Poisoned child: structured assessment and decontamination

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Target exams

Red flags

• Resuscitate first: a poisoned child with airway, breathing or circulation failure needs ABCDE stabilisation before any decontamination or antidote work-up
• A child with a falling conscious level, pin-point pupils and slow shallow breathing has an opioid toxidrome — give naloxone and support the airway
• Hyperthermia with rigidity, clonus or seizures suggests serotonin syndrome, neuroleptic malignant syndrome or sympathomimetic toxicity and is life-threatening
• Wide QRS or long QT on the ECG points to cardiotoxic drug poisoning (tricyclics, sodium-channel blockers) and needs early sodium bicarbonate and critical care
• Activated charcoal is not given when the airway is unprotected, after corrosive or hydrocarbon ingestion, or for iron, lithium, metals or toxic alcohols
• Intentional self-harm and non-accidental poisoning must be considered in every child — safeguarding runs in parallel with medical care
• Call the Poisons Information Centre early (Australia 13 11 26; UK NPIS; Ireland NPIC); the advice changes the decontamination and antidote plan

Life stages

Care settings

Clinical exam formats

Board mappings

• Acute Care
• Current 2026 PREP curriculum — Learning Objective 2.2.1: Recognise, prioritise and manage an acutely ill infant, child or young person
• Current 2026 PREP curriculum — Learning Objective 2.2.3: Perform acute resuscitation and advanced life support
• Current 2026 PREP curriculum — Learning Objective 2.4.4: Assess and manage infants, children and young people with potential cardiac, respiratory or neurological emergencies or acute sepsis
• Renewed curriculum for first-year trainees from 2027 — Learning goal 11: Acute care and procedures
• Renewed curriculum for first-year trainees from 2027 — Learning goal 17: Acute care
• Clinical Applications
• Medical Sciences
• Long Cases
• Short Cases
• 4. Professional skills and knowledge: Patient management
• 7. Patient safety, including safe prescribing
• 10. Complex child and young person and children with medical complexity
• General Paediatrics: Resuscitates, stabilises and treats extremely unwell babies, children and young people, liaising with specialist teams, as necessary
• Pharmacology: Manages poisoning and intoxication and seeks appropriate specialist advice
• Foundation of Practice (FOP)
• Theory and Science (TAS)
• Applied Knowledge in Practice (AKP)
• Clinical
• History
• Communication
• Video
• General Pediatrics Content Outline — Domain 7: Emergency and Critical Care
• General Pediatrics Content Outline — Universal Task 3: Diagnosis
• General Pediatrics Content Outline — Universal Task 4: Management and Treatment
• General Pediatrics EPA 7: Recognizing a Severely Ill Patient, Providing Initial Management, and Mobilizing Resources Needed for Continued Care
• Patient Care 3: Organize and Prioritize Patient Care
• Patient Care 4: Clinical Reasoning
• Patient Care 5: Patient Management
• Systems-Based Practice 1: Patient Safety
• Interpersonal and Communication Skills 2: Interprofessional and Team Communication
• Medical Expert
• Pediatrics: Foundations EPA #1 — Recognizing deteriorating and/or critically ill patients and initiating stabilization and management
• Pediatrics: Core EPA #2 — Resuscitating and stabilizing critically ill patients