Observation and patient disposition after iron poisoning
Admit patients with iron poisoning if they have:
- systemic toxicity
- metabolic acidosis
- a peak serum iron concentration of more than 90 micromol/L (5 mg/L)
- radio-opaque tablets visible in the gut on abdominal X-ray.
For all other patients with iron poisoning, the observation period depends on whether the poisoning is deliberate or unintentional, whether the patient is symptomatic and the amount ingested.
For symptomatic patients with minor toxicity (ie not systemic toxicity) or any patient who has taken a deliberate iron ingestion, observe for at least:
- 6 hours following ingestion of an immediate-release preparation
- 12 hours following ingestion of a modified-release preparation.
For asymptomatic patients who have taken an unintentional iron ingestion:
- if they have ingested more than 60 mg/kg of elemental iron and there are no radio-opaque tablets visible on X-ray—observe for at least 6 hours.
- if they have ingested less than 60 mg/kg of elemental iron—discharge without intervention.