Diagnosing Poisoning in Children

Emergency physicians at Hassenfeld Children’s Hospital at NYU Langone are experts in diagnosing poisoning in children and determining the appropriate treatment for the type of toxic substance a child has ingested, inhaled, injected, or absorbed. These items can include prescription or over-the-counter medications, household items such as cleaners or paint, indoor or outdoor plants, pesticides or insecticides, batteries, or carbon monoxide.

Symptoms depend on the type of poisoning, but can include difficulty breathing, dizziness, redness or burns in or around the mouth, changes in the size of the pupils, blurry vision, abdominal cramps, nausea, vomiting, irregular heart rate, hypoglycemia or low blood sugar, sleepiness, hyperactivity, confusion, seizures, or unconsciousness. You may notice burns, stains, or unusual odors on your child, on his or her clothing, or on his or her breath.

If Your Child Has Been Poisoned

Call 911 if your child is experiencing chest pain or difficulty breathing, is unconscious, or you feel that your child needs immediate medical attention.

If you suspect your child has been exposed to a toxic substance or if he or she is showing signs of poisoning, our doctors recommend calling Poison Help or the New York City Poison Control Center, both of which may be contacted at 1-800-222-1222. Experts there provide advice related to the type and amount of poison ingested or inhaled and the child’s age, weight, and medical history.

If your child has swallowed a toxic substance, our doctors recommend removing any visible substances from his or her mouth. If a poison is inhaled, make sure your child gets fresh air. If a poison has affected the skin, remove contaminated clothing and rinse the skin with water. Flush any poisons that have affected the eye with lukewarm water.

If you go to the hospital, bring the container for the toxic substance, including labels or any other information about the toxin.

Our emergency physicians diagnose poisoning in children based on medical history, physical examination, and, if needed, tests. Sometimes poison control experts and medical toxicologists help determine the cause of poisoning.

If the toxin is unknown, testing may be required to determine the cause of poisoning.

Medical History and Physical Exam

A doctor asks about the toxic substance your child may have ingested or inhaled and examines any containers you bring. He or she checks your child’s airway for obstructions and swelling and assesses the child’s ability to breathe. If necessary, a mask may be placed over the child’s nose and mouth to provide oxygen and assist with breathing.

The doctor or other medical staff check blood pressure, body temperature, skin temperature and color, mental state, and the size of the pupils. Your child’s level of alertness and responsiveness is also assessed.

Blood Tests

Blood tests can sometimes help doctors determine the type and amount of certain toxic substances. For example, blood can be tested for toxic levels of ingested acetaminophen or inhaled carbon monoxide.

Blood may be tested to assess glucose levels. Exposure to some substances, such as alcohol or insulin, can cause hypoglycemia, or low blood sugar, which can lead to unconsciousness.

Blood may also be tested to determine levels of sodium, potassium, chloride, bicarbonate, or liver enzymes in the blood to assess the functioning of organs, such as the liver and kidneys. An imbalance in these electrolytes may help the doctor determine which organs, if any, have been affected by the poison.

Electrocardiogram

Also called an ECG or EKG, an electrocardiogram measures electrical currents in the heart to record its activity. This test helps detect arrhythmias, or irregular heart rhythms.

During the test, small, painless electrodes are placed on a child’s chest, wrist, and ankles to transmit information about the heart’s electrical activity to a computer which prints a graph for the doctor to evaluate.

X-rays

Doctors may perform an X-ray of a child’s chest or abdomen. This can help the doctor determine if certain objects, such as a battery, have been swallowed or inhaled.

CT or MRI Scan

A CT or MRI scan produces three-dimensional cross-sectional images of the brain. Rarely, doctors perform a CT or MRI scan to determine the effects of a poison on the brain.