Pediatric emergency medicine trisk 3075 3075
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radiograph also suggests potential for significant absorption of iron ( Fig. 102.3 ).
Measurement of the total iron-binding capacity is no longer useful in acute
management. With these observations in mind, it is possible to construct a
protocol for the triage and initial management of the patient who has ingested a
possibly toxic amount of iron ( Fig. 102.4 ).
The treatment for acute iron poisoning includes efforts to decrease absorption
and hasten excretion.
Most children with toxic iron exposures will exhibit spontaneous vomiting.
Activated charcoal is not effective in binding iron salts. For serious poisonings,
gastric lavage with normal saline can be considered in patients who present early
after liquid iron ingestion, in the hope of minimizing any direct mucosal injury
caused by residual particulate matter and possibly contributing to the dissolution
of pill concretions.
