Clinical Practice Guidelines

Acute poisoning - guidelines for initial management

  •  See also the following Poisoning Guidelines:


    General principles


    • Type of ingestion (drug, preparation)
    • Time of incident
    • Amount of ingestion (include all medication that was potentially in the bottle or packet when calculating)
    • Weight of child
    • Is the ingestion potentially harmful?
    • Beware of the possibility of mixed overdose
    • Beware of the possibility of inaccurate dose reporting on history taking
    • If mixed or undetermined ingestion Paracetamol level should be done.

    The poisons information centre may provide useful information on toxins and doses found in various products, phone 131126.


    • Airway
    • Breathing
    • Circulation
    • Removal of poison (if necessary)
    • Emesis
      • No role in the hospital setting
    • Activated Charcoal  
      Has a very limited role in treatment and should not be used without consultation with a toxicologist.
      • Patients with altered conscious state 
      • The following agents:
        • Ethanol/glycols
        • Alkalis
        • Boric acid
        • Lithium
        • Iron compounds
        • Potassium and other metallic ions
        • Fluoride
        • Cyanide
        • Hydrocarbons
        • Mineral acids
    • Whole Bowel Irrigation has a limited role in treatment of some slow release preparations
    • Gastric Lavage has a very limited role in treatment and should not be used without consultation.
    • Specific antidotes may be available and serum drug levels may help in treatment decisions

    All acts of deliberate self harm must be taken extremely seriously.

    All intentional self poisonings in adolescents require admission under the adolescent unit after discussion with their on-call consultant. 

    If unexplained symptoms exist a urinary drug screen may be indicated..