- They were developed between 2005 and 2007. New medications have been approved since that time and there may be more recent data available.
- As with any poisoning, dose is only one factor when determining disposition. Consideration should also be given to intent, underlying medical conditions, co-ingestion of other medications, presence of symptoms, and drug formulation.
This PV Card summarizes the pediatric ingestion dose thresholds for referral to an ED.
PV Card: Pediatric Dose Thresholds
Adapted from [1–16]
Go to ALiEM (PV) Cards for more resources.
Thanks to Zlatan Coralic, PharmD (@ZEDPharm) for his excellently detailed expert peer review and suggestions for revisions for this important card.
References
- Wax P, Erdman A, Chyka P, et al. beta-blocker ingestion: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2005;43(3):131-146. [PubMed]
- Caravati E, Erdman A, Christianson G, et al. Ethylene glycol exposure: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2005;43(5):327-345. [PubMed]
- Manoguerra A, Erdman A, Booze L, et al. Iron ingestion: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2005;43(6):553-570. [PubMed]
- Olson K, Erdman A, Woolf A, et al. Calcium channel blocker ingestion: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2005;43(7):797-822. [PubMed]
- Dart R, Erdman A, Olson K, et al. Acetaminophen poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2006;44(1):1-18. [PubMed]
- Scharman E, Erdman A, Wax P, et al. Diphenhydramine and dimenhydrinate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2006;44(3):205-223. [PubMed]
- Manoguerra A, Erdman A, Wax P, et al. Camphor Poisoning: an evidence-based practice guideline for out-of-hospital management. Clin Toxicol (Phila). 2006;44(4):357-370. [PubMed]
- Caravati E, Erdman A, Scharman E, et al. Long-acting anticoagulant rodenticide poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(1):1-22. [PubMed]
- Chyka P, Erdman A, Christianson G, et al. Salicylate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(2):95-131. [PubMed]
- Woolf A, Erdman A, Nelson L, et al. Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(3):203-233. [PubMed]
- Nelson L, Erdman A, Booze L, et al. Selective serotonin reuptake inhibitor poisoning: An evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(4):315-332. [PubMed]
- Chyka P, Erdman A, Manoguerra A, et al. Dextromethorphan poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(6):662-677. [PubMed]
- Scharman E, Erdman A, Cobaugh D, et al. Methylphenidate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(7):737-752. [PubMed]
- Cobaugh D, Erdman A, Booze L, et al. Atypical antipsychotic medication poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(8):918-942. [PubMed]
- Caravati E, Erdman A, Christianson G, et al. Elemental mercury exposure: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2008;46(1):1-21. [PubMed]
- Manoguerra A, Erdman A, Woolf A, et al. Valproic acid poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2008;46(7):661-676. [PubMed]
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