Liquid nicotine: Dangerous to children

A bottle of liquid nicotine.The death in December 2014 of a 1-year-old boy in upstate New York has brought further attention to electronic cigarettes and the liquid nicotine used to refill them. The boy reportedly swallowed some liquid nicotine, which was sold in a bottle that did not have a child-resistant cap.

If you’ve been to a convenience store in the past year, you’ve probably seen these products—Blu, NJoy and VaporFi are some of the most common brands. E-cigarettes are rapidly gaining popularity, especially among younger people, and many view them as safer than traditional cigarettes.

E-cigarettes work by heating the liquid and turning it into a vapor that the smoker breathes in. This is where the slang term “vaping” comes from. E-cigarette liquid is available in a wide variety of flavors, including chocolate and cotton candy, and with different levels of nicotine.

While some liquid refills are nicotine-free, others contain as much as 240 milligrams of nicotine in a 10 milliliter bottle. That’s a very large amount of nicotine in a small bottle, and it means that just a taste could be enough to cause symptoms in a young child, and a large sip could be fatal. See our corresponding post, “How much nicotine?” for a comparison of the nicotine content of various products.

Because of this, even before the death in New York state, many lawmakers were pushing to require child-resistant caps for e-cigarette liquid. While some members of Congress are working on a national law, Vermont became one of the first states to require child-resistant caps—its law went into effect on January 1, 2015.

Adults should not rely on child-resistant caps alone. If you use e-cigarettes or any other nicotine products, be sure to always keep them out of the reach of children, in a locked cabinet if possible.

If a child does get into a nicotine product, don’t wait for symptoms—call the poison center right away at 1-800-222-1222 or chat live with a poison specialist.

For more information about nicotine and its poisoning effects, see our nicotine page.

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Clear your outdoor vents to avoid carbon monoxide poisoning

With so much snowfall in the last week, the Northern New England Poison Center has seen 30 cases of people exposed to carbon monoxide. This number is much higher than usual, even for this time of year. The NNEPC averaged about 8 carbon monoxide cases per week in January and February from 2012-2014.

Here are some tips to help avoid this potentially deadly poisoning:

  • Have a working carbon monoxide alarm. You cannot see or smell carbon monoxide, so an alarm is essential to make sure you can get out of the building before a poisoning becomes serious. You should have at least one alarm on each floor, and an alarm in each part of the building where there are bedrooms. Test the alarm to make sure the batteries are working. If you do not own an alarm, you can purchase one at most hardware and department stores.
  • Keep outside heating vents clear. With more than 2 feet of snowfall in many areas over the last week, it is easy for these vents to become blocked up. If your heating system cannot vent properly, carbon monoxide can build up inside your home.
  • Use generators outside only. Many Northern New England residents turn to a generator when the power goes out. It’s important to only use generators, as well as other outdoor equipment, like grills and gas-powered tools, outside. Your generator should be at least 15 feet away from any houses, with the exhaust facing away from houses.
  • Clear your vehicle’s tailpipe. If snow is blocking the tailpipe, carbon monoxide can build up in the vehicle.
  • Do not leave your car running in the garage.

If you think there is carbon monoxide in your home, get to fresh air right away. Call 911 or your local fire department, and then call the poison center at 1-800-222-1222.
 
The poison center is available 24/7 to answer any questions you have about carbon monoxide — 1-800-222-1222 or chat online.

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Child got into a laundry pod? The poison center is your go-to resource

Single-load laundry packet (laundry pod)

Laundry pod photo courtesy US CPSC

Laundry pods are pretty convenient for adults, but they can be harmful to children. These single-use soap packets are often brightly colored and can attract young children. A child may bite or squeeze a pod, squirting the highly concentrated soap into their mouth or eyes.

About one child gets into a laundry pod every hour, according to an analysis of U.S. poison center cases published recently in Pediatrics. The analysis found that most kids who swallow some of the laundry pod liquid have symptoms—throwing up is the most common. Some children who get the liquid in their eyes have swelling and irritation in the area for a few days.

