Pediatric emergency medicine trisk 3077 3077
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FIGURE 102.4 The initial approach to the patient ingesting a possibly toxic dose of iron. a Iron
levels expressed in mcg/dL.
The mainstay of GI decontamination for iron-poisoned patients, however, is the
early and aggressive use of WBI. This approach is believed to be effective in
decreasing iron absorption and in breaking up pill concretions that might be a risk
for direct mucosal injury. As noted previously, an abdominal radiograph should
be obtained early in the evaluation of symptomatic patients. If this study
demonstrates significant radiopaque material and the patient’s condition allows it,
WBI should be instituted for at least 4 to 6 hours. A few hours of WBI (until
rectal effluent is clear) may be indicated in symptomatic cases even without
definite radiographic findings to hasten elimination of residual iron pill particles
