Many years ago, when I was still in college, one of my early jobs was working at a huge warehouse store in Ithaca New York where I was spending the summer. One day, the ringing phone was answered by one of the other employees. There was a sobbing mom on the other end. My young coworker had no idea what to do with the call, so he grabbed me. Maybe because I was in nursing school, he figured that I would know how to handle it. The caller’s child had broken a lava lamp and had possibly eaten some of the content. She had bought the lamp from this store and wanted to know if it was poisonous (spoiler alert, please don’t have one for lunch, but the lava is in fact non-toxic) I had the caller take a deep breath and then I found the number of the poison control center for her (only those of you who were born before the internet would realize that things like finding a phone number, was not the simple task that it is today). That child wasn’t in actual danger, but Poisoning is the leading cause of accidental injury deaths of children in the US. Back in 1961 Congress established National Poison Prevention Week. It takes place the 3rd week of March. One of the main objectives is so that the public will know what to do in situations like the one above. Aside from highlighting the Poison Control Center it also aims to raise awareness and promote prevention. What is considered Poison? The definition is a substance that is capable of causing the harm or death of a living organism when it is ingested, inhaled or absorbed. The fact is that just about anything can be poisonous when used in the wrong way, in the wrong amount or by the wrong person. It is almost impossible to have a home that has absolutely no hazardous substances in it. In other words... It's a minefield out there Here is an example of what I mean by that. You can be surrounded by things that you pay no attention to until…… Years ago and before the pandemic, I had a little patient who squirted a glob of Purell hand sanitizer onto a cracker and ate it. In this case the child was fine, but it turns out that because the main ingredient in many of these products is alcohol, even a small amount can be hazardous. Since the pandemic, calls to the Poison Control related to hand sanitizer have increased by 79% compared to the previous years. Action If you have any question about an ingestion or exposure, The first call should be to Poison Control: 1-800-222-1222 The right thing to do if you are worried is ALWAYS to call or check in with them. If you prefer and If it doesn’t feel like an emergency you can also go to the online website for guidance. https://triage. The Poison control center gets more than 2 million calls every year. More than half of those are from parents who need help figuring out if the substance that their little one got a hold of is toxic or not. When you call them there are things you can do that will help. If possible, bring the medicine or container to the phone to help you answer any questions. They will need to know:
They will let you know what the next steps need to be. More often than not it is for you to take a deep breath, relax, but take steps to prevent something like this from happening again. In other cases they may have you go to an emergency room. Years ago, families were told to keep Syrup of ipecac on hand to induce vomiting. This is no longer recommended. Certainly check in with your doctor afterwards. If you call them first, they are likely going to tell you to hang up and call the hotline. That used to happen to me all the time when I was working at the pediatricians office. I was often the first one parents would call. Here are just some of the items that I referred to the Poison Control center. I was pretty sure that none of them required intervention (and I was correct), but it never hurts to check.
Prevention Ideally you are never in the position that you need to reach out to poison control, but keep that number handy! It is important to note that nearly 9 out of 10 unintentional poisonings occur in the home. You may think things are safely tucked away, but kids can climb and get access to all sorts of stuff. It only takes a moment for an ingestion or exposure to happen. Heads up, keep an eye on your brilliant little ones. What you think of as secure one month, may not be as safe as you’d like as they master the ability to open locked doors and cabinets. Here are some of the biggest culprits: Medications. Of course it goes without saying that all medications should be safely stored away. It isn’t a bad idea to go through your medicine cabinet to see what’s actually in there and get rid of things that are expired. What’s in your purse? Many people at the very least have some tylenol or basic remedies in there. Your friend who comes for a visit and leaves her purse on the chair within reach of your curious toddler, is a recipe for trouble. (I got that call!) Watch out for grandma and papa’s house. My house is no exception. Last month, Elliot saw a chewable Tum next to my bed and before I had a chance to react, he popped it into his mouth. "Yum, that was delicious. I want more Tum” Tums are simply calcium, so I wasn’t worried that he had one, but it was a nice little wakeup call not to leave them out. We got off lightly. I have had multiple patients have much more dangerous