Poison Control Center
Omaha and Council Bluffs Vicinity
Nebraska and Iowa Toll
During the last forty-five years much progress has been recorded as a result of a nationwide effort to decrease the incidence and fatalities associated with accidental poisoning in the United States. Our nation’s first poison control center opened in Chicago in 1953, after a study of accidental deaths in childhood determined that a large percentage were the result of accidental poisoning. Since those initial efforts, the overall death rates associated with accidental poisonings have been significantly lowered largely because of a combination of public education efforts, the mandated use of child-resistant safety caps, the widespread availability of poison control centers and advances in medical care.
In spite of all the recent advances, the number of ingestions and or exposures to household medications and chemicals continues to climb. The American Association of Poison Control Centers reports that in 1994 over one million children under the age of 5 were potentially exposed to poisonous substances. In that same year there were 26 children under the age of 5 who died because they accidentally swallowed medications and household substances.
Protecting children from the toxic exposure of drugs, chemicals, and other potential household hazards is an important role for parents. Poison prevention begins by educating parents, grandparents, and others who are entrusted with the care of our children about what types of substances can be harmful to children. We must learn to think from a child’s perspective and viewpoint when considering how the home environment may pose potential risks that could lead to an episode of accidental poisoning. Lastly, adults must know where and how to get help for poisonings when needed.
Tips for poison-proofing the home
The kitchen, bathroom and garage or storage areas are the most common sites of accidental poisoning in the home. Consider the following when evaluating your home for potential accidental poisoning risks:
Are all potentially harmful products out of the reach of children or stored in a locked cabinet?
Many kitchens contain at least a few of the following household cleaning products: ammonia, disinfectants, soaps, bleaches, detergents, furniture polish, oven and drain cleaners, rust removers and toilet bowl cleaners. All of these products contain chemicals that if ingested can harm a child. The only true way to prevent accidental poisoning is to be certain that the items are totally inaccessible to small children. Childproof locks can be placed on cabinet door or these items can be stored on shelves that are out of reach for small children. Remember that small children still require constant adult supervision. Never underestimate the ability of children to get into areas and containers that appear "childproof".
Are all potentially harmful products stored in their original containers?
Labels on the original container give important information in the event of accidental ingestion so they should always remain in place. Also, when containers are stored in soda bottles and cups they can more easily be mistaken for food and drink and therefore be accidentally ingested.
Are all of the medications and other potentially harmful substances in your home equipped with child-resistant caps? Are medicines kept in their original containers? Is your medicine cabinet accessible to small children?
The U.S. Consumer Product Safety Commission estimates that child-resistant packaging for aspirin and oral prescription medication has saved the lives of about 800 children since the requirements were put into effect in the early 1970s. In order for child-resistant packaging to be effective we must remember to resecure the lids to all medications and potentially harmful substances after using them. It may take a few extra minutes to tightly secure the lids on medications, but the time is well spent if it eliminates the potential for accidental poisoning in the home. Even if there are no small children living in your home it is advisable to use products with child-resistant packaging. A significant number of accidental poisonings occur when children are visiting grandparents and they come across medications stored on tables and in nightstand drawers. Likewise, older adults often take their medications into the homes where small children are residing and these medications may become easily accessible if a child finds them in a purse or suitcase.
Perform an inventory of your medicine cabinet several times each year. Discard old and expired medications and substances.
Vitamins and minerals can be dangerous to small children, although we often think of vitamins as non-toxic substances. Iron is especially harmful to small children. Between June 1992 and January 1993, five toddlers died after eating iron supplements according to the national Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report of Feb. 19, 1993. Iron is available without a prescription and it is often found in children’s, prenatal, and adult vitamins. The amount of iron contained in children’s and adult vitamins can be enough to kill a child when taken in excessive amounts. In 1997 the FDA implemented new rules that require unit-dose packaging for iron-containing products with 30 milligrams or more of iron per dosage unit. For a small child, as little as 600 milligrams of iron can be fatal.
Are you aware of the number of things stored in the garage or storage area of the home that can be poisonous when ingested?
Children have died after swallowing such everyday substances as charcoal lighter fluid, paint thinner and remover, antifreeze, turpentine, and pesticides. All of these products must be stored out of the reach of small children. Special shelves and cabinets can be installed to make these items inaccessible. If you keep these items in a garden shed be sure that childproof latches are in place to keep curious children from gaining entrance into them.
Be careful never to place rodent or insect baits where small children can get to them. Teach children that pesticides are poisons- something they should not touch. Mr. Yuk stickers can be obtained from your local poison control center for placement on dangerous substances.
What to do if a poisoning occurs
In case of accidental poisoning, try your best to remain calm. Obtaining a complete and reliable history is the first step in evaluating the potential problems. Keep the number of your local poison control center by the phone. If you are unable to locate this number, call your local emergency number (911 in most areas) or the operator and they will get you the Poison Control Center.
Be prepared to provide the following information when you reach a member of the Poison Control Center:
- The child’s age and approximate weight.
- Important medical information about the child, for example any existing health problems or conditions.
- The substance involved, was it ingested (swallowed), inhaled, splashed into the eyes, or absorbed through the skin?
- How much of the potential poison was involved? When unsure of the exact amount, err on the side of over-estimating. For example, if you are unsure how many pills remained in the bottle assume that the child ingested the full number that were prescribed.
