Toxic ingestions in children

Asymptomatic patients

Most children can be observed for onset of signs and symptoms and then discharged. Most ingested medications have onset of findings within 6 hours after ingestion. The child should be watched under observation for 6 hours after presentation. If children have ingested a substance that carries a high risk of delayed toxicity, a 24-hour observation is required. Children can be discharged only if they remain asymptomatic after the observation period and the laboratory tests and ECG are negative. This decision should be made only in concert with a regional poison control centre or a medical toxicologist.

Symptomatic patients

Most children do well with appropriate management. Fatalities are fortunately rare, although fatalities in low- and middle-income countries have been reported to be four times higher than in high-income countries.[67]World Health Organization. World report on child injury prevention. 2008 [internet publication]. https://www.who.int/publications/i/item/9789241563574 Most children can be discharged home 24 hours after complete resolution of all their signs and symptoms, provided that the child is discharged into the care of a responsible adult, home care has been arranged, appropriate social services have been involved, and, if necessary, psychiatric intervention has occurred.