Accidental Ingestion in Pediatric Patients

Over 1.2 million accidental ingestions occurred in children less than 6 years of age in 2001; these often occur in the home.44 Ingested substances can vary, from household cleaning solutions to prescription and nonprescription medications. Management of accidental ingestions varies depending on the ingested substance, the amount, and the age and size of the child. Clinicians receiving calls regarding management of accidental ingestions should direct them to the local or regional poison control center for specific recommendations, which can be located through the American Association of Poison Control Centers (www. aapcc.org).

Inducing emesis is not recommended for suspected ingestions of acidic or alkaline substances. The American Academy of Clinical Toxicology and the AAP do not recommend the use of ipecac syrup as it can decrease effectiveness of activated charcoal treatment administered in the emergency department and compromise patient out-comes.45 Activated charcoal use is preferred for treatment of ingestion in the emergency department at a dose of 1 g/kg for infants less than 1 year of age, 1 to 2 g/kg orally for children greater than 1 year of age and adults, as a single dose.46 Monitor symptoms of toxicities from the substance ingested during hospitalization. Parents/ caregivers should continue monitoring at home following discharge.

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