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Iron poisoning — RACP Paediatrics MCQ

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HardEmergency paediatricsIron poisoningRACP Paediatrics

A 3-year-old is found beside an open bottle of iron tablets. Four hours later she has vomiting, abdominal pain, lethargy and metabolic acidosis; abdominal radiograph shows multiple radio-opaque tablets. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Urgent toxicology advice with consideration of intravenous desferrioxamine

Severe iron poisoning causes gastrointestinal injury, shock and metabolic acidosis; urgent toxicology advice and chelation with IV desferrioxamine may be required. Activated charcoal does not bind iron effectively. The pearl is that a transient improvement after early gastrointestinal symptoms can precede severe systemic toxicity.

Reference: RCH Clinical Practice Guidelines: Iron poisoning; Poisons Information Centre guidance