The child who swallowed something harmful: first steps, the toxicology line and prevention
- Safe practice
Find out what, how much and when; do not make the child vomit; call the national toxicology line; and teach the family to store products safely.
What it is
Most poisonings in young children are accidental ingestions at home: medicines, cleaning products, fuels and pesticides. The nurse's first steps are to check airway, breathing and consciousness, find out what the child took, how much and when, and get expert advice. In Colombia the Línea Nacional de Toxicología answers 24 hours a day for health workers and the public. Decontamination and antidotes follow the medical order and the MinSalud guide. Prevention teaching for the family is part of every visit.
What it requires
- Assessment: airway, breathing, circulation, consciousness, pupils, skin, smell of breath.
- History: the substance, amount, time, route, and whether the exposure was accidental.
- Expert advice from the toxicology line and the institution's protocol.
- Notification to the public health surveillance system (Sivigila) when the case meets the definition.
How it is applied (and why)
- Check airway, breathing, circulation and consciousness first — a child with depressed consciousness is at risk of aspiration.
- Ask what was taken, how much, when and by which route; keep the product's name at hand — this guides the toxicologist.
- Do not give anything to make the child vomit and give nothing by mouth until assessed — vomiting can worsen lung and gut injury.
- For skin or eye exposure, remove contaminated clothing and wash with plenty of water — this stops further absorption.
- Call the Línea Nacional de Toxicología or follow the protocol, and inform the doctor — expert advice speeds the right treatment.
- Monitor vital signs, consciousness, breathing and SpO2 as ordered — some toxins act hours later.
- Give decontamination or antidotes only as ordered — each one has precise indications and contraindications.
- Record the event objectively and notify per protocol — poisonings are monitored in Sivigila.
- Teach prevention to the family before discharge — most childhood poisonings happen at home and can be prevented.
In nursing practice
- After caustic ingestion, a child may have few symptoms at first; serious injury can still be present.
- Hydrocarbon ingestion can cause chemical pneumonitis: watch for cough, fast breathing and falling SpO2.
- Accidental ingestion by children through careless storage is a recognised cause, for example of acetaminophen poisoning; ask about all medicines at home.
- If the circumstances raise concern about neglect or intentional poisoning, follow the institutional protection protocol.
Common mistakes
- Making the child vomit with salt water, fingers or home remedies.
- Trying to neutralise a caustic with an acid or an alkali, or giving drinks before assessment.
- Washing off a pesticide without protective equipment for the staff.
- Discharging without teaching safe storage of medicines and household products.
Test yourself
Think of the answer, then tap the question to see it.
Why should vomiting not be induced after a hydrocarbon ingestion?
Because the hydrocarbon can be aspirated into the lungs during vomiting and cause chemical pneumonitis.
What is the Línea Nacional de Toxicología in Colombia?
A 24-hour MinSalud phone service (toll-free 018000-916012) that advises health workers and the public on poisonings.
Does the absence of mouth burns rule out serious injury after a caustic ingestion?
No. Burns in the mouth do not correlate with internal injury; the child needs assessment.
Which questions does the nurse ask first about a possible poisoning?
What was taken, how much, when and by which route.
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Línea nacional de toxicología (Ministerio de Salud y Protección Social de Colombia, 2025); Guía para el Manejo de Emergencias Toxicológicas (Ministerio de Salud y Protección Social de Colombia / OPS, 2017); Medication Safety and Your Health (Centers for Disease Control and Prevention, 2024).
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Representative model, for educational purposes only.