If a child gets into a laundry pod, the best thing to do is to contact the poison center right away — call 1-800-222-1222 or chat online with the NNEPC. A poison specialist will be able to give you quick help based on how the child is doing. For example, if your child got the liquid in their eyes, the poison center can give you directions on rinsing them out to prevent any damage.

In rare cases, there have been more serious symptoms. If your child is having trouble breathing, call 911.

As with all cleaning products, it’s important to keep laundry pods up high, out of the reach of children. A locked cabinet is even better.

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Do you know your school’s medication policy?

Many children need to take medications during the school day. A child may take a medication regularly, such as Ritalin for attention deficit disorder, or have a medication that they use only at certain times, such as an inhaler for asthma attacks.Inhaler

Even if your child doesn’t currently take any medications, it’s likely they will need to some point, even if it’s just for a few days—maybe an antibiotic, or an over-the-counter pain reliever like ibuprofen or acetaminophen.

As a parent or guardian, you should know your school’s medication policy. You may be able to find the policy on the school’s website or in the student handbook. The policy will include information about:

  • Forms you or your doctor need to fill out
  • When your child needs a doctor’s note for the medication
  • Who can drop off the medication at the nurse’s office
  • What types of packaging are OK
  • Who is allowed to give your child medication
  • What happens if your child refuses to take the medication

Remember that medication is the top cause of poisoning among all age groups. For tips on prevention these poisonings, see our medication page.

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Jack o’lantern mushroom is a trick, not a treat

Jack o'lantern mushrooms photo by Jason Hollinger
Jack o’lantern mushrooms by Jason Hollinger, Creative Commons

In time for Halloween, jack o’lantern mushrooms are starting to show their faces. We had a call related to this mushroom last week, and they are common from July to October.

Eating a jack o’lantern won’t kill you, but it can leave you very sick, with some of the worst throwing up, stomach cramps or diarrhea you can imagine.

People sometimes eat jack o’lanterns thinking they are chanterelles, which are edible. The two types of mushroom can look pretty similar, and they bloom at the same time. Jack o’lanterns grow in large groups from a single base or stem (as in the picture), whereas chanterelles each have their own stem. In addition, jack o’lanterns have “gills” underneath the head, while chanterelles have ridges or folds.

These differences can be hard to tell. Remember, to avoid mushroom poisonings, only eat wild mushrooms that have been identified by someone with expert training.

If you think someone has eaten a poisonous mushroom, call the poison center at 1-800-222-1222, or chat with a poison specialist online.

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Get rid of your old medications this Saturday

The U.S. DEA is sponsoring another medication take-back day this Saturday at locations throughout the country. The DEA has been offering these events twice a year for a few years now and they offer a great opportunity to get rid of medications in your home that have expired or you no longer need. You can find a take-back location near you at the DEA’s website.

This could be the last time the DEA offers a national take-back day. Demand for this service has been so great that the DEA recently announced a new regulation that would allow pharmacies, hospitals and other facilities to become authorized drop-off sites. These sites would be able to take unused medications year-round.

Before now, patients had no way to get rid of controlled substances, like prescription pain medications, other than to give them to law enforcement. This meant that many people just kept their unneeded medications in their medicine cabinet, threw them in the trash or flushed them down the toilet, which can lead to their getting into the water supply.

Getting rid of medications safely is important. It can keep young children from accidentally swallowing them, and keep teens and adults from misusing or abusing them. Most youth who have abused prescription pain medications say they got the pills from a family member or friend. Using someone else’s prescription medication, especially pain medication, stimulants and depressants, can be unsafe, and even addicting, even if the person isn’t trying to get high.

It will take a while for the new collection sites to be up and running. In the meantime, be sure to take advantage of this Saturday’s take-back day. It’s the perfect time to clean out your medicine cabinet.

For more information about the new regulation, read the Department of Justice press release.

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Take these safety steps before you turn on your furnace

Thermostat
Photo by Jason Coleman, Creative Commons
 

When was the last time you had your furnace checked?

