Life-threatening pediatric poisonings.

Initial therapy of the poisoned child should follow the basic principles of advanced life support and include support of a patent airway and adequate oxygenation, ventilation, and circulation. Ingestion of certain substances require agent-specific therapy which may modify the standard resuscitative approach. Children can present following unknown or unsuspected ingestions. Any child with unexplained altered level of consciousness, respiratory, circulatory derangement, seizures or metabolic abnormalities should be considered for toxic ingestion. Knowing the typical signs and symptoms of the common toxic syndromes can help identification of the unknown ingestion. Recommendations for decontamination, detoxification, and antidotal therapies have changed over the past 10 years. Clinicians should be aware of the community resources available to help guide the evaluation and management of the poisoned child.