You’ve just seen a young lady who managed to swallow a tablet out of Grandma’s handbag whilst she was over for a visit. Luckily, it was a 20 mg esomeprazole tablet, so she will be okay.
You go in and reassure her worried family that nothing further will occur. Feeling your job is done, you turn to leave, but then her mother asks you, ‘How can we prevent this from happening in future?’.
This little kiddy stayed home.
Knowing the ins and outs of toxicology is one thing, but what about preventing poisoning from occurring in the first place? What advice can clinicians give to parents and caregivers about preventing poisoning in the home? After all, prevention is better than cure (and, in this case, antidote!). Interested? Please read on…
Poison Information Centres (PICs) have traditionally been co-located with children’s hospitals, and for good reason. For many years, a child dying from an accidental overdose was not uncommon. Thanks to the advent of child-proof containers and other public health initiatives, this is far less common and accidental overdose is usually benign in most cases.
Whilst PICs continue to provide expert advice to ensure kids at risk are safely managed, a large part of their work is related to preventing poisoning. Adult caregivers are often surprised at how a child found that tablet or this chemical, but here is some useful advice clinicians can give to patients and their families.
1. Always keep medicines and chemicals away and out of sight (and out of mind)
2. Always keep medicines and chemicals in their original containers
A personal bugbear of mine. Both adults and children can and have come to harm through this antiquated practice. A friend, trying to be helpful, pours off some amazing weed killer or heavy-duty cleaner into a soft drink bottle for someone to use. It doesn’t take much for someone to mistake the familiar shape or label as something safe to drink. Previous cases have even resulted in death from accidental ingestion of highly toxic substances.
Always encourage families to throw out any chemicals that are not in their original packaging. The same goes for medications. Lolly jars are for lollies, not medications.
Soft drink bottles should be destined for the recycle bin!
3. Always put medicines and chemicals away as soon as possible after use
My great uncle, who lives in New Jersey, has this rather cute ritual of meticulously taking out and then lining up his medication for the following day on the kitchen bench before he goes to bed. Whilst it was cute in context, in another scenario, this could spell trouble with young children around.
4. Don’t take medicines in front of children
Children learn everything from the adults around them – mannerisms, special words (my 3-year-old son tells his toys that he’s ‘on-call’ when he doesn’t want to play a particular game) and behaviours. Modelling behaviours like taking tablets only increases curiosity about said tablets and increases the likelihood that they might ingest a tablet they find lying around.
5. Don’t call medicines lollies
You might laugh, but this is more common than you think. Whilst it is common to simplify concepts for children, this is one that needs to stay as it is. Medicines are medicines and only for the person the doctor gave them to. Not a bad rule of thumb for adults, either…
6. Don’t assume children won’t be able to reach something poisonous nearby (they are very curious!)
Never doubt the ingenuity of a child to reach something that is either just out of reach or forbidden to touch. The sense of taboo seems to allow them to climb higher and faster than ever. Store it up high and away from commonly accessed areas they can reach.
7. Clean out your medicine cupboard regularly
If you can’t remember what the medicine is for or when you last took it, you don’t need it any more. Unlike several of my relatives, there is no need to stockpile medications in the event of a Zombie Apocalypse.
8. Check the dose twice before taking medicines
As a parent of two children, it’s not hard to make a dosing error with paracetamol or ibuprofen. Especially half-asleep in the middle of the night with a distressed little one. Personally, bigger syringes for dosing seem to help when you’re reading through bleary eyes.
9. Throw out any old medicines you don’t need OR take them to your local pharmacy
See point 7. Still don’t need them in a Zombie Apocalypse!
10. Don’t leave cigarettes or other drugs in reach of young children
I’ll discuss illicit substances in another post, but one cigarette can cause toxicity in a child, and nowadays, there are a range of substances that are not prescribed but are incredibly deadly if they are ingested by a child.
If unsure, call for help!
If someone is worried about poisoning (even a clinician), please get in touch with the Victorian Poisons Information Centre on 13 11 26. It is 24/7, and you will find a friendly and knowledgeable voice on the other end of the line ready to help.
Here is an infographic summary of this post below: