Disclaimer: Poison Center Pointers is brought to you by the Northern New England Poison Center. This podcast is not to replace timely advice or recommendations. If you have an actual poisoning emergency, scenario, or question, contact the Northern New England Poison Center by calling 1-800-222-1222, text the word “poison” to 85511, or chat online at nnepc.org.
Welcome to Poison Center Pointers, a podcast presented to you by the Northern New England.
Chris: Hello to our listeners and welcome back to Poison Center Pointers. My name is Chris. I’m here yet with my cohosts Karlee and Carolyn.
Carolyn: Hi everybody!
Chris: We are your friendly, neighborhood specialists in poison information. Just as a reminder what we like to do here on Poison Center Pointers—we just want to share our knowledge and experiences dealing with everyday situations we help manage at the poison center, and our goal is to keep our community safe by preventing a poisoning or making sure you know what to do if a poisoning occurs. This one might be a little more exciting than giving you some background information or talking about bugs…
Karlee and Carolyn laugh
Chris: …depending on your interests, because today we’re talking about common childhood exposures. The “meat and potatoes” of what poison centers do, if you will.
Chris: And, it’s great to have Carolyn here because you know, she’s been taking calls on children getting into substances they shouldn’t since my mother had me!
Carolyn: And boy did she call all the time!
Karlee: Chris was ‘that’ kid.
Carolyn: He still is!
Chris: That is neither here nor there…
Chris and Karlee laugh
Chris: …but, what we do want to cover today, first off, is what it is like when you call the poison center. A situation happens, you’re panicked, a child gets into something—what is it going to be like when you call us? And just talk briefly about a couple of things that your child might get into. And top of that, some prevention tips so maybe you won’t even have to call us in the first place.
Carolyn: Right. We do want to hear from you but we don’t want anyone to get hurt.
Chris: In that instance, say, a little kiddo gets into something, you’re worried, you pick up the phone and dial our number, what’s it going to be like when you call the poison center?
Karlee: That definitely is stressful but we’re here for you. So, you call the number, which is 1-800-222-1222…
Chris: She knows it by heart!
Karlee: I do! I’ve worked here for a little bit now, I know the number!
Karlee: So you’ll get a menu at first and be prompted to select a number that goes alone with why you’re calling. So, there’s a number that you’ll select for “exposure” and you’ll get us right away.
Carolyn: But don’t worry if you press the wrong number, we’ll help you no matter what.
Karlee: Yeah, we’ll still help you!
Karlee: So first we’ll ask you for some information. Kind of like Starbucks, we’ll ask you for your first name and some other personal information.
Carolyn: You don’t get a coffee though.
Karlee: And for the most part, the most important thing, we’re going to assess the situation. We’ll ask you a series questions and we’ll help determine how to manage the situation.
Chris: And if you listened to our first episode, you’ll know that 90 percent of the time we manage them on the spot.
Carolyn: So you don’t have to go to the emergency room. That’s what we’re hoping to be able to prevent, we’re hoping to be able to give you the information that you need to know at home.
Chris: And potentially will follow up with you if you still have concerns. You can certainly request that if you want to talk to us. That is what we’re here for.
Chris: So what is it that kiddos get into, what do we get calls on?
Carolyn: Oh my gosh… A lot of our calls are on medicines, and not just children’s medicines but that’s a lot of it, over-the-counter as well as prescription. Some of the more common over-the-counter meds are things like pain relievers, like you’d take for a headache, or cough and cold meds, or multivitamins. And anything can be a problem depending on how much you take and the size of the person, so we will ask things like what does it say on the label, what is the exact name of the active ingredients, and the amount.
Chris: Might even ask how much your child weighs and get some background health information for them.
Carolyn: Yes, absolutely right.
Karlee: That’s usually really important too. A lot of medications that we deal with aren’t necessarily going to cause symptoms even if it is a toxic amount, so those weight based calculations are really important and we’re trained to do those to make sure it is in a safe range to stay home.
Carolyn: Exactly, and some of those medications, like cough and cold, have several different active ingredients so we’ll do a calculation for each ingredient in there, so we can make sure all of it is safe or not to stay home.
Chris: We are conservative, if we don’t know how much the child got we’ll go by worst-case scenario was, how much they could’ve gotten at maximum.
Carolyn: I always feel like we’re part detective.
Chris and Karlee agree and laugh
Carolyn: You know we’ll help you figure it out. Some people will say, “I have no idea how much the child got,” and then we can ask those questions. We can’t tell you exactly what happened and we don’t try to, but we can maybe help you figure out the most possible.
Chris: That being said, there are certain medications where even a very small amount can be a concern.
Karlee: Ones we typically worry about would be prescription pain medications—opioids, medications for heart health, and medications for diabetes. There’s ways that anything can be a problem, but those specific categories are ones that small amounts may be even fatal, so just some of the ones that we specifically ask about…
Chris: We’re trained on a drug-by-drug basis to assess the corresponding toxicity.
Carolyn: And it is just as important for you to know that some meds can be very dangerous in children in a short period of time so again, don’t wait to call.
Chris: Maybe a category of calls that is a little less scary than when your kiddo gets into medication: personal care products, right? What do we get calls on?
Carolyn: Things like diaper rash cream, lotion, shampoos and soaps, toothpaste—stuff that kids use or you use on kids. I remember when I first started working here, the first call I got where a 7-month-old or somebody about that age bit into a tube of diaper rash cream, and I thought, “How does a 7 month old get a diaper rash cream?” and the parent said, “Oh I gave it to them while I was changing the diaper,” and I thought, “Why would a parent do that?!” And then, I had children!
Chris and Karlee laugh
Carolyn: And I realized if you don’t give them something, you can’t change the diaper. But just remember there will always be that time where they going to be able to bite into it, or get into it or open it, or whatever it might be. So, just be careful with those products.
