Pediatric Medicine

Answer 2 Administer deferoxamine. Iron poisoning is one of the most common potentially fatal intoxications in children. Chelation therapy with parenteral deferoxamine enhances excretion of iron and is indicated in very symptomatic children, regardless of the serum iron level; it is the antidote for significant iron poisoning. Iron does not bind to activated charcoal. Only 50% of radiographs are positive in children who ingest iron tablets; thus, lack of radiographic evidence proves nothing. The mainstay of GI decontamination is early and aggressive use of whole bowel irrigation, which should be used regardless of serum iron level. Hemodialysis is only indicated as an adjuvant to chelation therapy in patients with renal failure; it removes chelated iron but not free iron. Click here to return to the questions

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