The Reality of Poisoning

The Reality of Poisoning

As parents, grandparents, and child-care providers we all want to keep our children safe and secure, allowing them to live their full potential.  Prevention and knowledge of the leading cause of childhood injury; poisoning is a step toward reaching this goal. In the United States, everyday 300 children between the ages 0 to 19 are treated in the emergency department, two children die, as a result of being poisoned. It’s not just the chemicals in our home marked with clear warning labels that can be dangerous to children.

Everyday items in your home, such as household cleaners and medicines, can be poisonous to children as well. Active, curious children will often investigate; sometimes try to eat or drink anything that they can get into. Many household cleaners and medicines look like harmless items; candy, food, juice, or other type of beverage.

Pills look like candy

Cleaning products look like beverages 

Cleaning products look like food

Thankfully, there are ways you can help poison-proof your home and protect the children you love.

Prevention Tips

Lock them up. Keep medicines and toxic products, such as cleaning solutions, in their original packaging where children can’t see or get them.

Know the number. Put the national poison control center phone number, 1-800-222-1222, on or near every telephone in your home and program it into your cell phone. Call the poison control center if you think a child has been has been poisoned, they can be reached 24 hours a day, seven days a week. Call 911 if you have a poison emergency, if your child has collapsed or is not breathing.

Read the label. Follow label directions and read all warnings when giving medicines to children.

Don’t keep it if you don’t need it. Safely dispose of unused, unneeded, or expired prescription drugs and over the counter drug, vitamins, and supplements. To dispose of medicines, remove all identifying information, mix them with coffee grounds, kitty litter, soil, and water, and throw them away. You can also turn them in at a local take back program or during National Drug Take Back events.

Button batteries, harmful for small children, elderly, and pets

Have you ever noticed the amount of toys or products that use those small harmless looking button batteries? Those flat silver discs used in toys like remote control cars, musical greeting cards, bathroom scales, watches, flameless candles and many other types of home electronics. Some are lithium batteries in which pose the greatest potential for harm. There is an average of 3,500 button battery ingestions reported annually to Poison Control Centers. Swallowing batteries is not a new trend for children, elderly adults, or pets to ingest. The concern is over the years is the development of stronger, larger lithium cell batteries, increases the risk of potential severe complications to the individual following the ingestion. Most parents and adults are unaware of the potential for danger from these little items.

Deaths from battery ingestions are rare, per the poison center information there were 10 documented deaths in the past 6 years. Small children, elderly adults, and pets may view the battery as candy, medication, or food. The greatest concern is if the battery gets lodged in the esophagus. The battery has low voltage current that can be completed if it comes in contact with the right environment (a throat or esophagus), and cause severe damage; burns, erosions. One of the physicians from the Journal of Pediatrics did a test, he uses a hot dog and inserted a button battery in it to get an idea how it would react. The hot dog casing is similar to the esophagus of a human; the battery cooked the hot dog.

Possible complications from an ingestion of the battery, is the risk of getting lodged in the vocal cords or esophagus. This can cause serious injury to the vocal cords and digestive tract. Depending on the size of the battery the greater the risk, the larger the battery increase chance for serious injuries. The button battery has popular appeal and the manufacturing industry has shifted towards using this more frequently. Federal safety rules require toys that use the batteries to have a battery compartment that requires the use of screws as a deterrent for access to children. Unfortunately there are not such regulations or rules for devices intended for adult use, bathroom scales, watches, greeting cards, flameless candles or other electronic devices.

Children and pets will find the battery loose and ingest it without an adult even being aware. The common age of ingestion in children is 6. Elderly adults can also be at risk for ingestion of a button battery, thinking its medication when in fact it may be a hearing aid battery. There is a 2 hour window following battery ingestion before symptoms may be observed before complications can occur. Once burning occurs the damage may continue even when the battery has been removed. A majority of the time the ingestions are not witnessed. Children have been able to breathe with a disc battery in the airway; it is not an obvious ingestion and the child will not appear in distress. Children or pets may present with symptoms that are nonspecific; coughing, wheezing, vomiting, drooling, and refusing to eat are possible symptoms. This can be diagnosed as something else such as stomach flu or pneumonia. Information for handling ingestion in children, elderly, and pets is similar.

Tips for battery safety

• Search your home, and any place a child has potential to go for any device or gadget that may use disc lithium batteries
• Secure disc lithium battery controlled devices out of sight and reach of small children. Keep loose batteries locked up or in a safe area.
• Pass the information on to family members, babysitters, friends, and caregivers these important tips.

What to do is a disc battery has been ingested

• Go to a local emergency room immediately.  Inform health care providers of your concern that your child may have ingested a disc battery; if possible provide the identification number found on the battery package.
• Do not let the child eat or drink anything until a chest x-ray is completed to determine if a battery is present.
• Do not induce vomiting

For more information contact:

• National Battery Ingestion Hotline at 202-625-3333
• Poison Control Center 1-800-222-1222

Medication Safety-Grandparent's Homes

The average number of poisonings occurring in children is accidental. In general, all adults have some form of over –the –counter medication in their homes. The ratio of prescription drugs in the home is 79% of parents and 85% of grandparents. Over one-third of the accidental poisonings involve children involve getting into their grandparents mediation. Unfortunately, older adults are most likely to have health issues, requiring the need for prescription and over-the-counter medications. A majority of these medications will be stored in open sight and easy access for small children through the use of none child-resistance containers.  The general goal for older adults taking medication is to have easy access as a reminder to take their medication. Pill minders are handy tools to help people to remember to take their medication. But unfortunately this is easy access to a small child.

