SAQ 478 – Paediatrics – slow-release verapamil ingestion in a toddler

A 2-year-old is brought to the ED after a witnessed ingestion of two of his grandmother's slow-release verapamil tablets 2 hours earlier. He is alert, has a heart rate of 110/min and appears well perfused.

What is your risk assessment for this ingestion? Justify your answer.

(Marked out of 4.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Risk assessment</th> <th>Justification</th> </tr> </thead> <tbody> <tr> <td></td> <td></td> </tr> </tbody> </table> <p>

/ 4

What is the role of decontamination in this ingestion?

(Marked out of 2.0)

/ 2

What is the role of enhanced elimination?

(Marked out of 2.0)

/ 2

Two hours after arrival the child deteriorates. List four (4) key supportive or specific treatment steps, with detail for each.

(Marked out of 8.0)

Observation	Result
GCS	13 (E3 V5 M5)
Heart rate	60/min
Blood pressure	60/40 mmHg

</p> <table class="saq-prop-table"> <thead> <tr> <th>Supportive/specific treatment</th> <th>Detail</th> </tr> </thead> <tbody> <tr> <td>1.</td> <td></td> </tr> <tr> <td>2.</td> <td></td> </tr> <tr> <td>3.</td> <td></td> </tr> <tr> <td>4.</td> <td></td> </tr> </tbody> </table> <p>

/ 8

State your disposition and justify it.

(Marked out of 3.0)

/ 3

List four (4) other medications that may cause severe morbidity or death in a toddler after only 1-3 tablets or a mouthful, giving an example toxic effect for each.

(Marked out of 8.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Medication</th> <th>Potential toxic effect</th> </tr> </thead> <tbody> <tr> <td>1.</td> <td></td> </tr> <tr> <td>2.</td> <td></td> </tr> <tr> <td>3.</td> <td></td> </tr> <tr> <td>4.</td> <td></td> </tr> </tbody> </table> <p>

/ 8

For an asymptomatic child with a witnessed ingestion of an unknown medication, list three (3) key investigations.

(Marked out of 3.0)

/ 3

For that asymptomatic child, state your disposition and justify it.

(Marked out of 3.0)

/ 3

Total Score: 0 / 33

Percentage: 0%