Pediatric emergency medicine trisk 3052 3052
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Iron
Isoniazid (INH)
Local anesthetics
Methanol/ethylene
glycol
Methemoglobinemic
agents
Opioids
Phenothiazines
(dystonic reaction)
Sulfonylureas
Tricyclic
antidepressants
Warfarin (and
“superwarfarin” rat
poisons)
Animals
PO every 12 hrs for 14 days (Mercury, Lead )
Deferoxamine: 5–15 mg/kg/hrs IV; use higher dosage
for severe symptoms (see text) and decrease as
patient recovers
Pyridoxine 5–10%, 1 g per gram of INH ingested (70
mg/kg up to 5 g if dose unknown) IV slowly over
30–60 min
Intravenous lipid emulsion 20%, 1.5 mL/kg bolus
followed by infusion of 0.25 mL/kg/min
Fomepizole: Load 15 mg/kg; maintenance 10 mg/kg
q12h 4 doses, then 15 mg/kg q12h (dose should be
adjusted during dialysis)
Ethanol loading dose: 600 mg/kg infused over 1 hr (use
only if fomepizole unavailable)
Ethanol maintenance: 110 mg/kg/hr infusion; adjust as
needed with target level 100 mg/dL
Folate 1–2 mg/kg IV every 4–6 hrs (methanol)
Thiamine 0.25–0.5 mg/kg and pyridoxine 1–2 mg/kg
every 6 hrs (ethylene glycol)
Methylene blue 1%, 1–2 mg/kg (0.1–0.2 mL/kg) IV
slowly over 5–10 min if cyanosis is severe or
methemoglobin level >40%
Naloxone 0.04–2 mg IV, IM, sublingual or by ETT;
may repeat up to total 8–10 mg in adolescent/adult
(see text)
Diphenhydramine, 1–2 mg/kg IM or IV; or
benztropine, 1–2 mg IM or IV (adolescents)
Octreotide 1–2 μg/kg/dose subcutaneous (SC) or IV
every 6–12 hrs
Sodium bicarbonate, 1–2 mEq/kg IV
Vitamin Kt 10 mg (adult); 1–5 mg (pediatric) IV, IM,
SC, PO
Antivenin b for envenomation (see Chapter 10 Shock )
