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    Evaluation of forensic cases in the pediatric intensive care unit
    (KARE PUBL, 2021) Polat, Sinem; Terece, Cem; Yaman, Ayhan; Gürpınar, Kağan
    Objectives: Traffic accidents, falls, assaults, occupational accidents, intoxications, burns, electric shock, lightning strike, all cases of asphyxia, penetrating and firearm injuries, suspected or definite cases of sexual abuse, and suicide attempts should be evaluated in the forensic category. In this study, we aimed to present our intensive care experiences in forensic cases. Methods: We retrospectively evaluated forensic cases admitted to our Pediatric Intensive Care Unit between 1 February 2017 and 1 September 2018. Results: This study included 153 children, 65 (42.5%) boys and 88 (57.5%) girls. The forensic causes of hospitalizations in the intensive care unit included drug intoxication with a rate of 54.9%, followed by suicide attempts with 24.2%, falling from a high place with 5.2%, child abuse with 5.2%, pedestrian (out-of-vehicle) traffic accidents with 2.6%, drowning in water with 2.6%, road (in-vehicle) traffic accidents with 2%, electric shocks with 2%, and CO (carbon monoxide) poisoning with 1.3%. The drug intoxication was caused by drugs prescribed to the mother and the child with a rate of 40.6% and 27.1%, respectively. Analgesic anti-inflammatory drugs (33.1%) and antidepressant drugs (22.3%) were identified as major causes of intoxication. In addition, paracetamol was the most common cause of intoxication, with a rate of 21.9% among all intoxication cases and 72.5% in the analgesic group. Amitriptyline was the most common agent in the antidepressant group (59.2%). The admission rate to the intensive care unit between 08:00 and 14:00 was 35.1% for suicide attempts and 16.4% for non-suicide attempts, with a statistically significant difference (p=0.025; p<0.05, respectively). Conclusion: Drug intoxications had the highest rate of forensic cases followed in our pediatric intensive care unit. The majority of these intoxications (69.4%) arose from accidental drug ingestion. Therefore, we believe that there may be a significant decrease in the number of hospitalizations of forensic cases associated with drug intoxications in pediatric intensive care units by preventing children's access to drugs.
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    Infant death due to aluminum phosphide intoxication, an uncontrolled insecticide used : case report
    (DergiPark, 2019) Terece, Cem; Sagukpinar, Veysel Osman; Ozdemir, Nazim; Polat, Sinem
    Phosphine gas is a gas that is frequently used as rodenticide and insecticide due to its high diffusion capacity and the absence of residues in agricultural products. Since this gas is highly toxic, it is found in our country as aluminum phosphite tablets impregnated with clay, these tablets emit phosphine gas when they meet with the moisture in the air or gastric hydrochloric acid. Mortality rates in aluminum phosphite intoxications are 40-80% depending on the exposure dose. There is no control mechanism in the supply of aluminum phosphide tablets which are so dangerous and no information is given about the serious conditions that may occur during the use of these tablets. A 2 month old baby, whose family practiced drying pepper-eggplant, was reported to have been exposed to phosphine gas by inhalation, admitted to hospital with vomiting and cyanosis and lost his life within 24 hours. We present our case, who lost his life due to erroneous usage of aluminum phosphite, with additional emphasis on early diagnosis, treatment and gathering sample for toxicologic analysis, with corresponding forensic and medical documents.