Toxic ingestions in children

Children may ingest a toxic substance accidentally while exploring their environment, or deliberately in response to stress or underlying mental problems, or in an attempt to get 'high'.

A regional poison-control centre or medical toxicologist should be contacted with any suspected overdose in a child.

The range of possible ingestions is broad; diagnosis is based on a combination of thorough clinical assessment and comprehensive laboratory investigation to identify all ingested substances.

Some asymptomatic patients require observation for 6 hours, or 24 hours for high-risk ingestions.

The mainstay of management of symptomatic patients is management of airway, breathing, and circulation, with appropriate supportive care. Specific antidotes may also be required.

If patients present within 1 hour of ingestion, activated charcoal can be considered provided that it is not contraindicated. The decision to administer oral activated charcoal should be carefully considered and discussed with a medical toxicologist or poison control centre.

With prompt diagnosis and appropriate treatment, patients have a good outcome. Fatalities are rare.

Toxic ingestions refer to the accidental or deliberate ingestion of a substance with resultant toxicity or risk of toxicity. Agents consumed may be pharmaceutical substances; drugs of abuse (including alcohol); toxic plants, berries, or mushrooms; or chemicals.