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A clinical decision rule for triage of children under 5 years of age with hydrocarbon (kerosene) aspiration in developing countries (CROSBI ID 139207)

Prilog u časopisu | izvorni znanstveni rad | međunarodna recenzija

Bond, G. Randall ; Pieche, Sergio ; Sonicki, Zdenko ; Gamaluddin, H. ; El Guindi, M ; Sakr, M. ; El Seddawy, A ; Abouzaid, M. ; Youssef, A A clinical decision rule for triage of children under 5 years of age with hydrocarbon (kerosene) aspiration in developing countries // Clinical toxicology (Philadelphia), 46 (2008), 3; 222-229. doi: 10.1080/15563650701801218

Podaci o odgovornosti

Bond, G. Randall ; Pieche, Sergio ; Sonicki, Zdenko ; Gamaluddin, H. ; El Guindi, M ; Sakr, M. ; El Seddawy, A ; Abouzaid, M. ; Youssef, A

engleski

A clinical decision rule for triage of children under 5 years of age with hydrocarbon (kerosene) aspiration in developing countries

Background. Unintended hydrocarbon ingestion is a common reason for pediatric hospitalization in the developing world. Objective. To derive a clinical decision rule, to identify patients likely to require a higher level facility (resource-requiring cases), that can be used at primary health care facilities with limited diagnostic and therapeutic resources. Methods. A prospective study of children 2 to 59 months old presenting to a poison treatment facility within 2 hours of oral hydrocarbon exposure. History and objective signs were recorded at admission and at 6, 12, 24 and, if present, 48 hours. Inclusion in the resource-requiring outcome group required: oxygen saturation lt94% ; any CNS depression ; any treatment with (salbutamol) ; any care in the ICU ; or death. Results. 256 met the inclusion criteria and completed the study. Of these, 170 had a course requiring resources unavailable at most primary health care facilities, and 86 did not. The presence of wheezing, any alteration in consciousness (lethargy or any restlessness), or a rapid respiratory rate for age (RR ≥ 50/min if age lt 12mo, ≥ 40/min if age ≥ 12 mo) at presentation identified 167 of 170 of these patients (sensitivity 0.98). Thirty-six of 86 patients classified as non-resource requiring were correctly identified (specificity 0.42). No combination of clinical symptoms provided better discrimination while preserving sensitivity. Conclusions. This study suggests a triage decision rule based on the presence of wheezing, altered consciousness, or a rapid respiratory rate within 2 hours of hydrocarbon exposure. Such a rule requires validation in other settings.

Aspiration; Hydrocarbon; Kerosene; Pediatric; Poisoning

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Podaci o izdanju

46 (3)

2008.

222-229

objavljeno

1556-3650

10.1080/15563650701801218

Povezanost rada

Kliničke medicinske znanosti, Javno zdravstvo i zdravstvena zaštita

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