It’s getting to be that time when folks in northern New England are turning on their heating systems. Remember that furnaces and other equipment that burns fuel can put carbon monoxide into your home if isn’t working properly.

Carbon monoxide is a dangerous gas that in severe cases can kill you. You can’t see carbon monoxide, and it has no smell, so the only way to know if it’s in your home is with a working carbon monoxide alarm.

Before you turn on your furnace, consider having it checked by a heating service technician.

Test the batteries in your carbon monoxide alarm, and if you don’t have one, visit your local hardware store to pick one up. Place a carbon monoxide alarm near each sleeping area in your home, and have at least one on each floor.

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Synthetic cannabinoids in Manchester

Packets of Smacked, thought to be a synthetic cannabinoid, which was involved in a number of recent overdoses in Manchester, NH.

Packets of Smacked, thought to be a synthetic cannabinoid, which was involved in recent overdoses in Manchester, NH. Photo by Jeffrey Hastings.

New Hampshire Governor Maggie Hassan recently declared a state of emergency following a number of overdoses in Manchester related to a synthetic cannabinoid called “Smacked!” that is being sold at convenience stores. The state of emergency made it easier for police to confiscate and destroy this product.

Synthetic cannabinoids are made up of herbs that have been sprayed with chemicals similar to THC, which is found in marijuana. The patients in the Manchester cases have had more severe symptoms than what we usually see with this type of drug. It’s hard to know for certain what’s causing these reactions.

These drugs are not regulated and we don’t always know what’s in them. It’s possible that they contain particular synthetic cannabinoids that are more dangerous, or there could be other drugs mixed in that are causing the severe symptoms. It’s also possible that the patients in these cases were using additional drugs, such as bath salts or heroin, which could be contributing to the reactions.

Packets of Green Giant and Geeked Up, two synthetic cannabinoid products, found in Manchester, NH

Packets of Green Giant and Geeked Up, two synthetic cannabinoid products, found in Manchester, NH. Photo by Jeffrey Hastings.

Synthetic cannabinoids have been on the Northern New England Poison Center’s radar since 2010, and calls to the NNEPC about them peaked in 2012. The number of calls has dropped significantly since then, probably because of legislative and law enforcement efforts to control these products.

The NNEPC has developed a fact sheet with more detailed information on synthetic cannabinoids.

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Don’t trifle with a pigskin poison puffball

Pigskin Poison Puffball

Pigskin Poison Puffball Photo by Eric Steinert, Creative Commons 3.0

In the last week, the NNEPC has seen a few cases of people eating a mushroom called the pigskin poison puffball (scleroderma citrinum). As you might guess from the name, this mushroom won’t agree with your stomach, and eating some could leave you throwing up for quite awhile.

There are lots of these pigskin poison puffballs out right now. They are usually 1-4 inches wide and 1 or 2 inches tall and yellowish brown with rough warts on the outside. The spores inside are typically a deep black or purplish black, as in the picture here, but they can also be a lighter gray or brown.

The pigskin poison puffball is sometimes taken for an edible puffball or mistaken with a truffle.

To avoid mushroom poisonings, only eat wild mushrooms if they have been identified by a trained mushroom expert.

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Marijuana at home can be a risk for children

Medicinal marijuana is increasingly available in Northern New England, meaning the drug can be found in more and more homes. Like any other substance, if marijuana is available in the home, young children may be able to get into it.

Marijuana can have serious effects in kids. An amount that might cause very small effects in an adult can create a much stronger reaction in a young child.

Edible marijuana—like brownies, cookies and candy—can be an especially big problem. Kids don’t know the difference between a marijuana brownie and a regular brownie, and they may eat more than one, giving them an even bigger dose.

Fortunately, most children who get into marijuana do not have serious effects—typically they become very drowsy and their pupils get large.

But in other cases, children can become so drowsy that you cannot wake them up. In very rare situations, children have briefly gone into a coma—they could not be woken up and had trouble breathing.

All children who swallow marijuana need to be watched at a hospital.

For more information on marijuana, call the Northern New England Poison Center at 1-800-222-1222 or chat online.

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