Pediatric emergency medicine trisk 3057 3057
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are most properly cared for in specialized facilities that have skilled pediatric
critical care staff and access to toxicology consultation.
NONTOXIC INGESTION
Often, the emergency provider will be asked about a childhood ingestion of a
common household product, many of which are nontoxic unless taken in very
large amounts. The availability of a list of such nontoxic products often leads to
immediate relief of parental anxiety and avoids the institution of unnecessary
noxious interventions. Before using such a list, however, several precautions need
to be kept in mind. The fact that an ingestion is nontoxic does not necessarily
mean that it has no medical significance. Ingestions often occur in the context of
a suboptimal environment. There may be poor supervision or unusual family
stresses surrounding the incident, or the ingestion may not have been purely
exploratory in nature. Several criteria have been suggested to qualify an ingestion
as “nontoxic.” These include the assurance that only one identifiable product is
ingested in a well-approximated amount, that the product label includes no
cautionary signal word, that the child is symptom free and younger than 5 years,
and that an appropriate mechanism is available for telephone follow-up. When
used with these criteria, Table 102.12 provides an updated list of nontoxic
ingestions. Consultation with a regional poison control center is often helpful. In
the United States, the phone number 1-800-222-1222 may be used nationwide.
