Poisoning Questionnaire for Predicting Recurrent Accidental Poisoning

Description

Wright et al proposed the Oklahoma Poisoning Questionnaire (OPQ) as an instrument for identifying a young child with accidental poisoning who is at risk for another exposure. This can help identify a child for whom intervention may be warranted. The authors are from the University of Oklahoma, University of California Davis, Emory University, University of Alabama, University of Minnesota and Harvard Medical School.

Patient selection: child who has accidentally swallowed a poison

NOTE: The modifications to the OPQ include simplifying the scoring process and adjusting responses which may have become outdated since 1992 (like ranges of family income).

Parameters:

(1) age of child

(2) number of younger siblings of any relation living at home

(3) history of other childhood accidental poisonings in home

(4) medical care during current episode of poisoning

(5) person looking after the child at time of accidental poisoning

(6) age of the person looking after the child at the time of the accident

(7) interval between when poison swallowed and help sought

(8) container securely fastened

(9) oral behaviors shown by child (thumbsucking, nail biting, etc)

(10) weaning difficulty

(11) difficulty going to sleep at night

(12) frequency of getting into things compared to others

(13) impulsive behavior compared to siblings

(14) destructive behavior compared to children of same age

(15) masculinity of child

(16) problem child

(17) power struggle with parents related to putting things in mouth

(18) other power struggles with parents

(19) ability to make parent or caretaker angry

(20) disagreement between parents on how to discipline children

(21) family income

(22) education level of mother

(23) divorce of parents in past 6 months

(24) major parental illness in past 6 months

(25) other medications taken by mother on a regular basis other than tranquilizers

(26) how often the child sees others take medications

Parameter	Finding	Points
age of child	years of age	-0.8 * (age)
number of younger siblings living at home	number	8 * (number)
history of other childhood accidental poisonings in the home	no	0
	yes	15
medical care during current episode of poisoning	no	34
	yes	0
person looking after the child at time of accident	sister	63
	other	0
age of the person looking after the child at the time of the accident	years of age	-0.5 * (age)
interval between when poison swallowed and help sought	within the hour	4
	2-3 hours	8
	4-6 hours	12
	> 6 hours	16
container securely fastened	no	0
	yes	8
oral behaviors shown by child (thumbsucking, nail biting, etc)	never	10.5
	seldom	21
	often	31.5
	constantly	42
weaning difficulty	not at all	5.5
	mildly	11
	moderately	16.5
	extremely	22
difficulty going to sleep at night	never	2
	seldom	4
	often	6
	constantly	8
frequency of getting into things compared to others	never	12
	seldom	24
	often	36
	constantly	48
impulsive behavior compared to siblings	not at all	-5.5
	mildly	-11
	moderately	-16.5
	extremely	-22
destructive behavior compared to children of same age	not at all	-8.5
	mildly	-17
	moderately	-25.5
	extremely	-34
masculinity of child	not at all	-7
	seldom	-14
	often	-21
	extremely	-28
problem child	never	27
	seldom	54
	often	81
	constantly	108
power struggle with parents related to putting things in mouth	not at all	4
	mildly	8
	moderately	12
	extremely	16
other power struggles with parents	not at all	3
	mildly	6
	moderately	9
	extremely	12
ability to make parent or caretaker angry compared to siblings	never	-4.5
	seldom	-9
	often	-13.5
	constantly	-18
disagreement between parents on how to discipline children	no	32
	yes	0
family income	very low	-1
	low to moderate	-2
	moderate	-3
	moderate	-4
	high	-5
education level of mother	grade school	-2.5
	some high school	-5
	completed high school or vocational school	-7.5
	completed high school plus vocational training	-10
	some college	-12.5
	college graduate	-15
	graduate or professional school	-17.5
divorce of parents in past 6 months	no	0
	yes	54
major parental illness in past 6 months	no	0
	yes	34
other medications taken by mother on a regular basis other than tranquilizers	no	0
	yes	23
how often the child sees others take medications	never	8
	seldom	16
	often	24
	constantly	32

total score =

= SUM(points for all 26 parameters)

Interpretation:

• minimum score: <= 164

• maximum score: >= 407

• The higher the score the more likely that the child will experience another episode of accidental poisoning.

Total Score	Percentage with Recurrence
< 164	< 1%
164 - 197	(0.01442 * ((score)^2)) - (4.774 * (score)) + 396.2
197 - 274	(0.8426 * (score)) - 151.5
274 - 321	(-0.003754 * ((score)^2)) + (2.539 * (score)) - 333.4
> 321	> 95%

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Description

Specialty

Objective

ICD-10

Modified Oklahoma Poisoning Questionnaire (OPQ) for Predicting Recurrent Accidental Poisoning in a Young Child

Purpose: To determine the risk of a child who has swallowed a poison for having another such accident using the Oklahoma Poisoning Questionnaire (OPQ).

Description

Specialty

Objective

ICD-10