Definition Poisoning occurs when a child comes in contact with a toxic substance. Contact can mean swallowing, inhaling, touching, or injecting a toxic substance.
What are the signs and symptoms of the injury? Poisons can come from plants, medications, household chemicals, or illegal drugs. Their symptoms can vary greatly. The signs and symptoms of poisoning can include:
What are the causes and risks of the injury? In Australia (according to the Child Accident Prevention Foundation of Australia) most children who are poisoned are under five years of age. In seven out of ten cases, the poisons are as medicines. The three most common medications involved are paracetamol, rat bait and eucalyptus oil.
Certain situations are more risky for children, especially toddlers. These are situations in which the caretaker may not be paying usual attention to the child. This is more likely to happen:
during holidays when a home has lots of visitors
when older people, who are not used to being around toddlers and who have medication bottles with them, visit
when caretakers have been drinking alcohol or taking drugs
What can be done to prevent the injury? To prevent poisoning:
carefully watch young children at all times
keep all poisons out of children's reach
keep all medications in bottles with childproof caps, secured and out of children's reach
remove plants that can be poisonous to children
teach children about what the poison symbol means on containers
be aware of poisons around the house, including pesticides
do not store toxic or noxious substances in food containers
be aware that many substances meant to be eaten can be toxic if taken in large amounts
never tell children that medication is confectionary
store gasoline, lamp oil or solvents in a garage or other outbuilding and in a locked cabinet
Adolescents who are depressed may overdose with medication to attempt suicide. Some medications that may be readily available to them include paracetamol and tricyclic antidepressants. In large amounts these can cause death. Parents living with an adolescent who is depressed or at risk for suicide should take special efforts to make sure that all medications in the home are securely stored in a locked cabinet.
How is the injury diagnosed? In younger children, the poison taken is usually known. The same may not be true for an adolescent brought comatose to an emergency department by his or her friends.
What are the treatments for the injury? Call the local poison control centre to seek medical assistance on 13 11 26 Australia wide. These centres are operated 24 hours a day, 7 days a week. Keep the number and address in an easy-to-reach place. You can find the addresses and phone numbers of each poison centre at www.pharmacyweb.com.au
If a child has swallowed poison:
check the child's airway, breathing, and circulation. It's usually referred to as checking the ABCs. If necessary, do cardiopulmonary resuscitation (CPR).
try to find out how the child poisoned himself or herself. Pay attention to burns or smells that may help to identify the poison. If the poison is known, bring the container to the hospital.
if the child vomits, protect the airway by turning the head to the side
reassure and observe the child until medical help arrives. If there is poison on the clothing, remove the clothing. Clean the skin with water.
At the hospital, treatment for a poisoning can include:
gastric lavage. This is a procedure in which a large tube is inserted through the mouth into the stomach. The stomach is washed with salt water.
activated charcoal given by mouth to bind toxins in the stomach and intestines and prevent their absorption into the body
magnesium citrate to speed up the passage of material through the intestines
Whole-bowel irrigation involves putting large volumes of polyethylene glycol-electrolyte solution into the stomach by drinking or by a tube until the fluid coming out the rectum is clear. It is only used for poisonings with iron supplements, delayed-release medications or drugs like cocaine or heroin.
What are the side effects of the treatments? Vomiting can occur after taking activated charcoal. The vomit can be inhaled into the lungs causing aspiration pneumonia or infection. Use of magnesium citrate can result in fluid and mineral imbalance, dehydration and vomiting. Whole-bowel irrigation can cause vomiting, stomach cramps or bloating.
What happens after treatment for the injury? A child who has taken poison may need to be admitted to a hospital. Most children recover fully from being poisoned. In some cases, there could be serious injuries to the mouth, oesophagus, or lungs. These children will require long-term follow-up care from a doctor. Prevention is the key to avoid poisoning in the future.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
