Table 3.

Summary of treatment protocol for fluoride overdose (48)

Fluoride/kilogram body weight*	Treatment
< 5.0 mg/kg
	1.Oral administration of soluble calcium (milk) to relieve GIT symptoms
	2.Observe for a few hours
	3.Induced vomiting not required
> 5 mg/kg
	1.Require hospital admission
	2.Use emetic to empty the stomach. However, if the patient has depressed gag reflex for instance in the case of babies (<6 months old), Down’s syndrome, or mental retardation, endotracheal intubation should be performed before gastric lavage.
	3.Oral administration of soluble calcium (e.g. milk, calcium lactate, or gluconate solution).
	4. Keep under observation for a few hours.
>15 mg/kg
	1.Immediate hospital admission
	2.Immediate stomach emptying and gastric lavage
	3.Begin cardiac monitoring and be prepared for cardiac arrhythmias
	4.Intravenous administration of 10% calcium gluconate solution
	5.Electrolytes (calcium and potassium) should be monitored and corrected as required
	6.Maintenance of adequate urine output by diuretics if required
	7.General supportive measures for shock

^*Average weight/age: 1–2 years= 10 kg; 2–4 years= 15 kg; 4–6 years= 20 kg; 6–8 years= 23 kg