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Iron ingestion — RACP Paediatrics MCQ

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HardEmergencyIron ingestionRACP Paediatrics

A 3-year-old is brought to the ED after possibly ingesting 1-2 of his mother's sustained-release iron tablets 1 hour ago. The child is asymptomatic. What is the most appropriate initial management?

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Correct answer: A — Whole bowel irrigation

Activated charcoal does not bind iron effectively. For significant iron ingestion (especially sustained-release preparations), whole bowel irrigation with polyethylene glycol solution may be considered if tablets are still in the GI tract. Serum iron level should be measured at 4 hours. An abdominal X-ray can confirm the presence of radio-opaque tablets.

Reference: RCH Melbourne – 2023 – Poisoning CPG; Australian Therapeutic Guidelines – 2024 – Toxicology