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Over a period of 4 months,268 cases were reported,of which 240 were clinically evaluated.The most common site of injection(75%)was the finger or palm.Doses were up to 17-fold higher than standard doses for age.In 116 children(48%),systemic effects of atropine were observed,and 20(8%)had severe atropinization.Seizures and life-threatening arrhythmias were not reported,and there were no fatalities.The severity of atropinization was correlated with the dose following a classic nonlinear,dose-response relationship.Serum atropine levels(6.2 to 61.0 ng/ml)were much higher than those observed after administration of therapeutic doses.Conclusions.-The high incidence of injection in the hand implies accidental use of automatic atropine injectors among children.The lack of mortality or life- threatening complications from injection of large doses of atropine attests to its relative safety in children.The low risk from atropine injections weighed against expected benefit as a lifesaving antidote justifies the distribution of personal atropine injectors to children at risk of organophosphorus nerve agent attack. |
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