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Toxic Ingestion — Substances Lethal at Low Doses — Clinical Pathway: Emergency Department, ICU and Inpatient

Toxic Ingestion Clinical Pathway — Emergency Department, ICU and Inpatient

Medications Lethal to Small Children in Low Doses (e.g., 1-2 pills)
  • Benzocaine
  • Beta-blockers
  • Calcium channel blockers
  • Camphor
  • Chloroquine
  • Clonidine
  • Diabetic medications
    • Glyburide
    • Glipizide
  • Lindane
  • Methyl salicylates
  • Opioids
  • Phenothiazines
  • Quinidine
  • Theophylline
  • Tricyclic antidepressants

Polysubstance Ingestions

  • Ingestions of multiple substances are high-risk
  • A polysubstance ingestion may hinder the ability to identify a toxidrome or typical substance effects
  • Substances with similar or compounding clinical effects may potentiate a severe clinical course. Examples:
    • Multiple opioid medications
    • Multiple blood pressure medications

Note

Consultation with Poison Control Center is recommended to risk stratify children.
Polysubstance ingestions should raise a clinician’s index of suspicion for social concerns or behavioral health concerns.

 

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