A preschooler is seen in the emergency department for suspected poisoning. In which order would the nurse perform the actions?

• A. Assess the victim; Terminate poison exposure; Identify the poison; Prevent poison absorption.
• B. Terminate poison exposure; Identify the poison; Prevent poison absorption; Assess the victim.
• C. Identify the poison; Assess the victim; Terminate poison exposure; Prevent poison absorption.
• D. Assess the victim; Prevent poison absorption; Terminate poison exposure; Identify poison.

Answer: (A)

In suspected poisoning, the priority is to stabilize the child. The first task is to assess the victim and ensure airway, breathing, and circulation are intact, because a compromised airway or unstable vitals can quickly become life-threatening. Once the child is stabilized, the next essential step is to terminate the poison exposure to stop any further absorption. This means removing the child from the source, removing contaminated clothing, and initiating immediate decontamination if appropriate to the situation, all while continuing to monitor the child’s vital signs.

After exposure is halted, identify the poison. Knowing what was ingested or contacted guides the specific treatment and informs the choice of decontamination methods, antidotes, and monitoring needs. Finally, implement measures to prevent further absorption, such as activated charcoal or other decontamination and antidotal therapies as indicated, while continuing patient assessment and supportive care.

Other sequences place stopping exposure or decontamination before assessing stability or delay the identification of the toxin, which can delay critical life-saving interventions or lead to inappropriate treatment. The order that begins with assessing the victim, then terminating exposure, then identifying the poison, and finally preventing absorption aligns with the priority of patient safety, rapid control of ongoing harm, and targeted therapy.