Handling a poison emergency

Posted on 2 December 2015

With little hands constantly exploring and open mouths at the ready, it’s sometimes hard to keep track of what toddlers and kids are ingesting. Here’s what to do in a poison emergency.

As parents we tend to think that our homes are the safest places for our children. However, with most household cleaning products, drain cleaners, dishwasher tablets and powders, nail polish products, hair dye and straighteners, moth balls, paraffin, pesticides and all medication constituting potentially poisonous substances to kids and toddlers, our houses are often anything but safe havens – in fact most poison emergencies occur in the home. Keeping these substances well out of the reach of your little ones is essential but sometimes a momentary lapse can cause a potential disaster. Arm yourself with information on what to do if your child ingests something potentially poisonous.

Poison protocol
Many parents are far too familiar with the panic that comes with the realisation that their child has swallowed something potentially harmful. Yet racing to your nearest hospital is not always necessary. ‘In many instances toddlers don’t ingest sufficient amounts of the poisonous substance to need a hospital visit, particularly if they can be carefully monitored at home,’ says Dr Cindy Stephen, director
of the Poisons Information Centre (part of the UCT Department of Paediatrics and Child Health located in the Institute of Child Health at Red Cross War Memorial Children’s Hospital). However, in all cases, Dr Stephen stresses the need to call the Poisons Information Helpline of the Western Cape on 0861 555 777. ‘This service is a 24/7 helpline number for the whole country, staffed by doctors, pharmacists and scientists who are poisons experts.’ Determining how much amount constitutes an emergency depends entirely on what it is that’s been ingested, so always consult the experts.

First aid

Dr Stephen offers the following first aid tips:
• If the toddler has ingested something potentially poisonous, DO NOT induce vomiting, as this could cause further damage.
• If the toddler could be breathing in potentially poisonous fumes, remove the child to fresh
air.
• If a potentially harmful substance has spilt on a child, remove the child’s clothing and wash the skin (and eyes, if affected) with plenty of fresh water for at least 10 minutes.
• THEN call 0861 555 777 while someone stays with the child.

At the hospital
If you’re advised to take your child to the emergency room, don’t wait. Treatment will depend on what toxin your child has ingested, says Dr Heidi Ackermann, paediatrician at Mediclinic George. ‘When you arrive at the ER, the doctors and nurses will start by evaluating your child’s breathing, blood pressure and pulse and level of consciousness,’ she says. ‘They will also ask you about what and how much the child ingested, as well as when it happened. It is always very helpful if the parent brings along empty containers or medication packaging.’ Knowing what ingredients have been ingested can tell doctors what to look for.

Some children might only need to be observed for a while, but others might require treatment such as placement of a breathing tube and intravenous line (drip), notes Dr Ackermann. ‘Stomach pumping is not advocated as routine management. Occasionally, depending on the timing and type of toxin ingestion, your child may be given activated charcoal to drink, which binds certain toxins in the digestive tract, and in that way helps prevent further absorption of the toxin.’

‘After the initial emergency care of your child, he or she might need to be admitted to hospital,’ says Dr Ackermann. ‘The doctors can then manage the complications caused by the poison, and watch your child to see if any additional later complications occur. Some children only need a few hours of observation, but in severe cases a child may need to spend weeks in hospital to recover.’

According to data from the Red Cross War Memorial Children’s Hospital, the top four poisonous substances that send kids to the emergency centre are:
1) Paraffin (kerosene)
2) Medication (including traditional medication)
3) Household cleaning products
4) Pesticides

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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