Ingestion of Toxins

Prevention As pediatricians prevention is the key Child proof containers for medicines Child proof home from access to naphthalene balls, camphor Child should not eat things smaller than their thumb up to 2 years Make sure the strength of common medicines are explained Child proof electrical sockets Explain about the importance of not storing dangerous material in innocuous containers Advise against blind finger sweeps & inducing emesis

What will you do ? Child has swallowed dettol Child has drunk Listerine Swallowed a lizard Swallowed a piece of mercury thermometer Ate some soap Bit half of the mosquito repellent mat Interact!

Which will you remove ? Coin in cricopharynx in a 5year old after 4 hours of fasting Disc battery in stomach after 2 hours of ingestion

Recommended management algorithm for patients with disk battery ingestions

Acute pain abdomen, tarry or bloody stools, fever, and persistent vomiting are the symptoms to act. Disk batteries in the oesophagus must be removed. Endoscopy should be used if available. The Foley catheter technique may be used if the ingestion is less than 2 hours only, because it may increase the damage to the weakened oesophagus. When the Foley technique fails or is contraindicated, the disk battery should be removed endoscopically. Serum mercury levels and chelation therapy should be reserved for patients who develop signs of mercury toxicity.