POISONING

1. An eighteen-month-old boy is found in the garage coughing and choking. A jar of paint thinner is spilled on the floor and on his clothing. What advice would you give to the parents over the phone? Should they give Ipecac? What is the most serious toxicity of this ingestion/exposure?
2. A two-year-old boy is brought to the Emergency Department in a coma after his mother found him limp and unresponsive in his room. What questions would you want to ask the mother to help learn why this patient might be unresponsive?
3. You receive a phone call from the mother of a 2-year-old child who was found eating the mother’s prenatal vitamins. She thinks he may have swallowed 16 tablets. What is the toxic component of prenatal vitamins (if taken in excess)? What advice would you give the mother?
4. After a fight with her boyfriend, a sixteen-year-old girl takes 30 acetaminophen tablets. She presents to the emergency department six hours later when she is feeling nauseated. What is the appropriate management of this adolescent?
5. A three-year-old is brought to the Emergency Department because of weakness, diarrhea, and drooling. He had been playing unsupervised in the garage. He is found to have pinpoint pupils and bradycardia. What is the most likely cause of these symptoms and how should the patient be treated?
6. A three-year-old child is seen in the clinic because of irritability, decreased appetite and intermittent abdominal pain. He has developmental delay and mild anemia. How would you evaluate and manage this child?
7. Parents bring a 12-month-old girl for a routine health care supervision visit. What guidance would you give them so as to minimize the likelihood of an accidental poisoning occurring in the house?
8. A two year old girl is brought to the Emergency Room after ingesting an unknown quantity and type of her grandmother's pills. What findings in the physical exam will help to identify the type of pills? What resources are available to help identify and treat the ingestion?