In this section
Poisoning – Guidelines for initial management
For 24 hour advice, contact Victorian Poisons Information Centre 131126
NSAIDs include celecoxib, diclofenac, etoricoxib, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, meloxicam, naproxen, parecoxib, piroxicam, sulindac, tiaprofenic acid.
Massive ingestions can cause shock, coma, seizures and acute renal failure.
Note: this guideline does not cover aspirin. Please see Salicylate poisoning guideline.
All children with deliberate self-poisoning or significant accidental ingestion.
Any symptomatic child.
Any child whose developmental age is inconsistent with accidental poisoning as non-accidental poisoning should be considered.
Intentional overdose or accidental
GIT: Epigastric pain, nausea, vomiting
CNS: Drowsiness, lethargy, seizures, coma
Metabolic: acute renal failure
Mild GI and CNS effects
Risk of multi-organ dysfunction
Mefenamic acid ingestion of >3.5g can cause seizures.
Symptomatic children or those with concurrent illness:
Consider paracetamol concentration in all intentional overdoses.
Standard procedures and supportive care.
Ensure adequate hydration after large overdoses to reduce the likelihood of acute renal failure.
Activated charcoal is not indicated.
Ongoing care and monitoring
Specific Indications for admission for observation:
Consult Victorian Poisons Information Centre 131126 for advice
Children requiring care outside the capacity of the local centre.
For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.
Asymptomatic children with normal vital signs 4 hours post-ingestion may be discharged.
Prior to discharge, adolescents who present with deliberate ingestions need a risk assessment regarding the likelihood of further ingestions or other attempts to self-harm.
Assessment of other drug and alcohol use should also be undertaken.
If, after risk assessment, it is deemed safe to discharge a patient from hospital, but ongoing mental health or drug and alcohol needs are identified, the adolescent should be linked with appropriate services (see links below for services in the State of Victoria).
Parent Information Sheet: Poisoning prevention for children
Victorian Poisons Information Centre: 13 11 26
Mental Health Services
HEADSPACE: National Youth Mental Health Foundation
Local headspace centres
CAMHS: Child and Adolescent Mental Health Services
Local services alphabetically by suburb / city
Drug and alcohol services
YoDAA: Victoria's Youth Drug and Alcohol Advice Service
1800 458 685
Last Updated April 2019