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. 2015 Aug 15;12(1):111–120. doi: 10.1007/s13181-015-0498-4

Table 4.

Signs and symptoms in adult and pediatric patients as recorded by the medical toxicologist

Adult patients (>18 years) (n = 265) Pediatric patients (≤18 years) (n = 75)
Organ system Number Percent Organ system Number Percent
Nervous system 138 52.0 Nervous system 40 53.3
 Coma/central nervous system depression 59 22.3  Coma/central nervous system depression 18 24.0
 Delirium/toxic psychosis 38 14.3  Agitation 10 13.3
 Hyperreflexia/myoclonus/clonus/tremor 12 4.5  Hyperreflexia/myoclonus/clonus/tremor 4 5.3
 Agitation 10 3.8  Delirium/toxic psychosis 3 4.0
 Seizures 7 2.6  Hallucinations 2 2.7
 Hallucinations 4 1.5  Extrapyramidal symptoms/dystonia/rigidity 1 1.3
 Numbness/paresthesias 3 1.1  Seizures 1 1.3
 Weakness/paralysis 3 1.1  Weakness/paralysis 1 1.3
 Extrapyramidal symptoms/dystonia/rigidity 1 0.4
 Peripheral Neuropathy 1 0.4
Toxidrome 45 17.0 Toxidrome 16 21.3
 Sedative-hypnotic 28 10.6  Sedative-hypnotic 9 12.0
 Anticholinergic 6 2.3  Anticholinergic 3 4.0
 Serotonin syndrome 5 1.9  Opioid 1 1.3
 Opioid 3 1.1  Serotonin syndrome 1 1.3
 Cholinergic 1 0.4  Sympatholytic 1 1.3
 Sympathomimetic syndrome 1 0.4  Sympathomimetic syndrome 1 1.3
 Washout syndrome 1 0.4
Major vital sign abnormalities 39 14.7 Major vital sign abnormalities 13 17.3
 Hypotension (SBP < 80) 13 4.9  Tachycardia (P > 140) 6 8.0
 Hypertension (SBP > 200 and/or DBP > 120) 9 3.4  Hypotension (SBP < 80) 5 6.7
 Tachycardia (P > 140) 8 3.0  Hypertension (SBP > 200 and/or DBP > 120) 1 1.3
 Bradycardia (P < 50) 8 3.0  Bradycardia (P < 50) 1 1.3
 Bradypnea (R < 10) 1 0.4
Metabolic 22 7.9 Dermatologic 6 8.0
 Metabolic acidosis (pH < 7.2) 10 3.8  Rash 2 2.7
 Hypoglycemia (BG < 50) 5 1.9  Angioedema 2 2.7
 Elevated anion Gap (AG > 20) 5 1.9  Blisters 2 2.7
 Elevated osmolal gap (OG > 20) 2 0.8
Gastrointestinal/hepatic 18 6.8 Metabolic 5 6.7
 Hepatotoxicity (AST > 1000) 14 5.3  Metabolic acidosis (pH < 7.2) 3 4.0
 Gastrointestinal bleed 3 1.1  Hypoglycemia (BG < 50) 1 1.3
 Pancreatitis (lipase > 100) 1 0.4  Elevated anion gap (AG > 20) 1 1.3
Renal/muscle 19 7.2 Pulmonary 4 5.3
 Acute kidney injury (creat > 2.0) 13 4.9  Aspiration pneumonitis 2 2.7
 Rhabdomyolysis (CPK > 1000) 4 1.5  Respiratory depression 2 2.7
Hematologic 13 4.9 Cardiovascular 1 1.3
 Significant leukocytosis (WBC > 20,000) 6 2.3  Prolonged QTc (≥500 ms) 1 1.3
 Thrombocytopenia (PLTs < 20,000) 4 1.5
 Significant coagulopathy (PT > 15) 2 0.8
 Hemolysis (Hgb < 10) 1 0.4
Pulmonary 10 3.8 Hematologic 1 1.3
 Aspiration pneumonitis 6 2.3  Significant leukocytosis (WBC > 20,000) 1 1.3
 Respiratory depression 3 1.1
 Acute lung injury/acute respiratory distress syndrome 1 0.4
Cardiovascular 10 3.8
 Prolonged QTc (≥500 ms) 8 3.0
 Ventricular dysrhythmias 1 0.4
 Prolonged QRS (≥120 ms) 1 0.4
Dermatologic 9 3.4
 Rash 4 1.5
 Blisters 3 1.1
 Angioedema 2 0.8
No signs or symptoms 80 30.2 No signs or symptoms 24 32.0
Two or more organ systems affected 73 27.5 Two or more organ systems affected 19 25.3

Signs and symptoms are categorized by organ system and declining order of frequency. Percentages were calculated based on the number of adult or pediatric patients. Several patients may have had two or more organ systems affected; thus, the percentages do not add up to 100 %