Remember rabies prophylaxis for patients bitten by bats Treatment Guidelines for Lead in Children. Berlin CM, Gorman RL, May DG, et al. Lead poisoning may be a subacute or chronic problem detected on routine screening. However, a patient with acute lead encephalopathy may present to the ED seizing or comatose. The American Academy of Pediatrics Committee on Drugs reviews the current treatment guidelines for lead poisoning in this article.
Therapy includes decontamination, chelation, supportive care, and lead abatement in the home.
Calcium EDTA alone can precipitate encephalopathy by enhancing penetration of the blood brain barrier. BAL should always be used before calcium EDTA in severely lead poisoned patients. Gueye PN, Hoffman JR, Taboulet P, et al. Use of this agent in the overdose setting is limited by seizures. Patients at particular risk seem to include, those with a seizure history, chronic benzodiazepine use, or coingestion of tricyclic antidepressants.