The AAP states, “the first action for a caregiver of a child who may have ingested a toxic substance should be to consult with the local poison control center.”2 Certified specialists in poison information and their staff answer calls from the public and make recommendations as to whether or not a poisoned child can be managed at home or should be evaluated at a healthcare facility. The overwhelming majority of exposures are managed over the phone. Children who need further evaluation and may require GI decontamination should be transported to a healthcare facility as soon as possible, as the benefits of any method of decontamination decrease with time. Prehospital professionals should be trained to bring all possible clues to a toxic exposure (pill fragments, pill bottles, containers, etc.) with them to the receiving ED. Stabilization and supportive care for these children should begin en route to the hospital. As with all emergency patients, care begins with careful assessment and support of the airway, breathing, and circulation. In children who have ingested an unknown toxin, the child’s vital signs and neurologic examination at the scene and during transport may provide valuable clues as to the ingested substance. Several recent studies examined the feasibility and/or success of out-of-hospital administration of AC, either at home or on transport via EMS personnel.13,14 However, to date the AAP does not recommend out-ofhospital GI decontamination by any method, and the AAPCC does not comment on GI decontamination outside the ED setting.2,4 See the Controversies/CuttingEdge section of this article for a full discussion of out-of-hospital GI decontamination in children.