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Medical Author:

Douglas S Lee, MD

Coauthor:

Ruben Olmedo, MD

Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Once the doctor makes sure the child is breathing normally, the child likely will have his or her whole bowel cleaned by drinking a strong laxative fluid.

Severe poisonings will require IV chelation therapy - a series of IVs containing deferoxamine mesylate (Desferal), a chemical that binds to iron in a cell and is then excreted in urine.

• Deferoxamine can be administered by IV or injection, but the IV route is preferred for easier dose adjustment. A change in urine color (to a red-orange) and low blood pressure are common side effects with deferoxamine treatment.
• Usually children require no more than 24 hours of therapy.

Orogastric lavage, or pumping of the stomach, can be considered, but it is generally only helpful if performed within 1 hour of swallowing the pills. Insertion of the tube can cause complications, and many pills may not fit through the ports of a lavage tube if they are not disintegrated.

If ingestion of other medications is suspected, the physician may give the child activated charcoal to drink. Activated charcoal does not bind to iron but may be useful in adsorbing other medications.

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