Emergency Department, ICU and Inpatient Clinical Pathway
for Children with Known or Presumed Toxic Ingestion

Child, any age, with known or
suspected toxic ingestion
  • Consider early Poison Control Center (PCC) consultation 1-800-222-1222
FLOC/RN Team Assessment
Primary Survey — Identify critical illness
Critically Ill
Ingestion Red Flags
Symptomatic
or
Asymptomatic with Ingestion Red Flags
Asymptomatic
and
No Ingestion Red Flags
Ingestion of known substance
and
Symptoms consistent with expected toxidrome and substance effects
Ingestion with intent of self-harm
or
Ingestion of unknown substance
or
Symptoms not consistent with expected toxidrome and substance effects
Management
Disposition
  • Identify appropriate admitting service
  • Collect urine for a Save Our Specimen sample, if not previously collected
  • Request Social Work consultation upon arrival to observation/inpatient unit
  • Behavioral Health consult recommended for
    • Intentional ingestions, regardless of stated intent to self-harm
    • Known or suspected risk of alcohol, benzodiazepine or opioid withdrawal

Posted: October 2022
Revised: December 2022
Authors: M. Prieto, MD; C. Gaw, MD; F. Henretig, MD; H. Wolfe, MD; B. Chaiyachati, MD; C. Bennett, MD; C. Kerman, MD; K. White, MD; C. Cummings, MD; A. Grachen, PharmD; MK. Abbadessa, ACCNS-P; A. Koenigsberg, CRNP