Treatment of Rodenticide Ingestion

Immediate Management

The American Heart Association recommends immediately contacting poison control and prioritizing supportive care over toxin identification, focusing on airway management, hemodynamic support, and correction of critical vital signs before confirming the specific rodenticide type 1, 2
The American College of Medical Toxicology suggests not giving activated charcoal, ipecac, or performing gastric lavage in late presentations, as these are ineffective once absorption has occurred and may delay definitive care 1, 2
The American Academy of Clinical Toxicology advises not to administer milk or water for dilution unless specifically advised by poison control, as there is insufficient evidence of benefit and it may cause emesis and aspiration 1
The American College of Emergency Physicians recommends activating EMS immediately if the patient exhibits any life-threatening signs: sleepiness, seizures, difficulty breathing, or vomiting 1
The Society of Critical Care Medicine suggests securing airway, establishing IV access, and correcting hemodynamic instability before pursuing specific antidote therapy 2
The American College of Medical Toxicology advises monitoring for metabolic derangements requiring immediate correction 2

The Neurocritical Care Society recommends administering benzodiazepines for seizures or agitation in patients with intracranial hemorrhage 2
The American Clinical Neurophysiology Society suggests performing EEG monitoring for non-convulsive seizures in patients with altered mental status 2

The American College of Medical Toxicology advises never delaying supportive care while awaiting specific rodenticide identification 2
The American Academy of Clinical Toxicology recommends avoiding activated charcoal in late presentations, as it provides no benefit and delays definitive care 1, 2

The American College of Medical Toxicology suggests consulting medical toxicology for complex presentations with multiorgan bleeding 2
The American Academy of Clinical Toxicology recommends consulting medical toxicology for late presentations with established coagulopathy 2

Initial resuscitation steps should include securing the airway if the patient shows CNS depression, loss of protective reflexes, or respiratory compromise, as recommended by the American Heart Association 3, 4

The American College of Medical Toxicology recommends that treatment for anticoagulant rodenticide poisoning should begin with IV vitamin K1 in excess of 50-100 mg for acute hemorrhagic symptoms 3, 4

Activate emergency medical services promptly for any patient who exhibits CNS depression (e.g., sleepiness, seizures), respiratory compromise, or vomiting after a suspected rodenticide exposure. 5

Do not give activated charcoal, ipecac, or perform gastric lavage more than 1–2 hours after ingestion, because absorption is usually complete and these interventions can delay definitive care. 5
Do not administer milk or water for dilution unless specifically advised by poison‑control services; current evidence shows no benefit and the practice may induce emesis or aspiration. 5

For skin contact with rodenticide powder, first brush off the material with gloved hands and then wash the area with mild soap and water. 5