The ED nurse is assessing a toddler who swallowed bleach, and the parents report a tablespoon of Ipecac syrup was given. The priority action is which statement?

• A. I gave my toddler a tablespoon of Ipecac syrup
• B. I immediately contacted poison control
• C. I rinsed the child's mouth with water
• D. I removed the child from the exposure

Answer: (A)

Ingestion of a caustic substance like bleach requires immediate expert guidance to determine the safest and most appropriate next steps. The first priority is to contact poison control right away to get instructions tailored to the product, the amount ingested, and how long ago it occurred. Emesis with Ipecac is not recommended because vomiting can re-expose the esophagus to the caustic agent and increase the risk of aspiration and tissue injury; poison control can advise whether any decontamination is needed and whether the child should be transported for further evaluation.

In the meantime, ensure the child is removed from further exposure and monitor for airway or breathing problems. If feasible and advised, you can help rinse the mouth with water to remove residual chemical, but do not force fluids or attempt additional home remedies without poison control guidance. The ED team will perform a focused assessment for airway compromise and obtain a plan from poison control about decontamination, observation, or treatment.