A practical approach to the intoxicated child

Abstract

<h2>Abstract</h2> Suspected intoxication causes a range of clinical challenges in the Children's Emergency Department. The majority of ingestions, especially in younger children are unintentional, occurring mainly in the home environment. Adolescence alcohol intoxication is often part of risk-taking behaviour and experimentation; however, clinicians need to be wary of deliberate co-ingestion of other poisons with alcohol in acute mental health crisis. Anatomical and physiological differences in ages effect the way drugs are absorbed and eliminated in the body, effecting clinical features. A good knowledge base of the clinical manifestations of certain drugs can help predict and manage side effects. The management of toxic ingestion is mainly supportive, as side effects may take to become apparent. Investigation is determined by suspected drug ingested, however bedside blood glucose measurement and ECG should be the first consideration. The main life-threatening complications of alcohol intoxication are respiratory depression and hypoglycaemia. Other complications include hypovolaemia, hypothermia and alcoholic ketoacidosis. Any professional with safeguarding responsibility for children should take action to recognise and treat any addiction as well as identify specific social vulnerabilities. Children presenting with signs alcohol dependence, alcohol withdrawal, organ dysfunction or with self-harm should be referred for specialist care.