Ingestions may be acute or chronic. In general, acute ingestions may be more life threatening, while chronic ingestion carry more morbidity. A chronic ingestion may be life threatening and acute ingestions may carry lifelong morbidities depending on the toxin ingested. The differential diagnosis is extremely extensive and includes many medications, plant materials, and numerous organic and inorganic toxins. The history of an acute ingestion is often easier to take because the events are recent.
Histories concerning chronic ingestions are often more difficult to obtain.
The toxin may not be recognized as a noxious substance or the amount taken regarded as trivial and not important to mention to the health care provider. A complete physical examination is also important, with attention to subtle changes in vital signs, eyes, and skin, and odors from the patient. The specific physical signs seen on the physical examination will be different depending on the toxin ingested. The cardiovascular and neurologic status should receive the highest priority in evaluation. Evaluation Laboratory evaluation of an acute ingestion coincides with obtaining the history and physical and treatment of the patient.