TY  - JOUR
PY  - 2017//
TI  - Pediatric exposures to topical benzocaine preparations reported to a statewide poison control system
JO  - Western journal of emergency medicine
A1  - Vohra, Rais
A1  - Huntington, Serena
A1  - Koike, Jennifer
A1  - Le, Kevin
A1  - Geller, Richard J.
SP  - 923
EP  - 927
VL  - 18
IS  - 5
N2  - INTRODUCTION: Topical benzocaine is a local anesthetic commonly used to relieve pain caused by teething, periodontal irritation, burns, wounds, and insect bites. Oral preparations may contain benzocaine concentrations ranging from 7.5% to 20%. Pediatric exposure to such large concentrations may result in methemoglobinemia and secondarily cause anemia, cyanosis, and hypoxia. <br><br>METHODS: This is a retrospective study of exposures reported to a statewide poison control system. The electronic health records were queried for pediatric exposures to topical benzocaine treated at a healthcare facility from 2004 to 2014. Cases of benzocaine exposure were reviewed for demographic and clinical information, and descriptive statistical analysis was performed. <br><br>RESULTS: The query resulted in 157 cases; 58 were excluded due to co-ingestants, or miscoding of non-benzocaine exposures. Children four years of age and younger represented the majority of cases (93%) with a median age of 1 year. There were 88 cases of accidental/ exploratory exposure, while 6 cases resulted from therapeutic application or error, 4 cases from adverse reactions, and 1 case from an unknown cause. Asymptomatic children accounted for 75.5% of cases, but major clinical effects were observed in 5 patients. Those with serious effects were exposed to a range of benzocaine concentrations (7.5-20%), with 4 cases reporting methemoglobin levels between 20.2%-55%. Methylene blue was administered in 4 of the cases exhibiting major effects. <br><br>CONCLUSION: The majority of exposures were accidental ingestions by young children. Most exposures resulted in minor to no effects. However, some patients required treatment with methylene blue and admission to a critical care unit. Therapeutic application by parents or caregivers may lead to adverse effects from these commonly available products.<p />  <p>Language: en</p>
LA  - en
SN  - 1936-900X
UR  - http://dx.doi.org/10.5811/westjem.2017.6.33665
ID  - ref1
ER  -