Paediatric Nursing (PAED)
RESPONDING TO CHILDHOOD EMERGENCIES: POISONING
This is the immediate assessment and management of a child who has ingested, inhaled, or been exposed to toxic substances.
Purpose
- Ensure airway, breathing, circulation
- Prevent further absorption of poison
- Enhance elimination if indicated
- Administer antidotes when available
- Provide supportive care
- Prevent future incidents
Indications
- Known or suspected poisoning in a child
Equipment
- Resuscitation equipment
- Oxygen and suction
- IV cannula and fluids
- Activated charcoal
- Specific antidotes
- Toxicology screening kits
- Gastric lavage equipment (if indicated)
- Poison control center contact
Preparation
- Prepare resuscitation equipment
- Have activated charcoal ready
- Know location of antidotes
- Have poison control number available
Procedure steps
- Assess ABCs immediately
- Remove child from exposure source
- Remove contaminated clothing
- Flush skin/eyes with water if dermal/ocular exposure
- Establish IV access
- Obtain history: substance, amount, time, route
- Bring container/package to hospital
- Perform physical examination
- Contact poison control center
- Obtain toxicology samples if ordered
- Administer activated charcoal if indicated
- Administer specific antidote if available
- Consider gastric lavage only if indicated
- Provide supportive care
- Monitor vital signs continuously
- Observe for delayed effects
Precautions
- Do not induce vomiting unless directed
- Protect self from contamination
- Verify substance before treatment
- Monitor for delayed toxicity
Aftercare
- Continue monitoring
- Assess for complications
- Provide psychological support
- Arrange follow-up
Nursing considerations
- Consider possibility of non-accidental ingestion
- Assess home safety
- Address parental guilt sensitively
- Report intentional poisoning if suspected
Patient education
- Teach poison prevention
- Explain safe storage of substances
- Provide poison control number
- Discuss supervision requirements
Documentation
- Substance involved (bring container)
- Amount and time of exposure
- Route of exposure
- Symptoms and timeline
- All interventions with times
- Response to treatment
- Poison control recommendations
References and further reading
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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