Children's Health

Poisoning in children

Poisoning is one of the most common medical emergencies.
Children under 5 years are at greater risk due to their habit of pica. They also ingest the things because of their colour and taste in addition to its easy accessibility. This is most common in young children as they often learn about new things by putting them in their mouth. A sour or bitter taste does not stop a child from swallowing a poison, especially medications in tablet or capsule form that may look like ‘lollies’.
Any child with atypical manifestations or group of  symptoms not fitting into any disease scenario should be suspected of poisoning.
Altered mental status gastrointestinal complaints, cardiovascular compromise and seizures can all be toxin related. Some are subtle, such as the flu-like symptoms seen with carbon monoxide poisoning, whereas cardiotoxins such as digitalis, may mimic intrinsic heart disease.

What causes accidental poisoning ?

Most poisonings happen at home. Often the substance is in sight, ready to be used, but unattended by an adult. At other times, children have climbed up high to get something they are interested in, or opened closed cupboards.
Many household items can be poisonous like…

Medications
Exposure to either prescription or over-the-counter medications can be poisonous. Paracetamol, cold and flu remedies, cough syrup, mouthwashes, vitamins, herbal remedies, antiseptics, antibiotics, sedatives, antidepressants, heart medications
and more.

Cleaning products

Poisoning from these items can cause damage to a child’s gastrointestinal tract or airway. Some of these items can also burn the skin or eyes. Detergents and cleaning sprays, bleaches, washing machine and dishwashing powder, room deodorants, drain cleaners methylated spirits and turpentine are few.
Poisoning can also occur from the ingestion or inhalation of household substances, such toilet bowl cleaner, laundry detergent pods, glue, paint thinners and removers.

Cosmetics

Creams, ointments, shampoos, perfumes and aftershaves.

Poisonous plants

Oleander, datura, arum lily, fox glove. Berries, mushrooms and plants with coloured leaves can be attractive to children and harmful.

Carbon Monoxide

Dangerous levels of carbon monoxide may be emitted from fuel-burning appliances that aren’t working properly. These include space heaters, furnaces, ovens, clothes dryers, gas water heaters, portable generators, wood-burning fireplaces and stoves, and automobiles.
Low concentrations of carbon monoxide can cause flu-like symptoms such as fatigue and nausea. Higher concentrations can cause difficulty breathing, loss of consciousness and heart damage.

Alcohol, Nicotine, and Illicit Substances
Alcohol intoxication can affect children who drink alcoholic beverages, including wine, beer, and liquor. Alcohol can also be found in perfume, mouthwash, cleaning products, hand sanitizers, and over-the-counter cold medications. In children, alcohol poisoning can cause low blood sugar, which can lead to seizures and coma.
The liquid nicotine solution used in e-cigarettes can be poisonous if a child ingests it or if it comes in contact with the skin. Cigarettes, cigars, chewing tobacco, and nicotine gum can also be poisonous if ingested.
Poisoning from illicit substances can cause serious health consequences, including changes in alertness and responsiveness, slow or depressed breathing, unconsciousness, and seizures. These substances include cocaine, methamphetamine.

Hydrocarbons
Hydrocarbons include gasoline, kerosene, lamp oil, lighter fluid, paint thinners and removers, and motor oil. Exposure to these poisons can affect the respiratory and central nervous systems.

Batteries
Items such as, and toys may be battery-powered. Children may swallow small batteries, particularly flat “button” batteries of watches, calculators, remote controls. Batteries may contain alkaline chemicals that can leak or generate an electrical current, which can cause burns or holes in the esophagus.

Personal Care Products
Some personal care products, such as nail polish, remover or perfume, can be poisonous if ingested. Exposure to these products may lead to symptoms including vomiting, drowsiness, or difficulty breathing.

What are the symptoms ?
The symptoms will depend on what your child has swallowed,
the amount of poison and general health of child.
Some poisons cause only minor symptoms, while others
may cause:

• Burns or redness around the mouth and lips
• Breath that smells like chemicals, such as gasoline or paint thinner
• Nausea
• Vomiting
• Drowsiness
• Tummy pain
• Burns or damage inside the mouth and food pipe (oesophagus).
Some poisons are highly toxic and only a small amount can
cause serious problems including fits (seizures), respiratory or cardiac arrest (where the child’s breathing or heart stops),
unconsciousness (coma) or death.

Treatment

Different treatments are available, depending on the poison.
• Activated charcoal – this substance stops the body
absorbing the poison, but must be given within one hour of your child swallowing the poison for it to be effective.
It does not work with every substance.
• Observation – some poisons have a delayed effect and
your child may have to stay in hospital, possibly overnight.
• Monitoring – of heart rhythms and checking other vital
signs such as blood pressure and oxygen levels.
• Bloods tests – to check the level of poison in the blood.
This helps decide further treatment. In most cases the
level is very low and no problems are expected.
• Antidote – can be given for some poisons to reverse
the effects.
• Admission – a few children need further treatment in hospital.

Prevention

  • Simple safety measures are the best way to make sure
    your child cannot get access to poisons.
  • When buying medications, household chemicals and
    garden products, choose childproof containers if possible.
  • Ask for pills and tablets in blister packs and foil strips.
  • Put all poisonous substances out of reach of children after using or buying them.
  • Use child resistant locks on cupboards containing poisons.
  • Always read the labels of all medications and follow
    the instructions when giving medication to your child.
  • Do not confuse children by talking about pills and liquid medication as ‘lollies’.
  •  If you take pills, do so out of sight of children.
  •  Keep handbags out of reach of children.
  • Discard old medications, batteries and poisonous substances.
  • If you use an e-cigarette, keep the liquid nicotine refills locked up out of children’s reach and only buy refills that use child-resistant packaging.
  • Store medications in their original containers.
  • Try to keep a record of how many pills are left in their prescription containers
  • Never put poisons in drink bottles.
  • Keep children away from the dishwasher and close
    it after putting dishes in.
  • Parents and caregivers should consider doing a first
    aid course.
  • Do not grow poisonous plants. Know the names of all plants in your home and yard. If you have young children or pets, consider removing those that are poisonous.
  • Keep natural gas-powered appliances, furnaces, and coal, wood or kerosene stoves in safe working order. Maintain working smoke and carbon monoxide detectors.
  • Use safety latches that automatically lock when you close a cabinet door.
  • Never prepare or give medicine to a child in the dark. You may give the wrong dosage or even the wrong medicine.
  • Never tell a child that medicine tastes like candy.
  • Never put cockroach powders or rat poison on the floor of your home. Do not use insect sprays on furniture or mattresses.
  • Never leave cosmetics and toiletries within easy reach of children. Be especially cautious with perfume, hair dye, hairspray, nail and shoe polish, and nail polish remover.

Source:

http://www.health.vic.gov.au/edfactsheets/downloads/accidental-poisoning-kids.pdf
https://nyulangone.org/conditions/poisoning-in-children/typeshttps://www.mayoclinic.org/first-aid/first-aid-poisoning/basics/art-20056657