GI decontamination

a. Emesis. Outcome studies showed no advantage. Contra-indicated in infants younger than 6 months of age and in patients with potentially altered mental status, poor gag reflex, and caustic or hydrocarbon ingestions. Ingested substance and time of ingestion are two important factors to consider when deciding to induce emesis. Emesis is less likely to be helpful 1 hour after ingestion unless toxin delays gastric emptying. In rare cases when syrup of Ipecac is indicated, dose is 10 mL in patients aged 6-12 months, 15 mL in those 1-12 years, and 30 mL in those older than 12 years of age.This is followed by 1-3 ounces of water. Response is usually seen in 20 minutes.

b. Gastric lavage. Ineffective in most clinical scenarios. Contraindicated in caustic and hydrocarbon ingestions. If mental status is altered, trachea should be intubated with cuffed tube before lavage. Use large-bore orogastric tube, 28-40 Fr gauge. Lavage with 50-200 mL aliquots of normal

History of possible ingestion of a potentially toxic substance? Yes |

Consider GI decontamination Look for toxidrome

Is exam remarkable? Yes

Discharge to parental care if exam is normal

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