Mohammadi Ghahdarijani Fahimeh1, Ghodousi Arash*2, M.D, Gheshlaghi Farzad, M.D3
Purpose: Poisoning is a major cause of hospitalization and death in children. It is mainly cause by the accidental use of toxic substances and drugs. Prognosis depends on many factors. This study investigated the prognosis of poisoned children based on the provided nursing care.
Methods:This cross-sectional study was conducted on medical records of 93 children poisoned with methadone (selected through census) who were hospitalized and treated in Imam Hussein and Noor and Ali Asqar Hospitals (Isfahan, Iran). The severity of poisoning was estimated based on factors such as neural correlates of consciousness,level of consciousness,respiratory conditions,oxygen saturation,pulse,blood pressure,skin color and body temperature.The patients’ age, used dose of methadone and simultaneous use of other substances were also collected. The collected data were then analyzed and compared.
Results: Most cases of poisoning with oral methadone were observed in boys and five-year-old children. Most nursing care measures, e.g. immediate naloxone injection,were provided with one hour after patient admission. Moreover, 34% of the patients received naloxone infusion after primary naloxone injection. The severity of poisoning was mild-moderate in all cases. Additional measures , e.g. ventilation , consciousness monitoring , nasogastric intubation and gastric lavage , using charcoal , urinary catheterization , fluid absorption and excretion control and other paraclinical actions (such as obtaining electroencephalograms, electrocardiograms and computed tomography (CT)scans), were performed in more severe cases. Finally,one death and two cases of brain death was reported.
Conclusion: Immediate and appropriate nursing care measures can prevent the irreparable effects of poisoning and even death,especially in children. They can also significantly improve prognosis. In this respect,appropriate training of nurses in pediatric emergency departments seems necessary.
