Clinical Case 054: Just a sip
Mother of a 15 month old boy (weighs 11 kg) presents to the clinic with a bottle of massage liniment.
A quick glance at the label tells you the active ingredients are;
Per 50 milliliter:
Mum says she just popped out to hang the washing and left him playing on the floor. She was not aware that her teenage son had left the bottle on the couch after going to footy practice.
When she came back inside she immediately smelled the menthol and found the little guy on the floor, playing with the bottle, it was dripping down his chin and he was making a disgusted face – like he had a bad taste in his mouth. She picked him up and could smell the scent on his breath. But he was fine, happy and she gave hi a bottle of milk to settle him and get the taste out of his mouth.
Ok, now you are seeing him 45 minutes later – he still looks fine, he is playing happily, smells like a gymnasium. His obs are all normal and Mum says:
“I am sure it is fine – but I just thought I should bring him in for a quick once over…”
After examining him you agree that he is normal, no signs of respiratory distress, no chest or abdo signs. Now here are the questions:
Q1: What is likelihood that a toddler would have swallowed more than a few mils?
Q2: Which of the ingredients are potentially toxic? And how much would be required for potential serious badness?
Q3: What signs, symptoms and timeframe will you want to keep an eye on this little boy?
Q4: What resources can you use to help make this assessment and formulate a management plan?
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