NORCET -6 Prelims: A 5 year old baby drank Kerosine accidentally. What is the priority management in this case?

NORCET -6 Prelims

Child Health Nursing (Pediatrics)

Medium

Appeared in: NORCET -6 Prelims

Explanation

to keep the child NPO (nothing by mouth) until help arrives.
Kerosene is a hydrocarbon, and the most significant risk following ingestion is aspiration into the lungs, which can lead to severe and life-threatening chemical pneumonitis.
Keeping the stomach empty by withholding food and drink (NPO) minimizes the risk of spontaneous vomiting, thereby reducing the chance of aspiration.
This is a crucial 'do no harm' principle in managing hydrocarbon poisoning while awaiting emergency medical services.

Option A: Gastric lavage is contraindicated because the insertion of the tube and the procedure itself can induce vomiting and cause aspiration of kerosene into the lungs.
Option C: Inducing vomiting is extremely dangerous after kerosene ingestion. It re-exposes the esophagus to the chemical and dramatically increases the risk of aspiration into the lungs.
Option D: Activated charcoal is ineffective because it does not adsorb (bind to) hydrocarbons. Administering it provides no benefit and may cause vomiting, increasing the aspiration risk.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Management of hydrocarbon (kerosene) poisoning as background academic context rather than a clinical decision trigger.
A nurse's first action upon learning of kerosene ingestion is to instruct the caregiver to NOT induce vomiting and to seek immediate emergency help. The priority is preventing aspiration.
Nurses must perform vigilant respiratory assessment, monitoring for coughing, tachypnea, and wheezing, as these are early signs of chemical pneumonitis, the most common and serious complication.
What if the child is already coughing and having difficulty breathing upon arrival? The priority immediately shifts to airway management (ABCs). This indicates aspiration has already occurred, and the child will need oxygen, respiratory support, and possibly intubation.

How to Approach the Question

First, identify the substance ingested: Kerosene is a hydrocarbon (petroleum distillate).
Next, recall the primary danger associated with this class of poison. For hydrocarbons, the main risk is not systemic toxicity but aspiration into the lungs, causing chemical pneumonitis.
Evaluate each option based on whether it increases or decreases the risk of aspiration.
Eliminate 'Gastric Lavage' and 'Induce vomiting' as they both significantly increase the risk of aspiration.
Eliminate 'Give activated charcoal' as it is known to be ineffective for hydrocarbons.
The remaining option, 'NPO till help arrive', is a safe, supportive measure that minimizes the risk of aspiration by preventing further stomach contents that could be vomited. This is the correct priority action.

Concept Tested & Keywords

Concept Tested: Management of hydrocarbon (kerosene) poisoning
Stem keywords: 5 year old, drank Kerosine, priority management
Lead-in keywords: priority management
Clinical cues: Ingestion of a hydrocarbon (kerosene) is a medical emergency where preventing aspiration is the top priority.

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 752-754, 753-755

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 129-131