Important points in history

Remember there may not be a clear history

Important points in examination


Indications for admission


DO NOT induce vomiting

Treatment of specific poisons

Organophosphate compounds

Cholinergic signs: DUMBELS: Defecation, Urination, Miosis, Bronchorrhea/Bronchospasm/Bradycardia, Emesis, Lacrimation, Salivation. Also, fasciculations, muscle weakness and paralysis

Local medicines

Usually taken for diarrhoea and vomiting. May lead to acidosis, respiratory distress, paralytic ileus.

Petroleum compounds (Paraffin)

Frequently presents with features of respiratory distress. May cause pneumonitis, pneumomediastinum, pneumothorax and subcutaneous emphysema.

Carbon monoxide poisoning

Toxic effects are due to hypoxia. Oxygen saturations can be misleading.

Poisonous plants

Usually only small quantities are ingested


Snake bite


If local swelling is marked or there is evidence of systemic envenoming:

Iron poisoning

Salicylate overdose

Presents with tachypnoea, metabolic acidosis, and to a lesser extent, tachycardia. Early symptoms include tinnitus, vertigo, nausea, vomiting, and diarrhoea.
More severe intoxication can cause fever, altered mental status, coma, non-cardiogenic pulmonary oedema, and death.