Patient may present with
 Constricted pupils
 Cold sweats
 Difficulty in breathing and excessive salivation
 Convulsions
 Bradycardia or tachycardia
 Abdominal pain, diarrhoea, vomiting
ALWAYS WEAR GLOVES WHEN HANDLING THE PATIENT
Remove contaminated clothes and wash contaminated skin with lots of cold water
Give oxygen
Do not induce vomiting
Consider gastric lavage if within 2 hours of ingestion
 Left lateral position with head down, pass a large e.g. 24 gauge tube through the mouth into the stomach, then give 10 ml/kg N.Saline through the tube, and aspirate, with the patient in the head down position, carefully protect the airway during the procedure
Give activated charcoal –
 25-50 grams of charcoal – grind tablets into powder and mix with 100-
200 mls of water
 Give via NGT if not able to swallow
Atropine – 20 mcg/kg IV (or IM if not able to get IV access) every 15 minutes until reduced secretions, hot dry skin and dry mouth
Do give atropine until the pupils have dilated – this may cause atropine toxicity
Observe for seizures and treat with IV/PR diazepam and load with phenobarbitone 15mg/kg if necessary (seizures continuing despite two doses of diazepam given at least 10 minutes apart)
Paraffin is poorly absorbed in the GI tract but if aspiration occurs this can cause pneumonitis – cough, tachypnea, tachycardia, cyanosis, crepitations and ronchi.
 Do not induce vomiting, do not perform gastric lavage– may cause aspiration and pneumonitis
 Check saturations and give oxygen if necessary
 No role for activated charcoal