Pediatric emergency medicine trisk 3095 3095
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TABLE 102.13
Medications Dangerous to Toddlers in One to Two Doses a
The likely toxic volume of an ingested liquid depends on the alcohol
concentration. A rough rule is that ingestion of 1 g/kg of ethanol is sufficient to
raise blood alcohol to 100 mg/dL. Therefore, for a beverage such as beer (5%
alcohol), approximately 10 to 15 mL/kg must be ingested before serious toxicity
results. Similar estimates are 4 to 6 mL/kg for wine (14% alcohol) and 1 to 2
mL/kg for 80-proof liquor (40% alcohol).
The management of ethanol ingestion in children begins with prompt
recognition and evaluation of blood glucose level. Airway or ventilatory
compromise should be treated with endotracheal intubation. If seizures result
from hypoglycemia, they should be promptly treated with 10% to 50% (0.25 to 1
g/kg) IV dextrose. Warming techniques should be instituted to increase core
temperature. Because ethanol is rapidly absorbed from the gut and is not adsorbed
by activated charcoal, there is rarely a role for GI decontamination.
Alcohol is metabolized by the hepatic enzyme alcohol dehydrogenase; its
elimination rate is dose dependent. This means that the higher the blood alcohol
