$Unique_ID{PAR00133} $Font{NP} $Pretitle{} $Title{Medical Advice: Poisoning} $Subtitle{} $Author{ Editors of Consumer Guide Chasnoff, Ira J} $Subject{Poisoning Rapid breathing ears Ringing Nausea Overexcitement Unconsciousness Burns burning lips mouth tongue Abdominal pain Vomiting Blood vomit vomited lost consciousness syrup of ipecac poison control center Acids Ammonia Benzene Bleach Carbon tetrachloride Cleaning Correction fluid Dishwasher detergent Drain cleaner Furniture polish Gasoline Glue Insect spray Kerosene Lye Oven cleaner Paint thinner Polishes Solvents Tobacco products Turpentine poisonous substances unlabeled containers original container medication medications Adhesives swallow swallows swallowed emetic activated charcoal aspirin overdose vomitus inhale inhales inhaled carbon monoxide fumes iron tablets stomach pumped} $Log{} Your Child: A Medical Guide Poisoning Emergency Quick Reference POSSIBLE SYMPTOMS - Rapid breathing - Ringing in the ears - Nausea - Overexcitement - Unconsciousness - Burns on lips, mouth, and tongue - Abdominal pain - Vomiting - Blood in vomit EMERGENCY TREATMENT 1. Get the poison away from the child, and make sure that there is none left in his mouth. Try to find out what the child took, how much he took, and when the incident occurred. 2. Call your local poison control center for instructions. Do not wait for symptoms to appear, and do not call your doctor, the hospital, or anyone else first. 3. Be prepared to answer questions about your child's age and weight; what your child ate or drank, how much, and when; whether he has vomited or lost consciousness; and whether you have syrup of ipecac available. Have the poison container at hand, if possible; you may be asked to read the label over the telephone. 4. Exactly follow the instructions of the poison control center personnel. PRECAUTIONS - Keep the phone numbers of the local poison control center, your doctor, and emergency services (fire, police, ambulance) next to your telephone. Don't wait for an emergency to look up these numbers. - Always keep syrup of ipecac in your medicine cabinet. Check the expiration date periodically to be certain of effectiveness. - Never induce vomiting in a child who is not fully conscious. - Be aware that treatment for poisoning depends on the substance taken, and that in the case of some poisons, vomiting can worsen the child's condition. DO NOT INDUCE VOMITING IF YOUR CHILD HAS SWALLOWED: Acids Glue Ammonia Insect spray Benzene Kerosene Bleach Lye Carbon tetrachloride Oven cleaner Cleaning fluid Paint thinner Correction fluid Polishes Dishwasher detergent Solvents Drain cleaner Tobacco products Furniture polish Turpentine Gasoline - Keep all poisonous substances out of the reach of children, preferably in a locked cupboard to which only you have the key. - Never store a dangerous substance in anything but its original container. - Do not keep medications in unlabeled containers. - Make sure all medications, not just those intended for children's use, have child-resistant caps. - Make sure that your children do not come into contact with dangerous substances in other people's homes, and be alert to the possibility that visitors to your home may bring such substances with them (for example, a medication in a container without a child-resistant cap). COMMON HOUSEHOLD POISONS Adhesives (such as glue and paste) Laundry products After-shave Laxatives Alcoholic beverages Lighter fluid Ammonia Lye Antifreeze Medications of any kind Art materials Moth repellents Aspirin and acetaminophen Motor oil Auto wax Mouthwash Baby powder Nail polish Batteries (including "button" batteries) Nail polish remover Benzene Naphtha Bleach Oil of wintergreen Boric acid Oven cleaner Carbon tetrachloride Paint Charcoal lighting fluid Paint thinner Cleaning products Perfume Correction fluid Pet medications Cosmetics Plant sprays Deodorants Rodenticides (mouse and Dishwasher detergent rat poisons) Disinfectants Room deodorizers Drain cleaners Rubbing alcohol Fertilizers Rust remover Floor wax Scabicides Fungicides Shampoo Furniture polish Shoe polish Gasoline Soaps Grease remover Solvents Hair-care products Swimming pool and aquarium Herbicides chemicals Houseplants (some) Tobacco Ink Toilet bowl cleaner Insecticides and pest strips Turpentine Insect repellent Vitamin and mineral supplements Iodine Weed killer Kerosene Windshield washer solution Young children, because of their curiosity and their inexperience, are constantly at risk for poisoning. Knowing what to do (and what not to do) in an emergency can save your child's life. In a large enough quantity, any substance (even water) can be poisonous, but some substances are more apt to be swallowed in harmful amounts than others. In the United States, common causes of poisoning of children include soaps, detergents, cleaning products, bleaches, vitamins, iron tonics, insecticides, plants, polishes and waxes, tranquilizers, hormones, and other prescription and over-the-counter medications (including aspirin and aspirin substitutes). Other common poisons include boric acid, oil of wintergreen, volatile hydrocarbons (gasoline, kerosene, turpentine, naphtha, cleaning fluids), strong acids, and alkalis (such as drain and oven cleaners). The first step in preventing poisonings is to keep all medications, cleaning substances, paints, and other hazardous substances in places where your child cannot get to them. Many poison control centers provide information on childproofing your house; some will send packets of "Mr. Yuk" stickers for labeling poisonous materials, so that your child can learn to identify and avoid these dangerous substances. Another important way to be prepared for poisoning emergencies is to stock your medicine chest with syrup of ipecac. Syrup of ipecac is an emetic (a substance that makes one vomit). Periodically check the expiration date on the bottle to be certain of effectiveness. Some physicians also recommend that you keep activated charcoal (a special liquid form of charcoal) on hand. Activated charcoal works by being extremely absorbent--when swallowed, it will absorb a wide variety of substances from the stomach and prevent them from entering the bloodstream. Both syrup of ipecac and activated charcoal can be obtained