{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:29:31Z","timestamp":1760027371742,"version":"3.40.5"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005615","name":"Beth Israel Deaconess Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005615","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>When ingested by children, small quantities of beta\u2010adrenergic antagonists (BAA) are described as dangerous and even potentially lethal (\u201cone pill can kill\u201d). We characterize demographics, clinical characteristics, and the rate of serious outcomes among pediatric patients with reported BAA ingestions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a retrospective review of U.S. patients &lt;20\u2009years\u2009old with reported single\u2010agent BAA ingestions presenting to a health care facility between January 2000 and February 2020 for whom a poison control center was consulted. Data were abstracted from the National Poison Data System (NPDS). Medical outcomes were assessed by the NPDS scale of no effect, minor effect, moderate effect, major effect, and death. All relevant NPDS fatality narratives were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 35,436 reported exposures were identified. A total of 29,155 (82.3%) were\u2009&lt;6\u2009years\u2009old, of which 29,089 (99.8%) were unintentional. Twenty\u2010five patients (&lt;0.1%)\u2009&lt;6\u2009years\u2009old had major effects. A total of 2316 (8.8%) of patients with no\/mild effects were admitted to a critical care unit. Of all cases, 1460 (4.1%) had hypotension and 1403 (4.0%) had bradycardia. One hundred nineteen (0.3%) developed hypoglycemia. The only four fatalities resulted from intentional ingestions in patients &gt;10\u2009years\u2009old who sustained cardiac arrest in the prehospital setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Reported BAA ingestions in this multiyear national pediatric cohort caused infrequent toxicity, and no fatalities resulted from an unintentional ingestion. The frequency of bradycardia, hypotension, and hypoglycemia were low. While severely poisoned patients require aggressive treatment, 8.8% of patients were admitted to a critical care unit despite having no or mild effects, which suggests an opportunity to reduce resource utilization.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14769","type":"journal-article","created":{"date-parts":[[2023,6,25]],"date-time":"2023-06-25T00:54:02Z","timestamp":1687654442000},"page":"1129-1137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characterization of pediatric beta\u2010adrenergic antagonist ingestions reported to the National Poison Data System from 2000 to 2020"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1003-5798","authenticated-orcid":false,"given":"C. James","family":"Watson","sequence":"first","affiliation":[{"name":"Division of Medical Toxicology, Department of Emergency Medicine Maine Medical Center  Portland Maine USA"},{"name":"Tufts University School of Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael C.","family":"Monuteaux","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele M.","family":"Burns","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine Boston Children's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical Toxicology Program Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2022.2132768"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3928\/19382359-20171121-01"},{"key":"e_1_2_10_4_1","first-page":"926","volume-title":"Goldfrank's Toxicologic Emergencies","author":"Brubacher JR","year":"2019"},{"key":"e_1_2_10_5_1","unstructured":"Cincinnati Children's Hospital Medical Center 2003 The toxic toddler: one pill can kill"},{"issue":"11","key":"e_1_2_10_6_1","first-page":"826","article-title":"Small dose\u2026 big poison","volume":"39","author":"Braitberg G","year":"2010","journal-title":"Aust Fam Physician"},{"key":"e_1_2_10_7_1","article-title":"Just one pill can kill","author":"Richardson N","year":"2020","journal-title":"Emergency Physicians Monthly"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/08971900211017491"},{"key":"e_1_2_10_9_1","unstructured":"DavisT.Toxicology \u2010 a crash course in accidental overdoses. Don't Forget The Bubbles. Published June 23 2021. Accessed May 1 2022. Available from:https:\/\/dontforgetthebubbles.com\/paediatric\u2010toxicology\/."},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1191\/0960327106ht632oa"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2014.02.006"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1920"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2089"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001525"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-3335"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.10.066"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000958"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.13231"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14769","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T09:22:00Z","timestamp":1699867320000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.14769"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,10]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1111\/acem.14769"],"URL":"https:\/\/doi.org\/10.1111\/acem.14769","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"type":"print","value":"1069-6563"},{"type":"electronic","value":"1553-2712"}],"subject":[],"published":{"date-parts":[[2023,8,10]]},"assertion":[{"value":"2023-04-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}