LAUSR

BACKGROUND Poisoning is one of the leading causes of childhood morbidity and mortality worldwide. Despite the advancement of poison detection by modern investigation methods, the clinical skill of toxidrome recognition by combining the findings from a detailed history, thorough physical examination, and the results of basic investigations is still indispensable for the management of children with suspected poisoning. OBJECTIVE To review pediatric toxidromes and poisoning management. METHODS A literature search was conducted on PubMed (between February 1 and 15, 2020) with keywords of 'toxidrome' 'poisoning' 'intoxication" "children" and 'pediatric'. The search was customized by applying the appropriate filters so as to get the most relevant articles to meet the objective of this review article. RESULTS Toxidrome recognition may help to offer a rapid guide to possible toxicology diagnosis, so that specific antidote can be administered in a timely manner. This article discusses a few commonly encountered toxidromes in pediatric poisoning, with an emphasis on the symptomatology and source of exposure. The antidote and specific management for each toxidrome are also discussed. Although most patients with intoxication can be managed with close observation, supportive measures and antidote treatment, it is unfortunate that antidotes are only available for a limited number of poisons responsible for intoxication. Extracorporeal toxin removal is being increasingly recognized as a mode of treatment in patients with rapid deterioration of the clinical condition who are unresponsive to conventional management. The decision of applying such technique and the choice of removal modality are frequently individualized due to the paucity of high-level evidence. Various patient and toxin/medication factors involved in the decision-making process are discussed. CONCLUSION Poisoning is a common cause of pediatric accident and injury. Physicians should be familiar with common toxidromes and poisoning management.