Ingestion
most common between 6m and 3y (unless self harm)
Toxin (the dose maketh the poison)
- Fe: vomiting, palour, lethargy, hypothermia, rigid abdomen,
- Battery (sulphuric) acid: abdo pain Rx antacid
- Lead (chronic)
- Mercury (acute inhalation or chronic ingestion) CNS
- OH
- Paracetamol
Ex
?toxidrome
?peritonitis
Rx ?which is appropriate
NGT, ? aspi ? levage
?activated charcoal
?antacid
?ipecac
?gastroscopy
Non-toxic
3 tightest parts of GIT: cricoid (70%), aorta (15%), LOS (15%)
Ix
C/AXR
Rx
Urgent endoscopy if battery, sharp, resp comprimise
?observation of inert eg coin in oesophagus
Ix
?when do you ? TOF
?when muscle relaxant eg GTN, coke, domperidone
when to monitor with serial xrays
recurrent food bolus barium swallow ?achelasia (similar to hirschprungs ie aganglionic spasm with proximal dilation
Toxin (the dose maketh the poison)
- Fe: vomiting, palour, lethargy, hypothermia, rigid abdomen,
- Battery (sulphuric) acid: abdo pain Rx antacid
- Lead (chronic)
- Mercury (acute inhalation or chronic ingestion) CNS
- OH
- Paracetamol
Ex
?toxidrome
?peritonitis
Rx ?which is appropriate
NGT, ? aspi ? levage
?activated charcoal
?antacid
?ipecac
?gastroscopy
Non-toxic
3 tightest parts of GIT: cricoid (70%), aorta (15%), LOS (15%)
- Coin
- Needle
- Battery
- food bolus: ?stricture ?motility disorder ?EosinOesoph ?repaired atresia
- Magnet: needs to be removed from any part of GIT
Ix
C/AXR
Rx
Urgent endoscopy if battery, sharp, resp comprimise
?observation of inert eg coin in oesophagus
Ix
?when do you ? TOF
?when muscle relaxant eg GTN, coke, domperidone
when to monitor with serial xrays
recurrent food bolus barium swallow ?achelasia (similar to hirschprungs ie aganglionic spasm with proximal dilation