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<< Pediatric Ingestions: Emergency Department Management (Pharmacology CME)

Emergency Department Evaluation

Initial Stabilization

Pediatric patients who present in critical condition secondary to a toxic ingestion require immediate stabilization according to the Pediatric Advanced Life Support guidelines.13 As for any patient requiring resuscitation, evaluation and treatment should begin with an orderly progression through primary and secondary surveys, with a focused history and rapid bedside testing. Airway and respiratory status may be compromised, requiring emergent intubation. The airway may be obstructed by an inhaled object or by increased secretions (in the case of cholinergic ingestion). Early endotracheal intubation may be necessary in cases of caustic ingestion with potential for rapid development of airway damage.14 Respiratory status may be compromised by neurologic deterioration, sedation, metabolic derangement, or seizure. 

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