Case 2

4-year-old Lucy has been brought to the ED by her father as she feels very warm to touch and is acting strangely after playing out in a local field this afternoon. Her older brother thinks he may have seen her picking and eating berries from a plant earlier.

What important information should be gained from the history?

What should you be looking for when examining Lucy?

Lucy’s mother has just arrived in the ED with the berries that her older brother thinks she might have eaten earlier. Following a telephone call to the National Poisons Information Service, assisted by a thorough examination and description of the berries likely to have been ingested, the plant is identified as Deadly Nightshade (Atropa belladonna).

This plant is known to cause anticholinergic symptoms when ingested, with symptoms potentially being prolonged and alarming, particularly in children. What symptoms would fit with this toxidrome?