Pediatric toxicology: Part 3. What EMS providers need to know about "one-pill killers"

As discussed in Parts 1 and 2 in the April and May issues, most toxic exposures in children under 6 years old are secondary to exploration rather than intentional attempts to harm and therefore do not involve enough substance to cause significant toxicity. It is not until the teen years that toxic exposures with intent to cause personal harm begin to occur. There are several substances, however, that can result in significant toxicity, even when taken at low doses. These are referred to as "one-pill" or "one-dose" killers. Although it may take more than one pill or dose for death to occur, this is a good tenet to remember, as low doses of these substances can indeed cause significant toxicity or death. Therefore, it is imperative that prehospital providers be familiar with both the generic and trade names of these medications so exposure can be recognized and appropriate treatment initiated.