Paeds Vivas · acute-care-resuscitation-and-toxicology
Poisoned child: structured assessment and decontamination — branching viva
A branching viva following one poisoned child from the doorway through resuscitation before decontamination, the four-question ingestion history, reading the toxidrome, calling the Poisons Information Centre, deciding on activated charcoal within the first hour, escalating to whole bowel irrigation for a sustained-release ingestion, and a structured handover with safeguarding in parallel.
On this page
Study tools
Target exams
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 failing system, the immediate action and the reassessment endpoint. [1] [9]
Candidate brief
You are the senior paediatric clinician in a rural district emergency department. Speak as you would during resuscitation. Secure immediate threats before any decontamination, state the change you expect from each action, and say what you will reassess. This is one continuous case. Each escalation branch leads to the next update. [9]
References6ShowHide
- [1]Hoffman RJ, Nillas A Toxidromes and a general approach to poisoning Archives of disease in childhood, 2025.PMID 39978865
- [3]Hoegberg LCG, Shepherd G, Wood DM, et al. Systematic review on the use of activated charcoal for gastrointestinal decontamination following acute oral overdose Clinical toxicology (Philadelphia, Pa.), 2021.PMID 34424785
- [5]Zhao X, Dughly O, Simpson J Decontamination of the pediatric patient Current opinion in pediatrics, 2016.PMID 27031659
- [7]Tenenbein M Position statement: whole bowel irrigation. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists Journal of toxicology. Clinical toxicology, 1997.PMID 9482429
- [9]Berg SE, McCann SD Pediatric Toxicology: An Updated Review Pediatric annals, 2023.PMID 37036778
- [12]Bond GR The role of activated charcoal and gastric emptying in gastrointestinal decontamination: a state-of-the-art review Annals of emergency medicine, 2002.PMID 11867980