Health issues concerns in older adults cannot be corrected in addition to the need for medications for treatment. The challenge is providing education to the parents and grandparents on need for safe storage and inaccessibility to small children. Making the environment safe for the children is the main objective. Child-resistance packaging is a method used as deterring the small child. Storage and location is the another important contributing to child safety. Understandably some adults have arthritis or other conditions making it difficult to open the containers. This is the reason may choose to have easy to open medication containers. If this is the case it is important to know the container is closed and stored in a safe location. There is pill-minder boxes in which have child resistance packaging might be a preferable choice over easy to open containers. Small children are explorers and have a tendency to find everything a parent or grandparent wishes they wouldn't.

Just because something mentions it is child resistance does not mean it is child proof. Small children are geniuses when it comes to the containers and can figure out after several attempts how to get into the package. The use of child resistance products serves as a step in deterring children, it is the adult’s responsibility to limit the access and promote safety. Medication storage is another aspect of the battle in prevention of accidental poisoning. Medication needs to be kept out of reach of children, prescription and over-the-counter.  Grandparents and older adults should not leave the medication on the bathroom sink, bedside table, kitchen table, or counter. Children are curious and will explore these areas, how many times have you noticed your child going for something in plain sight. Suggestions for storage could include a lockbox, top of the refrigerator, or cupboard a child does not have access to.  Grandparents should also be careful with medications stored in their purses. Children are always looking for something good, and most of the time grandma has gum or some other treat in her purse. Another concern is medication left in suitcases when visiting a relative; this provides another easy access point for children. Older grandchildren factor in the equation to when it comes to medication storage and accessibility. Grandparents may be accidental suppliers for children looking to experiment with medication (pain killers).

Safety:

• Store medications out of reach from children
• Child-resistant containers
• Store medication in original containers, recycle or dispose of old one (This allows for a pill count)
• Grandparents and parents look over the area before leaving children unsupervised, make sure all medication is out of reach and no medication is on the floor.

What to do is a child ingests a medication

• Is the child okay? Choking? Breathing? If there is problem call 911.
• Do not induce vomiting. (This is no longer recommend along with the use of ipecac syrup)
• Take the child and the medication to the phone
• Take a deep breath, Call Poison Control Center, 1-800-222-1222 for help, the specialist may save you and your loved one an unnecessary trip to the Emergency room.
• Answer all the questions the specialists (nurse, pharmacist, MD) ask, this helps determine the recommendations for treatment.

Types of ingestions from calls at grandparents homes

• Over the counter medications; acetaminophen (Tylenol), aspirin, vitamins
• Prescription medications; Pain medication (Morphine, Vicodin), Blood pressure medications (Ace-inhibitors-Lisnopril, captopril; beta-blockers-metoprolol, atenolol; calcium channel blockers-amlodipine, isradipine), Diabetic medication (sulfonylureas- Glucotrol, Micronase; Biguanides-Metformin)

Medications all have serious potential to harm a small child depending on the dosage and the amount ingested. Child safety is always a major concern, the best method is education and prevention.

Poison danger in the home.

Dangers of accidental poisoning in the home, school, or work is one of the greatest risks for children, pets, or other loved ones. The risk of getting injured increases with the risk of access to the products in the environment, no area is completely child proof. Children have the greatest risks for unintentional poisoning in the home, they are smaller, faster, curious, and more susceptible to the toxins in their home or elsewhere. Children have the natural curiosity and desire to explore increase the potential for harm depending on the environment. A small child learning to climb on chairs demonstrates the risk of exposure to poisons on the counter, cupboards, or closets.

What types of poison do children have a tendency to get into? Most common include household and personal care products, medicine, vitamins, and plants. Other concerns can include lead, carbon monoxide, and other environmental factors. The risk of poisoning to the child depends on the packaging, accessibility, availability, formulation, and the toxicity to the product. The risk of injury decreases with parent awareness, education for prevention and safety, and appropriate interventions by contacting the poison control centers and health providers. The risk of injury decreases with child-resistant packaging, product reformation, and increased parent awareness are key factors for reducing the risk of exposure. 

Changes in health care require the need for prevention to reduce the number of unnecessary trips to the emergency room, urgent care, or health care provider. Health care should focus prevention, illness visits, well child visits, yearly physicals and what can be done to promote the health of the individual. Not everyone is fortunate to have insurance to meet these needs, that is why valuable resources such as the Poison Control Center, Ask a Nurse, and Health Coach can help decrease health care expenses. A visit to the emergency room can cause financial hardship on an individual and family

This blog will focus on providing information and direction on information for prevention of accidental poisoning and resources to parents, health care provider, or other individuals with questions. 

Call your local poison control center- 1-800-222-1222, the national hot line number, it will connect the you directly to your local poison control center based on your area code.

Ask for a free information kit (Lit Kit), magnet, stickers, and informative brochures (poison prevention, toxic plants)

One free tidbit- the poison control center provides free information at no charge to your insurance, the information collected is confidential, and used to help make products safer for our children.