An 18-month-old is brought 20 minutes after drinking kerosene stored in a soft drink bottle. He is coughing but alert, breathing comfortably at rest with saturations of 97% in room air, and has vomited once spontaneously at home. What is the correct approach?
- A Perform gastric lavage promptly to remove remaining kerosene
- B Give activated charcoal 1 g/kg orally to bind residual kerosene
- C Admit for observation with a chest radiograph, avoiding induced emesis and lavage ✓
- D Discharge home immediately since he is asymptomatic apart from coughing
Correct answer: C. Admit for observation with a chest radiograph, avoiding induced emesis and lavage
Explanation
Low-viscosity hydrocarbons like kerosene spread rapidly across the airway surface and carry a very high aspiration risk, so emetics, lavage, and charcoal are all avoided unless airway protection is guaranteed. Management is observation for 6 hours with a chest radiograph, since chemical pneumonitis may evolve even after an asymptomatic interval. Discharge is unsafe because pulmonary findings can be delayed, and charcoal offers no binding benefit for hydrocarbons.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.