- Any treatment that has already been given
- Is the child awake, lethargic, or drowsy and are they exhibiting any other symptoms?
- Your exact location and how far you are from the nearest hospital
- Save all original containers or bottles as they contain a list of ingredients included in the medication or product in question.
Once enough information about the episode has been obtained the poison control center will advise you of one of three general approaches to treatment. First, reassurance that the exposure is not serious and needs no specified treatment, second, if the exposure is potentially harmful, first aid advice, like instructions to administer syrup of ipecac or fluids will be given, along with instructions to have the child medically evaluated or third, if the exposure is dangerous, the child will need immediate medical evaluation at the nearest hospital.
You may be instructed by the poison control center to institute the following first aid measures:
Get the child to fresh air immediately. Open doors and windows. If the child is not breathing, you will be instructed to begin artificial respiration.
Poisons on the skin
Remove all clothing that is contaminated and begin to flood the skin with water for ten full minutes. Wash gently with soap and water and rinse the skin well.
Poisons in the eye
Flood the eye with lukewarm water poured from a large glass or pitcher held about two to three inches from the eye. Continue to do this for 15 minutes and ask the child to blink as much as possible to assist in irrigating the eye. Do not attempt to force the eyelids open.
Ingested or swallowed poisons
If a child has ingested a medication or potentially poisonous substance Do Not Give Anything By Mouth Until You Have Been Instructed To Do So. Some substances when ingested result in irritation and burning to the mouth, throat, and digestive tract. By forcing a child who has ingested a corrosive substance to vomit you can cause further damage. The poison control center will instruct you on how to treat a child who has swallowed a potentially harmful substance.
It is recommended that all families have a one-ounce bottle of syrup of ipecac available for each child residing in the home. It can be purchased without a prescription at most pharmacies for about $2.00. Syrup of ipecac is a medication that causes vomiting. It may be recommended by the poison control center to remove a harmful substance from a child’s body before it has a chance to act. Time is of the essence in treating accidental ingestions, as syrup of ipecac will only be effective when given within the first ½ hour or so following ingestion. For this reason, syrup of ipecac should be readily available in the home.
How to administer syrup of ipecac:
- Syrup of ipecac should not be given to children under one year of age.
- Syrup of ipecac should not be given to a child who is drowsy or who has taken a substance that causes drowsiness.
- Syrup of ipecac is not given when the ingested poison may cause burns to the tissues it comes in contact with.
- You will be instructed on how much syrup of ipecac to administer based on the child’s weight.
- Following administration of the medicine, the child must consume at least 4 to 8 ounces of liquid (water, juice, or soda may be given, avoid giving milk). Do not allow the child to eat solid food.
- About 20 minutes after administering the medication and giving fluids the child should begin to vomit. The child will probably become scared as they will not be feeling ill but will suddenly begin retching. Have a container or bucket ready so that you are prepared before the vomiting occurs.
- Once the child begins to vomit look for pill fragments or other evidence of the poison.
- At times, if the child does not vomit, a second dose of syrup of ipecac will be prescribed. The poison control center will remain in contact with you once they initiate treatment instructions.
- Once the child has stopped vomiting, wait at least two hours before giving anything else to drink. You can slowly begin to offer solid food if the child tolerates the liquids without vomiting.
What to expect if you are instructed to go to the hospital emergency department for treatment
If the poison control center determines that immediate medical intervention is needed you will be instructed to take the child to the closest hospital. When you arrive at the emergency department be sure tell the hospital staff that the child has ingested a poisonous substance. Medical treatment must begin as soon as possible as delays in treatment lead to increased absorption of the poisons.
Treatment efforts in the emergency department are aimed at removing or inactivating the poison and supporting the body systems that may be adversely affected by the substance. An intravenous catheter may be inserted into the child’s vein so that fluids or other medications can be given. At times a tube will be placed down the child’s mouth and into the stomach so that the stomach contents can be evacuated quickly. Other medications may be administered that will bind to the toxic substance and help to quickly eliminate them from the body. This may result in your child experiencing black liquid stools for a few hours. Blood samples may be needed to measure the exact levels of drugs or toxic substances in the blood. Depending on the child’s condition, admission into the hospital may be needed so that continued observation of the child can occur.
Preventing accidental poisoning
Childhood poisoning is a preventable injury. Efforts aimed at preventing accidental poisoning have to take into consideration the developmental age of the child. Children ages 1 to 3 years of age are at highest risk for accidental poisoning because they may put anything into their mouths. Children at this age are just beginning to become mobile and many things in the home are now accessible to them. Child proofing measures in the home are best initiated when the child is about 6 months of age, or before the child becomes mobile.
Children in the 3 to 5 age group will frequently eat any pills that they discover. These children are normally curious youngsters and they also like to mimic adult behaviors.
As children get closer to adolescence, poison prevention efforts need shift from protection to education. Family discussions about the dangers of alcohol and other drugs should begin in the home. Remember that adult behavior serves as an example to adolescents who are beginning to assert their independence and start making more decisions on their own.
Here are some general guidelines for safety regarding accidental poisoning.
American Academy of Pediatrics.Publication: Protect your child. Prevent Poisoning. C 1999.
Hingley, Audrey. Preventing Childhood Poisoning Feb 1, 1996. Publication of the Food and Drug Administration 97-1233.
US Food and Drug Administration. Important information about giving non-prescription medicine to your children.