Toxic Ingestion — Admission Criteria — Clinical Pathway: Emergency Department, ICU and Inpatient

Toxic Ingestion Clinical Pathway — Emergency Department, ICU and Inpatient

Admission Criteria

Optimal disposition requires clinical decision-making individualized to the care of each child.

Inpatient Unit
  • Prolonged period of observation required
    • > 4-6 hrs
  • Persistent symptoms beyond prescribed observation period
  • Need for ongoing treatment, elimination, or monitoring
    • All patients at KOPH who require telemetry need ICU admission
  • Safe discharge plan cannot be established
  • Ingestion associated with self-harm in patients who require specialized behavioral health resources (e.g., severe autism, acute psychosis, risk to self or staff)
  • History of substance use disorder
Intensive Care Unit
  • Impending or existing
    • Respiratory, circulatory, neurologic failure
  • Hemodialysis required
  • Close, hourly monitoring required
    • Glucose or neurologic examinations
  • Ingestion of substances lethal at low doses
  • Agitation requiring sedation

Admitting Service

Children who meet criteria for inpatient, non-ICU admission should be admitted to the General Pediatrics service with the following exceptions:

  • Consult and admit to trauma service if there are concerns for concomitant traumatic bodily harm, especially in the setting of child abuse or neglect
  • Consult and admit to Adolescent Medicine for all adolescents (12 and older) with known or suspected substance use disorder(s) or who will require medications for opiate, alcohol or benzodiazepine withdrawal