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Pediatrics · Paediatric emergencies: corrosive ingestion
Sample itemA 3-year-old swallowed a toilet cleaner 1 hour ago. She is drooling, refuses fluids and has hoarse cry with mild stridor. What is the correct initial management?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Keep nil by mouth, secure the airway, give fluids and plan early endoscopy
In corrosive ingestion, the priorities are the airway, nil by mouth, intravenous fluids, analgesia and early endoscopy within 24 to 48 hours to grade injury. Vomiting re-exposes the oesophagus, lavage risks perforation and neutralisation causes exothermic injury.
Option by option
A. Pass a wide-bore tube for gastric lavage
Gastric lavage risks perforating the damaged oesophagus and stomach.
B. Give a neutralising agent by mouth immediately
Neutralisation produces heat and further injury and is not recommended.
C. Keep nil by mouth, secure the airway, give fluids and plan early endoscopy (correct)
Correct. Airway protection, nil by mouth and early endoscopy are the cornerstones of care.
D. Induce vomiting to remove the agent quickly
Inducing vomiting re-exposes the oesophagus and airway to the corrosive and is contraindicated.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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