Pedemy All toolsPick the substance. Doses are calculated for the weight entered. Always call the poison center. Tap any earlier answer to change it.
This tool helps clinicians manage a child who may have swallowed a toxic substance. You pick what was taken and, if you enter a weight, the antidote and treatment doses are calculated in mg or units for that child. It covers unknown ingestions, opioids, iron, tricyclic antidepressants, calcium-channel and beta-blockers, sulfonylureas, clonidine or guanfacine, salicylates and toxic alcohols, and points to separate Pedemy tools for acetaminophen and button batteries.
Each substance has its own key thresholds. For iron, elemental doses under 20 mg/kg usually cause no toxicity, 20–60 mg/kg cause GI symptoms and over 60 mg/kg are potentially serious. For tricyclics, a QRS over 100 ms predicts seizures and over 160 ms predicts arrhythmias, and sodium bicarbonate is given until the QRS narrows. Salicylate over 150 mg/kg is toxic, and sulfonylurea hypoglycemia can be delayed up to 16–24 hours, so these children are admitted for 24 hours.
Every result also lists general steps: airway, breathing and circulation, bedside glucose, ECG, acetaminophen and salicylate levels when the substance is unclear, and a call to the poison center (1-800-222-1222 in the US). Content is based on Goldfrank’s Toxicologic Emergencies, 11th ed., and the AAPCC salicylate (2007) and iron (2005) guidelines.
The tool uses naloxone 0.1 mg/kg (max 2 mg) IV, IO, IM or intranasal, repeated every 2–3 minutes and titrated to breathing rather than full awakening. An infusion can run at two-thirds of the effective dose per hour. Toddlers who ingest buprenorphine or methadone are admitted for at least 24 hours.
Based on elemental iron: under 20 mg/kg usually causes no toxicity, 20–60 mg/kg makes GI symptoms likely, and over 60 mg/kg is potentially serious. Elemental iron is 20% of ferrous sulfate, 33% of fumarate and 12% of gluconate. Charcoal does not bind iron; deferoxamine 15 mg/kg/h is used for shock, acidosis or severe toxicity.
The tool lists tricyclic antidepressants, calcium-channel blockers, sulfonylureas, opioids such as buprenorphine and methadone, clonidine, camphor and diphenoxylate. A toddler who may have taken one of these should be observed and admitted, and the poison center should be called.
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