OSCE 10: Paediatric Iron Overdose. OSCEs done by recent fellows at a high level to provide an example of a good pass and additional advice on providing a framework to answer the scenarios.
acute ingestion results in gastrointestinal irritation and then dose-related systemic toxicity potentially leading to death. Iron takes hours to reach from the GI tract to the intracellular space. This gives us the opportunity to prevent further absorption in large overdoses with decontamination and chelation.
A 3 year-old boy ingested 50 mg/kg elemental iron 2 hours ago. You are called for advice about the management of iron poisoning from a remote hospital.
Iron overdose can have local gastrointestinal effects as well as characteristic systemic toxicity (metabolic acidosis, liver failure, shock and multi-organ failure). Risk assessment is based on the amount of elemental iron ingested