by Ed Shaheen, M.D.
Are your children safe at home?
Accidents are the most common cause of death in young children, and prevention begins at home. The list is seemingly endless, but some things are obvious: removing sharp objects and guns and preventing falls, burns, scalds, electrical shock, drowning, and choking. Sometimes overlooked are potentially poisonous substances that adults take for granted and thereby forget to put in a safe place. Automatic dishwasher soap is an example. The ingestion of even a small amount can cause burns in the mouth and life-long chronic scarring or strictures in the esophagus.
Another is wintergreen oil (active ingredient: methyl salicylate), a commonly used ingredient in lineaments for muscle pain – but also present in smaller, more dilute amounts in mouth wash products like Listerine. As little as 4 cc of methyl salicylate ingested by a small child can be fatal. One teaspoon full is equal to more than twenty-three 300 mgm aspirins. This is among the most common poisonings that present to an emergency room.
“A teaspoon of sugar makes the medicine go down” is true. If the medicine doesn’t taste good to your child, you may be wearing it or have to resort to force feeding or bribes in order to get your child to take it. I am not in favor of sugar, but, as a parent, I see a definite value here. On the other hand, some children get the idea that all medicine tastes good, leaving room for the unguarded moment when grandpa looks the other way with his medicine open on the table ready for a quick snack. (By the way, don’t think that the child-proof bottle will save the day. It has its place, but children are also more talented than we give them credit. They don’t read the directions on how to open these containers; they simply use their little teeth).
Don’t take medications in front of children, and never call them candy.
Recently much attention has been focused on an increase in the number of lithium button or cylindrical battery ingestions. These batteries are everywhere: in toys and greeting cards that speak, flashlights, remote controls, hearing aids, cameras, garage door openers, bathroom scales, digital thermometers. The most troublesome are the 20 mm button size in children less than 4 years old because they tend to get stuck in the esophagus, and if not retrieved within 2 hours can cause chemical burns, erosions and even death. A western physician should see all of these ingestions immediately.
Other risky items include all medications and supplements, household plants, cosmetics, nail care products, perfumes, cleaning agents, bleach, furniture polish, antifreeze, kerosene, turpentine, lye, lighter fluid, drain and toilet cleaners, mothballs, glue and other aerosols, plant food, alcohol, insecticides (whether organic or not), old flaking paint, and rat poison.
What do you do if your child puts something in their mouth that doesn’t belong there? The first thing is to call the National Poison Control Hotline at 1-800-222-1222.
Don’t induce vomiting unless instructed to do so by an expert. Be ready with the name of the product and the product container, the estimated amount that was taken, the time of ingestion, the age and weight of the child, any symptoms to date. Keeping medications in their original containers will help with accurate identification. The last thing that an ER doc wants to hear is "he took two little white pills." If you can't identify the plant or pills or whatever, bring them to the emergency room with you.
