This course explores the epidemiology, mechanisms, and management of poisoning in children, emphasising practical approaches for clinicians. Presented by Dr Nidhi Krishnan, it comprises five comprehensive units supported by real-world case discussions, interactive learning, and clinical assessment exercises. Participants will gain the knowledge to recognise key toxidromes, initiate prompt management, and counsel families on prevention strategies.
Unit 1 – Epidemiology and Assessment of Poisoning in Children
This introductory unit defines poisoning and its significance as a major cause of childhood morbidity and mortality. Learners explore common causes—including pharmaceuticals, household chemicals, plants, and recreational substances—and understand why toddlers and preschoolers are especially vulnerable. The module details the routes of exposure (ingestion, inhalation, dermal, ocular), the “ABCDE” approach to initial assessment, and the key components of effective history-taking, including identifying the substance, quantity, timing, and clinical symptoms.
Unit 2 – Common Ingestions and Their Management
This unit focuses on frequently encountered poisonings in children, including paracetamol, NSAIDs, button batteries, and household cleaning agents. Learners examine mechanisms of toxicity, signs and symptoms, and evidence-based management strategies such as activated charcoal and antidotal therapy (e.g., N-acetylcysteine for paracetamol overdose). Case studies illustrate clinical decision-making, safe referral practices, and collaboration with poison information centres.
Unit 3 – Toxidromes and Recognising Patterns of Poisoning
Participants are introduced to toxidromes—distinct symptom clusters that indicate specific toxin exposures. The unit covers cholinergic, anticholinergic, sympathomimetic, and opioid syndromes, exploring their characteristic presentations, pathophysiology, and management. Key antidotes such as atropine, pralidoxime, naloxone, and physostigmine are discussed in context. Emphasis is placed on pattern recognition, supportive care, and the importance of rapid consultation with toxicology experts.
Unit 4 – Specific Poisonings of Concern in Children
Building on earlier modules, this unit examines high-risk poisonings such as iron, salicylates, tricyclic antidepressants, calcium channel and beta blockers, and hydrocarbons. Learners study clinical features ranging from gastrointestinal injury to cardiac and neurological toxicity. Management strategies include whole bowel irrigation, antidotes (e.g., deferoxamine), alkalinisation, and advanced monitoring. Real-world cases illustrate timely recognition and escalation of care.
Unit 5 – Advanced Management and Prevention
The final unit integrates advanced decontamination and prevention strategies. It revisits the safe use of activated charcoal, gastric lavage, and whole bowel irrigation, and outlines protocols for skin and eye decontamination. Participants also review key antidotes in a consolidated guide and examine the critical role of general practitioners in poison prevention education—including safe medication storage, household chemical safety, and addressing intentional ingestion risks in adolescents.
