# Accidental poisoning and ingestion in children - Category: emergency - Review status: reviewed (every claim checked against a document named on this page) - Sources: Activated Charcoal - StatPearls (NCBI Bookshelf NBK482294) - https://www.ncbi.nlm.nih.gov/books/NBK482294/ · Organophosphate Toxicity - StatPearls (NCBI Bookshelf NBK470430) - https://www.ncbi.nlm.nih.gov/books/NBK470430/ · Acetaminophen Toxicity - StatPearls (NCBI Bookshelf NBK441917) - https://www.ncbi.nlm.nih.gov/books/NBK441917/ · Accidental poisoning and ingestion in children - disease-level clinical article (accidental-poisoning-child-full.txt) · Accidental poisoning and ingestion in children - disease-level clinical article (accidental-poisoning-child-clinical.txt) - Verified date: 2026-08 ## Verified against - Activated Charcoal - StatPearls (NCBI Bookshelf NBK482294) - https://www.ncbi.nlm.nih.gov/books/NBK482294/ - Organophosphate Toxicity - StatPearls (NCBI Bookshelf NBK470430) - https://www.ncbi.nlm.nih.gov/books/NBK470430/ - Acetaminophen Toxicity - StatPearls (NCBI Bookshelf NBK441917) - https://www.ncbi.nlm.nih.gov/books/NBK441917/ - Accidental poisoning and ingestion in children - disease-level clinical article (accidental-poisoning-child-full.txt) - Accidental poisoning and ingestion in children - disease-level clinical article (accidental-poisoning-child-clinical.txt) ## Treatment metadata - Referral & safety-netting (no drug therapy) - Activated charcoal — oral.liquid ## Complete treatment card ```text ACCIDENTAL POISONING AND INGESTION IN CHILDREN Sources: Activated Charcoal - StatPearls (NCBI Bookshelf NBK482294) - https://www.ncbi.nlm.nih.gov/books/NBK482294/ · Organophosphate Toxicity - StatPearls (NCBI Bookshelf NBK470430) - https://www.ncbi.nlm.nih.gov/books/NBK470430/ · Acetaminophen Toxicity - StatPearls (NCBI Bookshelf NBK441917) - https://www.ncbi.nlm.nih.gov/books/NBK441917/ · Accidental poisoning and ingestion in children - disease-level clinical article (accidental-poisoning-child-full.txt) · Accidental poisoning and ingestion in children - disease-level clinical article (accidental-poisoning-child-clinical.txt) Review status: REVIEWED against 5 sources listed above (2026-08) 1. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Organophosphate Toxicity - StatPearls (NCBI Bookshelf NBK470430) - https://www.ncbi.nlm.nih.gov/books/NBK470430/ Why Almost every childhood ingestion in Cairo is kerosene, a pesticide, or something from the family's own medicine shelf, and each of those three is a different emergency. What follows is how to tell them apart and what must not be done on the way to hospital. Caution NEVER MAKE THE CHILD VOMIT, AND NEVER WASH THE STOMACH OUT. Neither appears anywhere in the cached articles as treatment, and the charcoal article gives the reason vomiting is itself the danger: what comes back up can go into the lungs, and the pneumonitis that follows is the gravest of the risks. Inhaled material - from vomit, or from a nasogastric tube misplaced while giving charcoal - can wreck breathing badly enough to kill. Salt water, milk and finger-in-the-throat all end in the lungs. KEROSENE AND SOLVENTS ARE A LUNG PROBLEM, NOT A STOMACH PROBLEM - the charcoal article contraindicates it wherever giving it would make inhalation more likely or more severe, and names hydrocarbons that are readily inhaled as exactly that case. A child who has swallowed kerosene, paraffin, petrol, thinner or lamp oil is sent to hospital and given nothing by mouth. PESTICIDES - THE SMELL AND THE PUPILS GIVE IT AWAY. The usual picture is pinpoint pupils, heavy sweating and difficulty breathing. Some organophosphates carry a smell of garlic or of petroleum that points to the diagnosis. THE PESTICIDE SIGNS, IN THE ARTICLE'S OWN MNEMONIC - D for