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Pediatric emergency medicine trisk 3116 3116

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those compounds with the potential for irreversible systemic toxicity ( Table 102.15 ), including halogenated hydrocarbons (e.g., trichloroethane, carbon tetrachloride) and aromatic hydrocarbons (e.g., toluene, xylene, benzene) In addition, some petroleum distillates contain dangerous additives, such as heavy metals or insecticides Patients who have aspirated may exhibit immediate choking, coughing, and gagging as the product is swallowed and then vomited after ingestion Aspiration of the product may also occur at the time of the initial swallowing ED management of these patients is outlined in Figure 102.10 If the patient has any cough or respiratory symptoms upon arrival to the ED, a chest radiograph should be obtained immediately Because there is a gradual evolution of abnormal radiographs, an initially negative chest radiograph should be repeated at to hours after ingestion All patients with abnormal chest radiographs or persistent respiratory symptoms after to hours of ED observation warrant further medical observation Patients who are asymptomatic with normal chest radiographs after hours of observation may be discharged Because pneumonitis occasionally appears 12 to 24 hours after exposure, detailed instructions should be provided for warning signs of respiratory dysfunction

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