Pediatric emergency medicine trisk 3061 3061
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Teething rings (water sterility)
Thermometers (mercury)
Thyroid tablets
Toothpaste
Vitamins (without iron)
Warfarin (rat poison; excludes “superwarfarins”)
Watercolors
Zinc oxide (Desitin)
Zirconium oxide
Adapted in part from Mofenson HC, Greensher J. The unknown poison. Pediatrics 1974;54:336.
PHARMACEUTICALS
Acetaminophen
CLINICAL PEARLS
Aside from massive ingestions, patients are typically asymptomatic or
demonstrate only mild GI distress in the first stage of acetaminophen
toxicity
Acetaminophen levels drawn less than 4 hours postingestion should
not be used to guide management
Administration of N -acetylcysteine within 8 hours of ingestion is
associated with favorable outcomes in terms of liver toxicity
The Rumack-Matthew nomogram should only be used if the following
conditions are met: (a) known time of ingestion, (b) single acute
ingestion, and (c) presentation to care within 24 hours of ingestion.
Current Evidence
Acetaminophen, N -acetyl-p -aminophenol (APAP), is the most popular pediatric
analgesic–antipyretic and has now become one of the most common
pharmaceutical preparations ingested by young children. It is also one of the 10
most common drugs used by adolescents and adults in intentional self-poisoning.
Acetaminophen also occasionally turns up as an unreported coingestant in
intentional overdoses. Fortunately, exploratory ingestion in young children has