defecation and sweating, U for passing urine, M for pinpoint pupils, B for wheeze and a wet chest, E for vomiting, L for watering eyes, S for drooling; and on the nicotinic side, wide pupils, a fast pulse, weakness, a high blood pressure and muscle twitching. AND PESTICIDE POISONING KILLS THROUGH THE CHEST - death, where it comes, comes from respiratory failure: the airways tighten and fill with secretions, the drive to breathe is depressed centrally, and the breathing muscles weaken or stop altogether. UNDRESS AND WASH THE CHILD, AND PROTECT YOURSELF WHILE DOING IT - take off everything the child is wearing and dispose of it, then clean the skin with soap and water, and do that 3 times. Handle vomit and diarrhoea with care, since the pesticide is present in them too. None of this may delay getting the child treated. ATROPINE IS THE PESTICIDE ANTIDOTE AND IT IS GIVEN IN HOSPITAL - the article notes a hospital may get through very large amounts of it, running into hundreds of milligrams. It also describes a diagnostic trial: if the child improves after 0.6 mg to 1 mg of atropine, that points towards poisoning by a cholinesterase inhibitor. Those are resuscitation-room numbers. PARACETAMOL - A CHILD WHO LOOKS COMPLETELY WELL MAY STILL BE POISONED. Most children who have taken too much have no symptoms at first, or nothing beyond nausea and vomiting. The article's first stage covers the 30 minutes to 24 hours after the dose, and may be silent throughout. Looking well on the first day is the rule, not reassurance. HOW MUCH PARACETAMOL IS TOO MUCH - one dose of 150 mg/kg is the threshold for toxicity, and 200 mg/kg the figure the article gives in an otherwise healthy child aged 1 to 6. For comparison it puts the safe dose at 10 to 15 mg/kg a dose, every 4 to 6 hours, with a ceiling of 75 mg/kg in a day. THE PARACETAMOL ANTIDOTE IS TIME-CRITICAL - acetylcysteine, usually intravenous, is the antidote that matters in paracetamol poisoning, and it works best started inside the first 8 hours of an acute overdose. The blood paracetamol level is taken 4 hours after the ingestion. Waiting to see whether the child becomes unwell wastes the window. IF NOBODY KNOWS WHEN IT WAS TAKEN, THE HOSPITAL TREATS ANYWAY - where the poison went down more than 8 hours before arrival, acetylcysteine is given empirically; where the timing is simply unknown, it is started straight away and the blood tests follow. SEND THE CONTAINER WITH THE CHILD. The paracetamol article stresses a detailed history - exactly when, which preparation, how much, and what else was swallowed alongside it - and the bottle answers all four questions faster than a frightened parent can. AND IT IS WORTH PHONING AHEAD - the charcoal article suggests it is reasonable to speak to a regional toxicologist or a poison control centre before starting repeat-dose treatment. PREVENTION IS THE PART A CLINIC CAN ACTUALLY CHANGE - the paracetamol article records that 50% of cases are accidental overdoses, and draws from that a need for clinicians to teach patients how the drug is dosed and how many preparations, prescribed and over-the- counter, already contain it. Kerosene kept in a soft-drink bottle under the sink is the Egyptian version of the same failure. 2. ACTIVATED CHARCOAL [2nd line] Adult 50 to 100 g as a single dose, within 1 hour of ingestion, and only where the airway is safe - Single dose Peds 1 year and under: 10 to 25 g. The alternative is 1 g/kg of body weight. 2 to 12 years: 25 to 50 g. The alternative is 1 g/kg of body weight. 