In this section
Poisoning - Acute guidelines for initial management
Recreational Drug Overdose
Acute behavioural disturbance: Acute management
Poisons Information contact number (131126)
Most accidental paediatric drug ingestions involve doses that fall well below what would be considered a toxic ingestion. There are a handful of drugs and chemicals that are dangerous after relatively small paediatric ingestions involving 1 or 2 dose units of an available preparation or a mouthful. These agents demand a cautious approach to risk assessment.
Drugs or chemicals with potential paediatric toxicity after accidental small dose ingestions
Calcium channel blockers
HypotensionRefractory shock** Delayed toxicity (beyond 12 hours) may occur after sustained release preparation.
Chloroquine and hydroxychloroquine
Rapid onset coma
Opioids (methadone most toxic)
Propranolol and sotolol (other beta blockers are better tolerated)
Hypoglycaemia (may be delayed 8 hours)
Features of toxicity
Amphetamines (including ice, speed, ecstasy)
As above for prescription amphetamines
Hyponatraemia with ecstasy
Rapid onset respiratory depression and coma with recovery in a few hours
Hypotension (rapid onset)
Hydrocarbons, solvents, eucalyptus oil
Aspiration (rapid onset)
Lead foreign body (eg fishing sinker)
Naphthalene moth ball
(Most moth balls now contain less toxic paradichlorbenzene)
Organophosphate and carbamate insecticides
Multi organ failure
Admission for observation is mandated if there is any concern that a small child may have ingested one of these drugs or chemicals.
All cases should be discussed with a senior clinician / Poisons Information / clinical toxicologist.
For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.