2024 20 Poisoning in children

Poisoning is a common problem in children, from ingestion of medications prescribed for other family members, household cleaning products or garden or industrial chemicals which are inappropriately stored, or deliberate ingestions in adolescents seeking to self-harm. There are hundreds of potential poisons, and we cannot possibly know everything about all, but we can understand the principles of management. In all poisons there is a risk to airway, breathing, circulation, or conscious state. These risks are both general, and often specific to the poison (caustic ingestion causes airway burns, hydrocarbons cause aspiration pneumonia, oleander and digoxin causes heart block, seizures from theophylline overdose, etc). There may be specific risks to other organs too, such as lead poisoning causing haemolysis, ethylene glycol causing acute kidney injury, and paracetamol and toxic mushrooms causing liver failure. The management of poisoning includes decontamination, measures to reduce absorption of the poison or drug, giving a specific antidote if there is one, close monitoring and vital organ support. The mortality rate from poisoning can be reduced if a systematic approach is taken, and if specific information can be available for the type of poison and its effects. This lecture is an introduction to the management of poisoning, good online resources are available to help, and we discuss these too.