situations after playing around in grandma’s bedside drawer. The most extreme case was a child who got ahold of an oxycontin. Grandparents or adults who don’t have kids in the house, often don’t pay attention to this. It is quite reasonable to remind them to take a look and make sure things are out of reach when the little ones are visiting. I just learned about a brilliant hack from one smart Grandma. She told the grandkids that if they ever find something that looks like a pill, if they turn it over to her, they would get rewarded with an M&M or some similar treat. She ended up passing out more rewards than she was expecting. Accidental poisoning can happen and isn't always the kids fault! I once had a young patient who had been prescribed .5 ml of medication to be taken twice a day. The pharmacy made a serious error and wrote 5 ml on the directions. 5 ml is only a teaspoonful and is a reasonably small volume, but in this case it was 10 times the proper dose. The baby did get that first mega-dose. The reason the parent called to check about it, was that the 30 ml that had been dispensed, was meant to be a one month supply. Giving 5 ml every dose would last only 3 days. In this case, the parent caught on that there was an issue pretty quickly. Fortunately the baby was unharmed. The takeaway here is that errors can happen. Always double check! If something doesn’t make sense, looks different, smells different etc, go over the details and directions with your doctor or pharmacist. I also can not even count how many kids have gotten double doses of medication when parents haven’t checked in with each other. “I just gave some tylenol” “Oh No! I gave a dose 15 minutes ago!” I strongly suggest putting a piece of masking tape on all medication bottles and mark down dates and times of all doses. An alternative is to have a physical notebook or a shared document online, where you write down the time and keep track of anything that is given. Gummies Many medications and supplements now come in gummy form.. The upside is that for some kids this form increases compliance. The downside is that some kids may try to get a hold of these and take more than they should. I remember a nine year old patient with a mystery tummy ache. After all the obvious causes were ruled out, at the threat of a trip to the specialist, he confessed that he had been sneaking extra gummy vitamins on a daily basis. Mom had bought a giant cost-co sized container. At some point she would have noticed that they were disappearing, but when you have a larger container of something, it is harder to keep track. Cannabis This can overlap with the gummy category, but Cannabis comes in many forms. In 2021 there were more than 3000 calls to poison control centers about cannabis exposure in kids under the age of 6 inadvertently consuming an edible. That is up from just 207 reports in 2017. This is an increase of 1,375%!!! From 2017-2021, there were more than 7,000 confirmed exposures in young children. Thankfully there were no deaths reported but nearly a quarter of those kids ended up in the hospital. By far, most of these exposures happened at home. Half of the cases involved 2 and 3 year olds. No judgment if you have edibles around. Many adults take them to help them sleep. The essential thing is that they are locked away. 5% of calls made to Poison control this year were related to melatonin Toothpaste Fluoride is recommended, but too much can be toxic. Kids should get no more than a pea sized amount. The tricky thing is that kids' toothpastes are made to be enticing to encourage brushing. Make sure you store it away when you are not using it, so that it is only available with supervision. Household goods Anything that looks like candy can be tempting. Items can range from bath salts to colorful deodorizer balls that go into the vacuum cleaner. Some bright colored cleaning products could be mistaken for juice by kids who can’t read labels. All cleaning solvents should be kept in a childproofed cupboard. Keep things in their original containers. Repackaging or transferring them can lead to mix-ups and accidental exposures. It is a good idea to know what plants you have in your home and yard. There are lots of handy little apps that can help you identify them. Once you know what you are dealing with, the link above has a list of plants that you should avoid. Teach your kids that it is never okay to eat a berry, seed or part of a plant without your supervision. Some plants can be toxic when eaten, others can cause irritation from any contact. The biggest culprit for that is poison oak. Inhalation Poison isn’t only something you ingest. Certain things that you inhale can also be considered poisonous Carbon Monoxide - is possibly the deadliest one on the list. It is also the easiest to prevent. It is required that every house or apartment have a working carbon monoxide detector. If you aren’t sure if you have one, please check right now. If you are renting, your landlord is required to provide this. Some cleaning supplies can create toxic gasses when mixed together. Refer to the photo below. A bit of prevention goes a long way! Be as careful as you can out there, but if something happens, you know who to call first! (I adore you, but it isn't me) |
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