Assess neurological function:

• A rapid measure of level of consciousness should be recorded using the AVPU scale.

• Depression of conscious level suggests poisoning with opiates, sedatives (such as benzodiazapines) antihistamines, hypoglycaemic agents.

• Pupillary size and reaction should be noted Very small pupils suggest opiate or organophosphate poisoning, large pupils amphetamines, atropine, tricyclic antidepressants.

• Note the child's posture. Hypertonia is seen in amphetamine, ecstasy, theophylline and tricyclic antidepressant poisoning.

• The presence of convulsive movements should be sought. Convulsions are associated with any drug that causes hypoglycaemia (ethanol) and with tricyclic antidepressant poisoning.

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