{"pk":10568,"title":"Pediatric Exposures to Topical Benzocaine Preparations Reported to a Statewide Poison Control System","subtitle":null,"abstract":"Introduction: \nTopical benzocaine is a local anesthetic commonly used to relieve pain caused byteething, periodontal irritation, burns, wounds, and insect bites. Oral preparations may containbenzocaine concentrations ranging from 7.5% to 20%. Pediatric exposure to such large concentrationsmay result in methemoglobinemia and secondarily cause anemia, cyanosis, and hypoxia.\nMethods:\n This is a retrospective study of exposures reported to a statewide poison controlsystem. The electronic health records were queried for pediatric exposures to topical benzocainetreated at a healthcare facility from 2004 to 2014. Cases of benzocaine exposure were reviewedfor demographic and clinical information, and descriptive statistical analysis was performed.\nResults: \nThe query resulted in 157 cases; 58 were excluded due to co-ingestants, or miscodingof non-benzocaine exposures. Children four years of age and younger represented the majorityof cases (93%) with a median age of 1 year. There were 88 cases of accidental/ exploratoryexposure, while 6 cases resulted from therapeutic application or error, 4 cases from adversereactions, 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 effectswere exposed to a range of benzocaine concentrations (7.5-20%), with 4 cases reportingmethemoglobin levels between 20.2%-55%. Methylene blue was administered in 4 of the casesexhibiting major effects.\nConclusion:\n The majority of exposures were accidental ingestions by young children. Most exposuresresulted in minor to no effects. However, some patients required treatment with methylene blue andadmission to a critical care unit. Therapeutic application by parents or caregivers may lead to adverseeffects from these commonly available products. [West J Emerg Med.2017;18(5)923–927.]","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"benzocaine"},{"word":"teething gels"},{"word":"pediatric poisoning"},{"word":"methemoglobinemia"}],"section":"Injury Prevention and Population Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6tv959rw","frozenauthors":[{"first_name":"Rais","middle_name":"","last_name":"Vohra","name_suffix":"","institution":"California Poison Control System, Valley Children’s Hospital, Madera, California\nUniversity of California San Francisco, Fresno Medical Education and Research Program, Fresno, California","department":"None"},{"first_name":"Serena","middle_name":"","last_name":"Huntington","name_suffix":"","institution":"California Poison Control System, Valley Children’s Hospital, Madera, California","department":"None"},{"first_name":"Jennifer","middle_name":"","last_name":"Koike","name_suffix":"","institution":"University of California, San Francisco, School of Pharmacy, San Francisco, California","department":"None"},{"first_name":"Kevin","middle_name":"","last_name":"Le","name_suffix":"","institution":"University of California, San Francisco, School of Pharmacy, San Francisco, California","department":"None"},{"first_name":"Richard","middle_name":"J.","last_name":"Geller","name_suffix":"","institution":"California Poison Control System, Valley Children’s Hospital, Madera, California","department":"None"}],"date_submitted":"2017-01-19T22:05:08Z","date_accepted":"2017-01-19T22:05:08Z","date_published":"2017-07-14T18:35:40Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10568/galley/5802/download/"}]}