Kerala State Drug Formulary.pdf

Paediatrics
neurological status. If the child is seen soon after ingestion, vomiting
should be induced,by tricking the throat after giving 1 glass of water or
fruit juice.. If induction of emesis is not successful gastric lavage should be
done carefully using a ryles tube. 30 -50 mL water or 1/2 N. saline is
introduced each time and then aspirated until returning fluid is clear.
Specific antidote if available should be given immediately eg. Desferrioxamine
for Iron poisoning. Close observation and masterly inactivity is all that is
required in most cases.
Symptomatic and supportive treatment will be required in all cases.
Severe cases with organ dysfunction should be managed in secondary
care units Therapeutic interventions include treatment of shock,
anticonvulsants, correction of acidosis and fluid-electrolyte balance and
infections .Urinary excretion of poisons like salicylate, and phenobarbitone
can be hastened by forced alkaline diuresis.Haemodialysis may be required
at times. At the time of discharge parents should be advised on prevention
of poisoning
Some Common Poisoning in Children and their Management .
Sl.
No. Poison Clinical features Treatment
1. Acids
Severe pain, erythema and
swelling/ulceration of mouth
Laryngeal oedema-watch for
shock, renal failure
No emetic/lavage
cold water/milk, IVfluid
antibiotic + steroid surgical
consultation
2 Alkali
Pain, swelling, white plaques in
the mouth Dysphagia, drooling
No emetics/lavage. Cold Water
milk IV. fluid, antibiotic
surgical consultation
3. Aspirin
Vomiting, flushing, tinnitus, Lavage/emetics Fluid
abdominal.
electrolyte
Pain, Gl bleed, acidotic breathing therapy. Correct acidosis,
seizure, coma. hypoglycaemia, Glucose, Vit.K, forced alkaline
salicylate level >l00mg/dl. diuresis. Dialysis
in severe poisoning
431