The recent Royal College of Paediatrics and Child Health (RCPCH) guideline on decreased conscious level in children1 overlooks a treatable cause of coma. Opiates or benzodiazepines can cause coma following deliberate or accidental ingestion. The guideline advises considering drug ingestion and urine toxicology but fails to explicitly recommend naloxone or flumazenil as immediate therapy. These are harmless drugs and response is dramatic if intoxication …