Crisis and Care: Global Trends in Pediatric Poisoning First-Aid Practices (2000-2025)

The objectives of this review were to present pre‑hospital first‑aid measures administered by caregivers, identify the determinants underpinning both beneficial and harmful interventions, and evaluate the design, implementation, and outcomes of educational and policy initiatives aimed at improving caregiver responses.  A scoping review was conducted in accordance with the PRISMA-ScR guidelines. We searched PubMed for articles published between January 1, 2000, and March 1, 2025, using keywords and MeSH terms related to paediatric poisoning and first-aid. Studies were included if they addressed pre-hospital first aid for acute poisoning in children aged 0–18 years. Two reviewers independently screened articles and extracted data on study characteristics, poisoning agents, first aid measures, determinants, and outcomes. A thematic synthesis was used to collate findings. From 59 unique records, 36 full texts were reviewed, and 17 studies met the inclusion criteria. Study designs included cross-sectional surveys (n=11), retrospective cohorts (n=3), interventional trials (n=1), programmatic studies (1) and systematic reviews (n=1), spanning nine countries across Asia, Africa, Europe, North America, and Oceania. Common pre-hospital interventions included dilution strategies (35–60%), emesis induction (10–40%), home remedies (5–15%), and immediate transport without any intervention (20–45%). Harmful practices—such as forced emesis, administration of herbal concoctions, and delaying professional care—were reported in 20–55% of poisoning events. Key determinants of first-aid behaviours included caregiver education level, socioeconomic factors, cultural beliefs, prior poisoning experience, and availability of poison control resources. Educational interventions significantly improved knowledge scores and correct first aid behaviours. Poison centre utilisation was markedly lower in LMICs compared to HICs. First-aid practices following paediatric poisoning are heterogeneous and frequently suboptimal, particularly in resource-limited settings. Tailored, culturally sensitive educational programs and expanded access to poison control services are essential to address the gaps in existing first-aid practices.