PMID- 28408236
OWN - NLM
STAT- MEDLINE
DCOM- 20180430
LR  - 20180430
IS  - 0736-4679 (Print)
IS  - 0736-4679 (Linking)
VI  - 52
IP  - 6
DP  - 2017 Jun
TI  - Unintentional Pediatric Cocaine Exposures Result in Worse Outcomes than Other
      Unintentional Pediatric Poisonings.
PG  - 825-832
LID - S0736-4679(17)30229-9 [pii]
LID - 10.1016/j.jemermed.2017.03.017 [doi]
AB  - BACKGROUND: Unintentional pediatric cocaine exposures are rare but concerning due
      to potentially serious complications such as seizures, dysrhythmias, and death.
      OBJECTIVES: The objectives were to assess the demographic and clinical
      characteristics of pediatric cocaine exposures reported to the California Poison 
      Control System. METHODS: This is a retrospective study of all confirmed pediatric
      (< 6 years of age) cocaine exposures reported to the California Poison Control
      System from January 1, 1997-September 30, 2010. Case narratives were reviewed for
      patient demographics, exposure details, clinical effects, therapy,
      hospitalization, and final outcome. RESULTS: Of the 86 reported pediatric cocaine
      exposures, 36 had positive urine drug testing and were included in the study
      cohort. The median age at presentation was 18 months (range: 0-48 months), and
      56% were male (n = 20). The most common clinical manifestations were tachycardia 
      and seizures. The most common disposition was admission to an intensive care unit
      (n = 14; 39%). Eleven cases (31%) were classified as having a major effect as per
      American Association of Poison Control Centers case coding guidelines. One child 
      presented in asystole with return of spontaneous circulation after
      cardiopulmonary resuscitation and multiple vasoactive medications. The proportion
      of cocaine exposures with serious (moderate or major) outcomes (66.7%; 95%
      confidence interval 50.3-79.8%) was higher than other pediatric poisonings
      reported to the American Association of Poison Control Centers during the study
      period (0.88%; 95% confidence interval 0.87-0.88). CONCLUSIONS: Although
      pediatric cocaine exposures are rare, they result in more severe outcomes than
      most unintentional pediatric poisonings. Practitioners need to be aware of the
      risk of recurrent seizures and cardiovascular collapse associated with cocaine
      poisoning.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Armenian, Patil
AU  - Armenian P
AD  - Department of Emergency Medicine, University of California, San Francisco-Fresno,
      Fresno, California.
FAU - Fleurat, Michelle
AU  - Fleurat M
AD  - California Poison Control System, San Francisco Division, Department of Clinical 
      Pharmacy, School of Pharmacy, University of California, San Francisco, San
      Francisco, California.
FAU - Mittendorf, George
AU  - Mittendorf G
AD  - Department of Emergency Medicine, University of California, San Francisco-Fresno,
      Fresno, California.
FAU - Olson, Kent R
AU  - Olson KR
AD  - California Poison Control System, San Francisco Division, Department of Clinical 
      Pharmacy, School of Pharmacy, University of California, San Francisco, San
      Francisco, California.
LA  - eng
PT  - Journal Article
DEP - 20170410
PL  - United States
TA  - J Emerg Med
JT  - The Journal of emergency medicine
JID - 8412174
RN  - 0 (Anticonvulsants)
RN  - 0 (Antidotes)
RN  - 16291-96-6 (Charcoal)
RN  - I5Y540LHVR (Cocaine)
SB  - IM
CIN - J Emerg Med. 2018 Aug;55(2):266. PMID: 29871830
MH  - Anticonvulsants/therapeutic use
MH  - Antidotes/therapeutic use
MH  - Arrhythmias, Cardiac/etiology
MH  - California/epidemiology
MH  - Cause of Death
MH  - Charcoal/therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Cocaine/adverse effects/*poisoning
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Poison Control Centers/statistics & numerical data
MH  - Poisoning/*epidemiology/etiology
MH  - Retrospective Studies
MH  - Seizures/etiology
OTO - NOTNLM
OT  - cocaine
OT  - pediatric poisonings
OT  - poison control centers
OT  - toxicology
EDAT- 2017/04/15 06:00
MHDA- 2018/05/01 06:00
CRDT- 2017/04/15 06:00
PHST- 2016/12/13 00:00 [received]
PHST- 2017/02/20 00:00 [revised]
PHST- 2017/03/08 00:00 [accepted]
PHST- 2017/04/15 06:00 [pubmed]
PHST- 2018/05/01 06:00 [medline]
PHST- 2017/04/15 06:00 [entrez]
AID - S0736-4679(17)30229-9 [pii]
AID - 10.1016/j.jemermed.2017.03.017 [doi]
PST - ppublish
SO  - J Emerg Med. 2017 Jun;52(6):825-832. doi: 10.1016/j.jemermed.2017.03.017. Epub
      2017 Apr 10.