without a prescription from any drugstore. It is a good idea to contact your local poison control center before an emergency arises. Confirm the phone number and find out if the center is staffed with poison control specialists 24 hours a day. If not, try to find a facility that is, and keep their phone number handy. SIGNS AND SYMPTOMS It is often apparent when a child has taken a poison. He may tell you, or you may see an empty bottle lying around. If your child is behaving strangely, suspect poisoning. The telltale signs of aspirin overdose are rapid breathing, ringing in the ears, nausea, overexcitement, and eventually unconsciousness. If your child consumes an acid or alkaline substance, there will usually be burns on his mouth and tongue. Many liquids have a distinctive odor that may be a tip-off. An overdose of an iron tonic produces abdominal pain and severe vomiting, often with blood in the vomited material, followed by collapse. Not all poisons leave telltale signs, however. If you have any suspicion at all that your child has been poisoned, call the poison control center immediately. Do not wait for the appearance of definite symptoms. HOME CARE The first step in treating poisoning is to get the remaining poison away from your child. If there is any poison left in his mouth, try to get him to spit it out. Try to ascertain exactly what and how much the child consumed and when the poisoning occurred. Immediately call your local poison control center--before you call your doctor, the hospital, or anyone else. Be prepared to tell them what your child ate or drank, how much, and when; your child's age and weight; whether he has vomited or lost consciousness; and whether you have syrup of ipecac available. They can then tell you what to do next. Treatment differs for different types of poisons. What is right for one poison may be wrong for another. Follow their instructions exactly. Make every attempt to contact a poison control center, hospital, or doctor. If professional help is unavailable, however, follow these general guidelines before taking your child to the nearest emergency room: Do not attempt any treatment if your child is unconscious or very woozy or is having a convulsion. Concentrate your efforts on getting him to a medical facility. Most poisons should be gotten out of a child's stomach (by vomiting) as soon as possible; however, others are better left in the stomach temporarily, because they will do additional damage as they come back up through the esophagus and the throat. As a general rule, if your child has taken a normally edible substance (such as a medication), induce vomiting with syrup of ipecac, but if he has taken an acid or alkaline substance or any substance that is not normally edible (for example, gasoline or furniture polish), do not induce vomiting--just get him to a hospital. Read the label on the bottle or container of the substance ingested; many product labels tell you if you should try to induce vomiting. Syrup of ipecac is the best medicine for inducing vomiting. For children under one year of age, give one to two teaspoonfuls of syrup of ipecac; for children over one year of age give three teaspoonfuls. Follow the dose immediately with one or two glasses of water, and then leave for the nearest medical facility. Do not expect immediate results; it takes five to ten minutes for ipecac to work. If you get no results, give your child more water. Do not give your child milk; it may lessen the effectiveness of the ipecac and make it more difficult to see what is in the vomitus (the material he throws up). Do not use syrup of ipecac and activated charcoal together; the charcoal will absorb the ipecac before it can work. If there are no results in 20 to 30 minutes, repeat the ipecac dose (only if the child is over a year old). Once begun, vomiting may continue for 20 to 30 minutes. Even if you think that the danger has passed--your child seems to have vomited all of the poison and to be feeling all right--take him to a medical facility as soon as you can. (Bring a sample of the poison and the vomitus, if available.) Effects of poisons are not always immediately apparent, and delayed reactions are possible. If your child inhales a poison (for example, carbon monoxide from car exhaust fumes or from a blocked chimney), immediately remove him from the vicinity of the fumes to fresh air, and then contact the fire department or the emergency room of your local hospital. PRECAUTIONS - Keep the telephone numbers of police and fire departments, your doctor, and the local poison control center near the telephone. - Always have syrup of ipecac in the house. Check the expiration date periodically to be certain of effectiveness. - The most important precaution is prevention. See that all poisonous substances are stored out of the reach of children, under lock and key if necessary. - Put safety locks on all cupboards that contain poisonous substances. - Never store a dangerous substance in anything but its original container. - Do not keep medications in unlabeled bottles. - Insist on child-resistant caps on all bottles that contain poisonous substances. (However, don't be casual about storage of substances in containers with such caps. Remember that "child-resistant" means only that most children cannot manage to open it.) - Many drugs and vitamin and mineral supplements look and taste like candy. Teach your child that medicine isn't candy, and don't present medicine or vitamins as a treat. - Be aware that more children are fatally poisoned by adult aspirin than by children's flavored aspirin. - Be careful with iron tablets. They taste sweet, look like candy, and can be deadly. - When visiting other people's homes, do not let your children explore until you are sure that there are no poisons within reach. - When guests visit you, be certain that their medications are out of reach of children. MEDICAL TREATMENT If the syrup of ipecac doesn't work, your child may need to have his stomach pumped. A flexible plastic tube win be inserted up into his nose and down into his stomach. Although the insertion is uncomfortable, it is necessary to allow the doctor to clean out the child's stomach. Further, treatment varies with the substance taken and your child's condition.