Unintentional acute poisoning in emergency care: a eight-year retrospective study in a type II hospital in Portugal

Introduction and Objectives: Unintentional poisoning is a frequent reason for admission to pediatric emergency services. This study aimed to characterize cases of accidental poisoning in a Pediatric Emergency Department in Lisbon. Methods: A retrospective and descriptive study of patients under 18 years of age diagnosed with accidental poisoning in a Pediatric Emergency Department in Lisbon between 2015 and 2022. Cases of intentional poisoning and unconfirmed diagnoses were excluded. Statistical analysis was performed using IBM SPSS® Statistics. Results: A total of 148 patients were included (median age: two years; 52.7% male), with 89.2% under five years of age and comorbidities present in 10.8%. No seasonal pattern was identified, although peaks were observed in January and August, coinciding with school holidays. Social risk factors were found in 14.9% of cases. Most patients (67.6%) required short-term hospitalization; 6.8% were admitted to intensive care, with no reported deaths. Poisoning was suspected upon admission in 92.6% of cases, with immediate disclosure by caregivers in 81.5% of cases. Failure to disclose poisoning was significantly associated with more severe clinical presentations (p < 0.05). In 62.8% of cases, only clinical observation was needed; 4.1% received an antidote, 30.4% underwent gastric lavage, and 25.0% were given activated charcoal. Out of all the toxicology screenings performed (38.5%), 50.9% were positive. The main toxic agents were medications, recreational drugs, and household products; 44.6% involved medications prescribed to caregivers. Discussion: The vast majority of poisonings involved medications. Early disclosure by caregivers is associated with better clinical outcomes. Preventive strategies should focus on health literacy and accident prevention.