Paediatric Caustic Ingestion

You are the on-duty anaesthetist in a large regional centre with a paediatric surgical service. You are called to assist in the Emergency Department with the management of an otherwise healthy 2-year-old girl who has ingested drain cleaner (sodium hydroxide) at home about two hours ago. There are concerns about likely aspiration or inhalational injury from vapours. The Emergency Medicine specialist tells you that the girl was brought in to hospital by her mother after she found the child sitting on the kitchen floor with a pile of drain cleaner crystals next to her and crystals on her hands and inside her mouth. The mother was unable to quantify the amount ingested. The girl vomited once on the way to hospital and is currently drooling and distressed in her mother's arms.