12 years and over: The adult amount. (By age: an infant of 1 year and under gets 10 to 25 g; a child of 2 to 12 years, 25 to 50 g; and from 12 upwards, the adult amount. The alternative is by weight, 1 g/kg of body weight. No weight calculator is offered above because the article's own paediatric instruction is by age band, not per kilogram.) Source Activated Charcoal - StatPearls (NCBI Bookshelf NBK482294) - https://www.ncbi.nlm.nih.gov/books/NBK482294/ Why Indication and amount are both stated in the same opened article. It allows an oral suspension of activated charcoal to be considered where a poisoning needs the gut decontaminated, and the same sentence shuts the window at 1 hour from the ingestion. For the amount it gives a weight rule and an age table side by side: 1 g/kg of body weight, or else by age - adults 50 to 100 g; infants of 1 year and under, 10 to 25 g; children of 2 to 12 years, 25 to 50 g; and from 12 upwards the adult amount. Charcoal is a hospital-side decontamination step printed here so it is recognised, not a substitute for sending the child. Caution CONTRAINDICATED IF THE CHILD SWALLOWED KEROSENE, PARAFFIN, PETROL OR A SOLVENT - charcoal is barred wherever it would make inhalation more likely or more severe, and hydrocarbons that are readily inhaled are named as that case. CONTRAINDICATED IF THE CHILD IS DROWSY, FITTING OR NOT FULLY AWAKE - an unprotected airway bars it: a reduced conscious level, with no tube in place. The article puts the safe case the other way round too - the patient alert and cooperative, with airway reflexes intact, or an endotracheal tube protecting the airway. THE OTHER BARS, IN THE ARTICLE'S OWN LIST - a high risk of perforation or bleeding in the gut, whether from an existing condition or from recent bowel surgery; any situation likely to need endoscopy, since charcoal blocks the view; intestinal obstruction; and poisons charcoal does not meaningfully bind. ASPIRATION IS THE THING THAT KILLS CHILDREN GIVEN CHARCOAL - inhaling it, and the pneumonitis that follows, are the most serious risks of giving it, so the airway must be assessed properly before any charcoal goes in. THE ONE-HOUR WINDOW IS REAL, AND SO IS THE MODEST BENEFIT - given within an hour of the poison, charcoal cuts how much of it is absorbed, and for many poisons cuts it substantially; but no study has shown it changes what happens to the patient - not deaths, not illness, not length of stay. Charcoal is never a reason to keep a poisoned child in the clinic. LATER THAN AN HOUR, ONLY IN PARTICULAR INGESTIONS - charcoal may still help up to 4 hours after a large ingestion, after a delayed-release preparation, or after a poison with anticholinergic or opioid effects that slows the bowel down. FOR PARACETAMOL SPECIFICALLY, IT IS AN ADJUNCT AND A DEBATED ONE - the paracetamol article calls the use of charcoal in paracetamol poisoning controversial, and says it may be considered within 2 hours of an acute ingestion, with little data showing it improves the outcome. It does not replace acetylcysteine. PREGNANCY IS NOT A REASON TO WITHHOLD IT - where charcoal or another antidote is clearly indicated, pregnancy is no reason to hold it back over a fear of harm to the fetus. Egypt CHAR 500 MG 30 CAPSULES HP PHARMA 45.00 EGP (1.50/unit) -> ? different route - not oral liquid GAMPS ACTIVATED CHARCOAL 30 CAPSULES PHARMAZAD > DOPAMINE PH... 120.00 EGP (4.00/unit) -> ? different route - not oral liquid CHARCLONE 250MG 30 CAPS. DULEXLAB > MI... 130.00 EGP (4.33/unit) -> ? different route - not oral liquid CHARC PRITTO 30 CAPSULE PHARMA ZAD > ... 140.00 EGP (4.67/unit) -> ? different route - not oral liquid GAMPS ACTIVATED CHARCOAL 10 CAPSULES PHARMA ZAD > SELWAN PHARMA 60.00 EGP (6.00/unit) -> ? different route - not oral liquid CHARCLONE 1000MG 30 TABS. DULEXLAB > MI... 195.00 EGP (6.50/unit) -> ? different route - not oral liquid CARBONECOL 30 H.G. CAPS . ORGANIX > VORTEX 150.00 EGP -> ? different route - not oral liquid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)