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Blaine E Benson

Publications and source records attributed to Blaine E Benson.

6 recordsLinked to original sources

TESS-based dose-response using pediatric clonidine exposures.

OBJECTIVE: The toxic and lethal doses of clonidine in children are unclear. This study was designed to determine whether data from the American Association of Poison Control Centers Toxic Exposure Surveillance System (TESS) could be utilized to determine a dose-response relationship for pediatric clonidine exposure. METHODS: 3,458 single-substance clonidine exposures in children <6 years of age reported to TESS from January 2000 through December 2003 were examined. Dose ingested, age, and medical outcome were available for 1550 cases. Respiratory arrest cases (n = 8) were classified as the most severe of the medical outcome categories (Arrest, Major, Moderate, Mild, and No effect). Exposures reported as a "taste or lick" (n = 51) were included as a dose of 1/10 of the dosage form involved. Dose ranged from 0.4 to 1980 (median 13) microg/kg. Weight was imputed based on a quadratic estimate of weight for age. Dose certainty was coded as exact (26% of cases) or not exact (74%). Medical outcome (response) was examined via logistic regression using SAS JMP (release 5.1). RESULTS: The logistic model describing medical outcome (P < 0.0001) included Log dose/kg (P = 0.0000) and Certainty (P = 0.045). CONCLUSION: TESS data can provide the basis for a statistically sound description of dose-response for pediatric clonidine poisoning exposures.

Accidents↗

Do poison center guidelines adversely affect patient outcomes as triage referral values increase?

BACKGROUND: The purpose of this study was to determine whether patient outcomes were adversely affected as healthcare referral values increased for two common poisonings: acute, unintentional acetaminophen (APAP) poisonings and acute, unintentional iron (Fe) poisonings. We hypothesized that symptom rates would increase with high referral values. METHODS: Qualifying 1997 exposures were separated by substance (APAP or Fe) and then further stratified into three healthcare referral value ranges. Symptomatic and asymptomatic patients were totaled for each stratum. Expected vs. observed distributions of symptomatic and asymptomatic patients across triage referral strata for a given substance and treatment location were compared using chi-square test for independence. The Wilcoxon-Mann-Whitney test was used to compare the distribution of patients across referral strata for home vs. healthcare facility locations for a specific substance. RESULTS: There were no statistically significant differences in the distribution of symptomatic patients within referral value strata for APAP or for Fe. There was also no difference in distribution of symptomatic patients across strata when comparing home vs. healthcare facility for APAP and Fe. CONCLUSION: Referral values as high as 201 mg/kg for APAP and 61 mg/kg for Fe do not appear to adversely affect patient outcomes.

Acetaminophen↗

Methanol poisoning exposures in the United States: 1993-1998.

OBJECTIVES: We investigated U.S. methanol-poisoning exposures since little recent information is available about the frequency, sources of methanol, or outcomes of individuals who consume methanol. METHODS: We reviewed human methanol exposures reported to the American Association of Poison Control Centers Toxic Exposure Surveillance System 1993-1998. RESULTS: The mean number of cases per year was 2254. Each year 167 cases had an outcome of moderate effect, major effect, or death. One death occurred in every 183 exposures to methanol. Symptomatic cases increased abruptly from 1.8 to 2.5% for infants and children, from 14.1 to 12.3% for adolescents and adults, while the intentional exposures increased from < 1 to 21% for adolescents, and 11% for adults. Cases occurred in every decade of life but toddlers had the highest number of exposures. In 68 methanol fatalities, confusion developedfollowed by coma, hypotension, respiratory depression, and cerebral edema. Blood methanol levels were above 100mg/dL (70%), metabolic acidoses (62%), and anion gaps > 25 (100%). Methanol products were recorded, showing windshield wiper fluids to be 60.8% of exposures. Other automotive sources were 23.7%. Commercial nonautomotive products were 12.2% and pure methanol products were 2.3%. Unintentional exposures were reported in 90.3% of all cases, while 8.3% were due to intentional exposures, and 1.4% wasfor unknown or mixed reasons. Intentional exposures resulted from suspected suicides (51.2%) and from abuse and misuse (38.8%). CONCLUSIONS: Methanol poisonings continue to occur in the United States with toddlers at the highest risk for exposure, but adolescents and adults at the highest risk for life-threatening intoxications. Over half of product-identified cases were due to consumption of windshield wiperfluid. Efforts should be undertaken to minimize methanol exposures.

Adolescent↗