A 2-year-old girl presents to the ED with her parents, who state that they saw her drink a mouthful of toilet bowl cleaner that was in an unmarked container that had been left unattended. She cried and vomited immediately post ingestion. Upon presentation to the ED, she is still crying. Her vital signs are: heart rate, 164 beats/ min; blood pressure, 94/65 mm Hg; respiratory rate, 30 breaths/min; and oxygen saturation, 98% on room air. She is afebrile. Inspection of the skin and oropharynx is unremarkable, without ulcerations, lesions, or evidence of edema, and she is tolerating her secretions. Her lungs are clear to auscultation, and cardiac examination is significant only for tachycardia. Her abdominal examination demonstrates mild epigastric tenderness. You wonder about the best way to manage this patient: Does she need an IV? Laboratory tests? Imaging? Admission?
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