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Poisoning in children (Types (Garden Animal faeces, slugs, compost …
Poisoning in
children
Types
Garden
Animal faeces, slugs, compost
Death cap mushroom, foxglove, organophospherous pesticides
Household products
Liquid soap, washing up liquid,
bleach, oven cleaner,antifreeze, petroleum
Medicines
E.g. Abx, COCP, paracetmol,
Fe, B-blockers
Diagnosis
Examination
Abdo exam
Abdominal pain/tenderness,
vomiiting
Neuro exam
Headache, nausea, pinpoint/dilated pupils
reduced GCS (cofusion, coma), seizures
Cardio exam
Tachy/bradycardia, hypo/hypertension
Investigations
Bloods
FBC, U+E, LFT
Tox screen (paracetamol, salicylate, TCA, etc.)
Imaging
CXR/AXR: e.g. button batteries
Bedside
Obs (shock)
ECG (arrhythmias)
History
DH
Meds, allergies
PMH
Previous accidents and poisoning
Previous DSH/suicide attempts
Known medical and psychiatric conditions
SH
Living arrangements, occupation/school,
relationships, drugs, alcohol, smoking
PC/HPC
What ingested, when, how much, any vomiting, any abdominal pain, confusion, altered conciousness, jaundice
Purpose: accident, poisoning by another, DSH, intent suicide
Management
Initial ABCDE
Definitive
Conservative
Information, advice, support
Identify and manage cause
Consult TOXBASE
Safeguarding, CAMHS referral if needed
Definition
Accidental or deliberate ingestion
of substances to a toxic level
Epidemiology
Accidental (common); peak ~2.5y
Intentional (rare)
Aetiology
Any age
Intentional (carers, parents)
Iatrogenic (drug errors by HCPs)
Young children
Accidental
Adolescents
DSH or recreational drug use