UMEM Educational Pearls

Category: Toxicology

Title: Rodenticides

Keywords: cholecalciferol, brodifacoum (PubMed Search)

Posted: 2/18/2010 by Fermin Barrueto, MD (Updated: 10/14/2019)
Click here to contact Fermin Barrueto, MD

When a child is reported to be exposed to a rat poison it is commonly a long acting coumarin like brodifacoum. The rat usually eats the poison then during its traumatic little life will cause its own death by jumping and squeezing through a crack. When a human is exposed, this is the typical sequence of events:

  1. Exposure (and when you usually see them in the ED)
  2. 24-72 hrs later you will actually see an INR rise if actually ingested

Treatment is the same as for coumadin, vitamin K. However, do not start empirically since the patient will be committed to high doses of vitamin K for several months. Let the patient prove they have been poisoned which means they will require recheck of their INR 2-3 days later though they can be sent home with specific warning signs of anticoagulation.