FIGURE 102.4 The initial approach to the patient ingesting a possibly toxic dose of iron a Iron levels expressed in mcg/dL The mainstay of GI decontamination for iron-poisoned patients, however, is the early and aggressive use of WBI This approach is believed to be effective in decreasing iron absorption and in breaking up pill concretions that might be a risk for direct mucosal injury As noted previously, an abdominal radiograph should be obtained early in the evaluation of symptomatic patients If this study demonstrates significant radiopaque material and the patient’s condition allows it, WBI should be instituted for at least to hours A few hours of WBI (until rectal effluent is clear) may be indicated in symptomatic cases even without definite radiographic findings to hasten elimination of residual iron pill particles