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Poisoning in children under 5 years of age is common, the majority of cases are accidental ingestions. Children may ingest pharmaceutical products, household substances, chemicals, plants or street drugs. Most children develop no clinical features or only mild effects and the challenge in managing these children is to identify the 1% who may go on to develop severe clinical effects and require specific management. The latest guidelines on gastric decontamination are reviewed together with developments in the management of poisoning with paracetamol, tricyclic antidepressants, iron, lead and ethylene glycol and methanol. Prevention of childhood poisoning is important and the use of child-resistant packaging and adequate supervision together with the secure storage of household substances are the basis of prevention of accidental childhood poisoning.
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