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Paeds Casesacute-care-resuscitation-and-toxicology

Paeds Cases · acute-care-resuscitation-and-toxicology

Recognise the pattern, not the bottle — paediatric drug toxicity

A bedside structured clinical encounter testing recognition of the opioid toxidrome, leadership of an ABCDE primary survey with oxygen, ventilation, bedside glucose and access, naloxone titrated to effective ventilation with an infusion for a long-acting opioid, the decision to decline flumazenil for a possible co-ingestion, communication with an adolescent and parent, and a structured handover and disposition.

structured clinical encounter (resuscitation leadership)4 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
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Study tools

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
A 16-year-old is brought to the acute assessment area by friends after collapsing at a party, unconscious with slow shallow breathing and pinpoint pupils.

Station status

This is one MedVellum formative structured clinical encounter. The scoring, prompts and performance descriptions are educational feedback tools. They are not an official college station, timing, mark allocation, pass score or reproduced examination format. The encounter assesses first-impression toxidrome recognition, leadership of the ABCDE primary survey, naloxone titration to effective ventilation with an infusion for a long-acting opioid, the flumazenil caution, communication with an adolescent and parent, and a structured handover and disposition. [1] [2]

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You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship library.

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References5ShowHide
  1. [1]Hoffman RJ, Nillas A Toxidromes and a general approach to poisoning Archives of disease in childhood, 2025.PMID 39978865
  2. [2]Boyer EW Management of opioid analgesic overdose The New England journal of medicine, 2012.PMID 22784117
  3. [8]Kreshak AA, Tomaszewski CA, Clark RF, et al. Flumazenil administration in poisoned pediatric patients Pediatric emergency care, 2012.PMID 22531190
  4. [9]McDuffee AT, Tobias JD Seizure after flumazenil administration in a pediatric patient Pediatric emergency care, 1995.PMID 7651879
  5. [10]Levine M, Lovecchio F New Designer Drugs Emergency medicine clinics of North America, 2021.PMID 34215409
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