A 2-year old boy presented to the emergency department with a chief complaint of blood-tinged vomiting. His mother was tending to her newborn infant when the patient climbed up and grabbed his mom's bottle of iron pills from the counter. He was able to open the bottle and thinking that the pills looked like candy, he ate them. His mother brought in her bottle of ferrous sulfate 325 mg (65 mg elemental iron) tablets. Counting the iron tablets in the bottle there is a maximum of 15 tablets missing (975 elemental Fe/12 kg = 81 mg/kg of elemental iron ingested). Physical Exam: VS T 36.9, P 120, R 30, BP 88/60, weight 12kg (10th percentile).
Patient is alert, and being carried by mom. His skin is pink and warm with good perfusion and capillary refill. HEENT exam is negative. His oral mucosa is moist and there are no lesions. Neck is nontender . Heart regular rhythm and normal…
