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Paeds Vivasacute-care-resuscitation-and-toxicology

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

By the product, not the symptom — household chemical exposure viva

A branching viva following one child who presents after a household chemical exposure, beginning as a suspected lamp-oil ingestion and then crossing into a caustic comparator. The candidate must identify the product, apply the contraindications of induced emesis and gastric lavage for hydrocarbons and of neutralisation for caustics, run the six-hour hydrocarbon observation, justify the six-to-twenty-four-hour endoscopy window, apply the Zargar grade, and arrange surgical and long-term surveillance.

branching clinical structured oral6 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCERCPCH Progress+MRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics
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Target exams

RACP General PaediatricsRACP DCERCPCH Progress+MRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics
Prompt
A two-year-old is brought to the emergency department after a household chemical exposure. The examiner releases information in stages. The candidate must identify the product, apply the contraindications (no emesis, no lavage for hydrocarbons, no neutralisation for caustics), run the six-hour observation for a hydrocarbon, justify timed endoscopy for a caustic, apply the Zargar grade, and arrange surgical readiness and surveillance.

Branching cross-examination

This is a MedVellum formative viva. It is not an official RACP, MRCPCH, ABP, ACGME or RCPSC station, mark scheme, duration or pass standard. Release each update only after the candidate states the dominant threat, the contraindications, the immediate action and the reassessment endpoint. [1]

Candidate brief

You are the senior paediatric clinician in the emergency department. Speak as you would during a household chemical exposure assessment. State the product you need to identify, the contraindications you will apply, the pathway you will run and what you will reassess. This is one continuous case that moves from a hydrocarbon pathway into a caustic comparator. Each escalation branch leads to the next update. [1]

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References5ShowHide
  1. [1]Hoffman RS, Burns MM, Gosselin S Ingestion of Caustic Substances New England Journal of Medicine, 2020.PMID 32348645
  2. [3]Irlayıcı FI, Elmas A, Akcam M Corrosive substance ingestion in children: clinical features, management and outcomes in a tertiary care setting European Journal of Pediatrics, 2025.PMID 40802074
  3. [4]Bolia R, Sarma MS, Biradar V, Sathiyasekaran M, Srivastava A Current practices in the management of corrosive ingestion in children: A questionnaire-based survey and recommendations Indian Journal of Gastroenterology, 2021.PMID 33991312
  4. [8]Das S, Behera SK, Xavier AS, Selvarajan S Prophylactic Use of Steroids and Antibiotics in Acute Hydrocarbon Poisoning in Children Journal of Pharmacy Practice, 2020.PMID 29673294
  5. [9]Reddy MV, Ganesan SL, Narayanan K, Jayashree M, Singhi SC, Nallasamy K, et al Liquid Mosquito Repellent Ingestion in Children Indian Journal of Pediatrics, 2020.PMID 31768860
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