................................................................................................1235 Scenarios .........................................................................................................1235 Reason by age.....................................................................................................1235 Route of exposure.....................................................................................................1235 Clinical effects ........................................................................................................1235 Case management site ................................................................................................1235 Medical outcome .....................................................................................................1236 Decontamination procedures and specific antidotes ......................................................................1236 Top substances in human exposures ....................................................................................1238 Changes over time ....................................................................................................1239 Emerging trends – adolescent intentional – suspected suicides .............................................................1241 Distribution of suicides ................................................................................................1242 Plant exposures .......................................................................................................1242 Deaths and exposure-related fatalities...................................................................................1243 All fatalities – all ages ..............................................................................................1243 Pediatric fatalities – age 5 years ..................................................................................1244 Pediatric fatalities – ages 6–12 years .................................................................................1244 Adolescent fatalities – ages 13–19 years ..............................................................................1245 Pregnancy and fatalities ............................................................................................1245 AAPCC surveillance results .............................................................................................1245 Discussion . 1245 CONTACT David D. Gummin [email protected] American Association of Poison Control Centers 515 King Street, Suite 510, Alexandria, VA 22314, USA This article was originally published with errors, which have now been corrected in the online version. Please see Correction (http://dx.doi.org/10.1080/ 15563650.2020.1722486) ß 2019 American Association of Poison Control Centers CLINICAL TOXICOLOGY 1221 Summary...............................................................................................................1246 Disclaimer . 1246 Declaration of interest . 1246 References . 1246 Appendix A: Acknowledgments . 1247 Poison centers (PCs) ...................................................................................................1247 AAPCC fatality review team ............................................................................................1249 AAPCC micromedex joint coding group ..................................................................................1249 AAPCC rapid coding team .............................................................................................1249 AAPCC surveillance team ..............................................................................................1249 Regional poison center fatality awards ..................................................................................1249 Appendix B: Data definitions . 1250 Reason for exposure...................................................................................................1250 Medical outcome .....................................................................................................1250 Relative contribution to fatality (RCF) ...................................................................................1251 AppendixC:Abstractsofselectedcases...................................................................................1251 Selection of abstracts for publication ....................................................................................1251 Abstracts .............................................................................................................1251 Abbreviations & Normal Ranges ........................................................................................1262 Appendix D: Table 21. Listing of fatal nonpharmaceutical and pharmaceutical exposures . 1265 Appendix E: Table 22(A) & Table 22(B), Demographic profile of SINGLE SUBSTANCE exposure cases by generic category . 1382
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