Unintentional pediatric superwarfarin exposures: do we really need a prothrombin time?

• Published in: Pediatrics (Evanston) Vol. 105; no. 2; p. 402
• Main Authors: Mullins, M E, Brands, C L, Daya, M R
• Format: Journal Article
• Language: English
• Published: United States 01.02.2000
• Subjects: 4-Hydroxycoumarins - poisoning; Anticoagulants - poisoning; Child; Hemorrhagic Disorders - chemically induced; Hemorrhagic Disorders - diagnosis; Humans; Prothrombin Time; Retrospective Studies; Rodenticides - poisoning
• ISSN: 1098-4275
• DOI: 10.1542/peds.105.2.402

To determine whether routine follow-up coagulation studies are useful in children with accidental exposures to rodenticides containing superwarfarin compounds. Retrospective review of poison center charts involving pediatric superwarfarin exposures occurring in two 2-year periods. An American Association of Poison Control Centers-certified regional poison control center with an annual call volume of 55 000 calls per year from a 2-state area with a combined population of 4 million people. Prothrombin times and/or international normalized ratios and reported clinical signs of excessive anticoagulation after exposure. Of 542 children in 4 years of data collection, follow-up prothrombin times and/or international normalized ratios measurements did not detect any significant coagulation abnormalities. No child developed bleeding complications. No child required or received antidotal treatment with vitamin K. Normal preschool-aged children with unintentional acute exposures to superwarfarin rodenticides do not require any routine follow-up laboratory studies and do not require any medical intervention.