Acute Valproic Acid Poisoning in Young Children

Lifshitz, Matitiahu; Gavrilov, Vladimir

doi:10.1177/875512250101700406

Cited by 15 publications

(29 citation statements)

References 12 publications

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“…The remainder were from Saudi Arabia[55], Spain[38], UK[50, 53], Canada[56], Israel[44, 58, 60], France[41, 47, 66], Australia[30, 45], China[46] and South Korea[67]. Only one studied formal carers, i.e.…”

Section: Resultsmentioning

confidence: 99%

Carers' Medication Administration Errors in the Domiciliary Setting: A Systematic Review

et al. 2016

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PurposeMedications are mostly taken in patients’ own homes, increasingly administered by carers, yet studies of medication safety have been largely conducted in the hospital setting. We aimed to review studies of how carers cause and/or prevent medication administration errors (MAEs) within the patient’s home; to identify types, prevalence and causes of these MAEs and any interventions to prevent them.MethodsA narrative systematic review of literature published between 1 Jan 1946 and 23 Sep 2013 was carried out across the databases EMBASE, MEDLINE, PSYCHINFO, COCHRANE and CINAHL. Empirical studies were included where carers were responsible for preventing/causing MAEs in the home and standardised tools used for data extraction and quality assessment.ResultsThirty-six papers met the criteria for narrative review, 33 of which included parents caring for children, two predominantly comprised adult children and spouses caring for older parents/partners, and one focused on paid carers mostly looking after older adults. The carer administration error rate ranged from 1.9 to 33% of medications administered and from 12 to 92.7% of carers administering medication. These included dosage errors, omitted administration, wrong medication and wrong time or route of administration. Contributory factors included individual carer factors (e.g. carer age), environmental factors (e.g. storage), medication factors (e.g. number of medicines), prescription communication factors (e.g. comprehensibility of instructions), psychosocial factors (e.g. carer-to-carer communication), and care-recipient factors (e.g. recipient age). The few interventions effective in preventing MAEs involved carer training and tailored equipment.ConclusionThis review shows that home medication administration errors made by carers are a potentially serious patient safety issue. Carers made similar errors to those made by professionals in other contexts and a wide variety of contributory factors were identified. The home care setting should be a priority for the development of patient safety interventions.

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Section: Resultsmentioning

confidence: 99%

Carers' Medication Administration Errors in the Domiciliary Setting: A Systematic Review

et al. 2016

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“…Similar to previous studies, we found that most of the children exposed to poisons were younger than 5 years; the majority were boys, [8][9][10] and most of the poisoning occurred at the child's own home. [10][11][12][13] As in those studies, [8][9][10][11][12][13] medication (mainly minerals, vitamins, analgesics, and anti-inflammatory drugs) and household products were the most common poisoning agents.…”

Section: Discussionmentioning

confidence: 98%

Unintentional Childhood Poisoning in the Sharon Area in Israel

Uziel¹,

Adler²,

Aharonowitz³

et al. 2005

Pediatric Emergency Care

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In children with an unequivocal choking event while eating even with normal physical and radiographic findings, FBA requires to be excluded by thorough investigations in such instances. Similarly, in toddlers with unexplained persistent cough with refractory parenchymal infiltrates, unrecognized FBA should also be considered. A witnessed choking event is the most important historical information to make an early diagnosis of FBA.

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“…Despite a number of public health interventions over the past 40 years, poisonings from prescription medications continue to be a major cause of morbidity among children. [1][2][3][4][5] Interventions have included educational campaigns on safe medication storage and the introduction of child-resistant closures on adult prescription medication bottles. Although these measures are credited in part with reducing overall deaths from medication poisoning in children, visits to emergency departments (EDs) for medication exposures are increasing.…”

Section: Discussionmentioning

confidence: 99%

Adult Prescription Drug Use and Pediatric Medication Exposures and Poisonings

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Medication ingestions are increasing among children despite a number of public health interventions. The majority of these poisonings are related to prescription as opposed to over-the-counter medications. WHAT THIS STUDY ADDS:Rising rates of poisonings in children are strongly correlated with rising use of hypoglycemics, antihyperlipidemics, b-blockers, and opioids among adults. These events are associated with considerable health care utilization, both in terms of emergency department visits and hospital admissions. abstract BACKGROUND AND OBJECTIVES: Nontherapeutic medication ingestions continue to be a major pediatric health problem, with recent increases in ingestions despite a number of public health interventions. It is unknown how changes in adult prescription drug use relate to pediatric medication poisonings. The objective of the study was to measure the association between changing adult prescription drug patterns and pediatric medication exposures and poisonings and identify high-risk classes of medications and pediatric age groups. METHODS:We measured monthly pediatric exposures and poisonings using the National Poison Data System and prescriptions written for adults using the National Ambulatory Medical Care Surveys for 2000 through 2009. Associations between adult prescriptions for oral hypoglycemics, antihyperlipidemics, b-blockers, and opioids and exposures and poisonings among children 0 to 5, 6 to 12, and 13 to 19 years were analyzed by using multiple time-series analysis. Emergency department visits, serious injuries, and hospitalizations stemming from these associations were described.RESULTS: Adult medication prescriptions were statistically significantly associated with exposures and poisonings in children of all ages, with the strongest association observed for opioids. Across medications, the greatest risk was among children 0 to 5 years old, followed by 13-to 19-year-olds. Rates of emergency department visits were highest for events related to hypoglycemics (60.1%) and b-blockers (59.7%), whereas serious injuries and hospitalizations occurred most frequently with opioids (26.8% and 35.2%, respectively) and hypoglycemics (19.5% and 49.4%, respectively). CONCLUSIONS:Increasing adult drug prescriptions are strongly associated with rising pediatric exposures and poisonings, particularly for opioids and among children 0 to 5 years old. These associations have sizable impacts, including high rates of serious injury and health care use. Dr Burghardt contributed to study conception and design, data acquisition, analysis and interpretation of data, drafting, and revising the article; Dr Ayers contributed to data acquisition, analysis and interpretation of data, and revising the article; Dr Brownstein contributed to study conception and design, data acquisition and analysis, and revision; Dr Bronstein contributed to study conception and design and revision; Dr Burns Ewald contributed to study conception and design, data acquisition, and revision; and Dr Bourgeois con...

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Acute Valproic Acid Poisoning in Young Children

Cited by 15 publications

References 12 publications

Carers' Medication Administration Errors in the Domiciliary Setting: A Systematic Review

Carers' Medication Administration Errors in the Domiciliary Setting: A Systematic Review

Unintentional Childhood Poisoning in the Sharon Area in Israel

Adult Prescription Drug Use and Pediatric Medication Exposures and Poisonings

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