Clinical Investigation Of Children With Accidental Intoxication In Emergency Department In Suzhou

Objective:1.To understand the clinical epidemiological characteristics of children’s accidental poisoning in emergency treatment in Soochow.2.To analyze the influencing factors of children’s accidental ingestion and poisoning.3.To further explore the deep-seated causes of the children’s accidental poisoning,so as to provide reliable basis for formulating scientific comprehensive prevention and intervention strategies.Methods:This study used the descriptive analysis of clinical investigation and phenomenological study method in qualitative research.1.Clinical investigation:332 cases of poisoning children who came to the Emergency Department of Children’s Hospital Affiliated to Soochow University from January 1,2019 to August 31,2019 were selected as the research objects.The investigation included sex,age,name of poison,dosage,poisoning time,initial symptoms,place of occurrence,parental literature and occupational nature,laboratory examinations,auxiliary examinations,first aid measures,outcome of children and family financial burden.Also,prospective and descriptive epidemiological studies were conducted.2.Qualitative interviews:Using the objective sampling method of qualitative research,18 children with PSS(Poisoning Severity Score)>2,who were interviewed by semi-structured qualitative interviews after signing the informed consent of their parents,until the information was saturated.Finally,12 family members were interviewed.And the underlying causes of children’s misuse were further explored..Results:1.Epidemiological characteristics:The general data of the clinical investigation on children’s accidental poisoning showed that the incidence of children’s accidental poisoning in this investigation was higher in boys than in girls,186 of whom were boys(56.02%)and 146 were girls(43.98%),and the ratio of boys to girls is 1.27:1;the age of the children ranged from 45 days to 15 years.Among them,188(56.63%)of 1-3 year old children were the most poisoning victims with an average age of(2.36±0.76)years;there were many kinds of poisoning,211 cases of drug poisoning(63.55%)ranked first,followed by 183 cases(55.12%)taking medicine orally,31 cases(9.34%)using daily necessities,30 cases(9.04%,including drying agent,mercury,oily pen-core oil,etc.).Herbicides(mainly paraquat)are rare but highly toxic;the time of accidental poisoning is 20 minutes to 8 hours,and the average time of poisoning is(2.02±0.46)hours;in 332 studies,the causes of poisoning include accidental misuse of 258 cases(77.71%),drug overdose of 18 cases(18.37%),family misfeeding of 13 cases(3.92%)and self-poisoning.Five cases(1.51%)were killed;103 cases were from rural areas,93 cases were from urban areas and 136 cases were left-behind children;311 cases(93.67%)were from their own homes;230 cases(69.23%)were caregivers when they were mistakenly taken;72.33%of the children did not take any emergency measures after mistakenly taken,and only 13.46%of the children were treated with the emetic method or by drinking milk or yogurt.89.72%of the families would put the poisons everywhere(where the children could reach);after emergency emetic,gastric lavage,activated carbon adsorption,intravenous infusion and other rescue treatment,53 cases(15.96%)were admitted to hospital for treatment(21 cases were admitted to intensive care unit).325 cases were eventually cured and discharged,6 cases were left with liver and kidney function damage and nervous system sequelae,and 1 case of poisoned mushroom was still hospitalized in the intensive care unit without death.2.The analysis of the influencing factors of children’s misuse shows that there is a certain correlation between mother’s education level,safety education training and safety education awareness of children(P<0.05)by using Spearman grade correlation analysis to analyze the correlation between the two variables.3.The results of qualitative research on the influencing factors of children’s accidental poisoning show that:children are curious,and delighted,and their cognitive ability,physiological and psychological maturity are not high enough;family members are insensitive to safety awareness and lack of systematic safety education knowledge;the pace of life is fast,family structure is unstable,parents are lack of direct supervision and education;besides,the poor management of the custodian,the inadequate social safety education and propaganda are also the influencing factors of children’s accidental poisoning.Conclusion:1.The causes and related factors of children’s poisoning caused by misusing occurred in different degrees due to their gender and age,which was negatively correlated with their mothers’ education level.2.The weak awareness of family safety education and the tearing of poison packaging should be paid more attention to by the society.3.Attention should be paid to the preservation and management of poisons and to the promotion and education of family safety awareness.