{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:40:08Z","timestamp":1746384008881,"version":"3.40.4"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>Children endure a prolonged observation after xenobiotic ingestions, despite low associated morbidity and mortality. The primary objective was to describe the management and outcomes of acute xenobiotic exposures in asymptomatic pediatric patients presenting to the emergency department (ED). A secondary objective was to explore the impact of vital signs on the patients' management and outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a retrospective review of asymptomatic children (younger than 18 years) presenting to a pediatric ED after a toxic ingestion from 2014 to 2018. Ingestions of hydrocarbons, acetaminophen, salicylates, sulfonylureas, caustic, and\/or extended release agents were excluded. Demographic and clinical data were abstracted.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 2817 charts, we identified 109 asymptomatic patients with a mean age of 4.7 years. The average observation from registration to disposition was 4.06 hours. Five patients were admitted and were subsequently discharged within 24 hours. Of the discharged patients, 2 returned within 72 hours and were subsequently discharged home. A total of 321 asymptomatic patients presented with \u22651 abnormal vital signs (mean age, 6.6 years) and were observed in the ED for an average of 4.54 hours. They had a higher percentage of ingestions related to suicide attempts (odds ratio, 6.8). Twenty-two were admitted. Of those discharged home, 11 returned to the ED within 72 hours; all were subsequently discharged home.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Prolonged observations may not be necessary after ingestions in asymptomatic children. Vital sign abnormalities at presentation did not impact disposition. Prospective studies are needed to determine the safety and efficacy of this shortened observation.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002707","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T14:12:14Z","timestamp":1649167934000},"page":"e24-e29","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Time of Observation in Xenobiotic Ingestions in Children"],"prefix":"10.1097","volume":"39","author":[{"given":"Maya","family":"Capua","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maire","family":"Amlicke","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Cohen Children's Medical Center, New Hyde Park, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Esposito","sequence":"additional","affiliation":[{"name":"St. George's University Medical School, West Indies, Grenada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Belfer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Cohen Children's Medical Center, New Hyde Park, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitchell","family":"Bellis","sequence":"additional","affiliation":[{"name":"New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daria","family":"Falkowitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Teng","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Cohen Children's Medical Center, New Hyde Park, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,4,4]]},"reference":[{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1080\/15563650.2019.1677022","article-title":"2018 Annual report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 36th annual report","volume":"57","year":"2019","journal-title":"Clin Toxicol (Phila)"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1097\/00132584-200201000-00007","article-title":"Evaluation and management of pediatric poisonings","volume":"2","year":"2002","journal-title":"Pediatr Case Rev"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jemermed.2012.11.056","article-title":"The limited utility of screening laboratory tests and electrocardiograms in the management of unintentional asymptomatic pediatric ingestions","volume":"45","year":"2013","journal-title":"J Emerg Med"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1111\/j.1553-2712.1999.tb01235.x","article-title":"Emergency department observation of poisoned patients: how long is necessary?","volume":"6","year":"1999","journal-title":"Acad Emerg Med"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"S141","DOI":"10.1016\/j.annemergmed.2014.07.425","article-title":"Outcomes of unintentional pediatric ingestions in a pediatric emergency department observation unit: which ingestion is most likely to lead to an admission?","volume":"64","year":"2014","journal-title":"Ann Emerg Med"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1542\/peds.55.6.871","article-title":"Acetaminophen poisoning and toxicity","volume":"55","year":"1975","journal-title":"Pediatrics"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1001\/archpedi.1984.02140470061020","article-title":"Caustic ingestions. Symptoms as predictors of esophageal injury","volume":"138","year":"1984","journal-title":"Am J Dis Child"},{"key":"bib10-20250504","first-page":"800","article-title":"Salicylate intoxication. Significance of measurements of salicylate in blood in cases of acute ingestion","volume":"26","year":"1960","journal-title":"Pediatrics"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"e1173","DOI":"10.1542\/peds.2014-3738","article-title":"Heart rates in hospitalized children by age and body temperature","volume":"135","year":"2015","journal-title":"Pediatrics"},{"key":"bib13-20250504","first-page":"9","article-title":"Characteristics of patients and families who make early return visits to the pediatric emergency department","volume":"5","year":"2013","journal-title":"Open Access Emerg Med"},{"key":"bib14-20250504","doi-asserted-by":"crossref","first-page":"66","DOI":"10.3389\/fped.2018.00066","article-title":"Pediatric vital sign distribution derived from a multi-centered emergency department database","volume":"6","year":"2018","journal-title":"Front Pediatr"},{"key":"bib15-20250504","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/S0140-6736(10)62226-X","article-title":"Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies","volume":"377","year":"2011","journal-title":"Lancet"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002707","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:04:52Z","timestamp":1746381892000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002707"}},"subtitle":["Is 6 Hours Too Long?"],"short-title":[],"issued":{"date-parts":[[2022,4,4]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000002707","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"type":"electronic","value":"1535-1815"},{"type":"print","value":"0749-5161"}],"subject":[],"published":{"date-parts":[[2022,4,4]]}}}