Chris: And again, we know a range of commercially available products. We know what the concerns for toothpaste would be versus hair conditioner, and we can go into detail on that sort of thing with you.
Chris: Cleaners, huh? Do we get calls on cleaners?
Karlee: Cleaners are a very common call. It could be disinfectants, dish soaps, laundry detergent. Kind of a really popular—not popular, but sort of well-known exposure right now is laundry pods.
Chris: The Tide Pod Challenge!
Karlee: Yeah…why, just why?
Chris and Karlee laugh
Karlee: Yeah, or bleach and other products out there—you never know if there is going to be an exposure. And similar to the personal care products, there is just a large range. Some things are a little less toxic versus other things are very, very toxic and dangerous, and we’re trained on that.
Chris: We know all sorts of weird chemical names that would be weird for you to know otherwise, outside of this job.
Chris: So if you can bring that bottle with you and read the label, it’s very helpful. We’re usually pretty good at narrowing it down.
Carolyn: That is so important—the exact name of the product if at all possible, is really, really helpful. We don’t just help with ingestions, we can help if it gets in the eyes or on the skin. Sometimes you know, another sibling will, the baby doesn’t smell good because they have a full diaper and they spray deodorizer on them.
Carolyn: You know they think they’re being helpful! I am not making this up. Really these things happen…
Carolyn: We can help, we can tell you how to flush an eye or wash the skin appropriately, or whatever it might be.
Chris: Sure, sure.
Karlee: Speaking of how important it is to have the packaging available, Chris do you want to talk about the actual laws regarding packaging?
Carolyn: Yeah, great!
Chris: Yes. So, The Poison Prevention Packaging Act has been around since 1970, and what that is relevant to is child resistant packaging for prescription drugs, over the counter drugs, these household chemicals we’re talking about, and any other hazardous materials that kiddos can get into. In particular we find it can be a concern when kids get into medication. You know when you buy a bottle from the store it’s pesky, and you can’t get the lid off, it’s frustrating, maybe embarrassing?
Carolyn: Hurts your hands…
Chris: That’s by design. Basically the standard is, the agency that regulates this sort of stuff, they want children under the age of 5, they want at least 80 percent of children to not be able to open it within 5 minutes of coming into contact. And important to note that 80 percent is not 100 percent. There are clever kids out there.
Carolyn: I swear there’s more than 20 percent that can open them. They’re not childproof, they’re resistant, and resistant at best.
Karlee: Common misconception too, people will call all the time and say, “It was child resistant or childproof!” And it’s not. It just sometimes slows them down, but they can sometimes still get into it.
Carolyn: Yes, you can’t rely on that.
Chris: Going along with the Poison Prevention Packaging Act, why don’t we talk about some prevention tips?
Carolyn: Sure! The first one of course, and you’ve heard this before—keep everything up and out of sight, and away. And that’s great! But, there is the day that that 2-and-a-half-year-old learns to climb!
Chris: A valuable life skill, just not in this context.
Carolyn: That’s right, or they know, they figure out, because they’re so smart they’ll move the chair over to climb on the chair. So just remember that and try to think about where they can’t get into, maybe a cabinet you can lock.
Karlee: A lot of the times they’ll watch you if they know they’re not supposed to have it they’ll try even harder to get it.
Chris: I think all the parents already know that one!
Chris: We get a lot of calls on kiddos who get into substances stored underneath the kitchen or bathroom sink. That is another situation where locks may come in handy, up and away or locked.
Karlee: Even when you’re using it, just remembering to put it away as soon as you can every time is important. It seems like a simple concept but in the moment when there’s so much going on it can be easy to forget or even delay it. We get a lot of calls where, someone was doing laundry for example, and they just took out a laundry pod to do the laundry and you look back and suddenly the kiddo is in the laundry pod container.
Carolyn: Same thing with meds you know, you go to dose one child with something you know, a multivitamin or an antibiotic and then the other child grabs it while you’re turned with the other one!
Chris: Filling up the weekly pill minder, that’s a really common one too.
Karlee: Oh yeah, really common.
Chris: One thing we can do is, depending on the child’s age, teaching them about what exactly what medicine is for. Right? Because what kind of situations do we encounter where children misinterpret what the medication does?
Karlee: If you were to put medication and pictures of candy in a lineup it would be really hard to pick out which is which, even for an adult.
Karlee: It is one of those things where it is so close to looking like something that a kid would be happy to eat, we just want to make sure we teach them that medicine is not candy.
Carolyn: Some people actually use that, if the child won’t take the medicine they’ll call it candy, and that sort of sets up for them potentially getting into something later on when they find they have access to it, so just be careful of that.
Chris: What else do kiddos love besides candy? Toys. Right, we encounter situations where children will be allowed to play with a bottle because it shakes and sounds like a rattle or a maraca? Also not recommended because again the lid can pop right off, it’s not completely childproof. Do we have any other good prevention tips we’ve learned over the years?
Carolyn: Keeping products in their original containers, that’s a huge one.
Karlee: Yeah, for sure.
Carolyn: Don’t put medicines in baggies, which are not child resistant at all and we often don’t know how many are in there, or sometimes what’s in there.
Karlee: How many times what we gotten a call where someone, say, accidentally drank something that they put in a different container, like a Gatorade bottle. I’ve had a lot of people drink gas, or hydrogen peroxide by accident.
Carolyn: And some of you are thinking, “These people did what?” and others are saying, “Oh yeah I’ve done that before.”
Chris: I had a guy put antifreeze in his Gatorade bottle and it looks blue…
Carolyn: Yeah, so he drank it, or a child might drink it…
Karlee: …and it is very toxic and dangerous…
Chris: We can get into that in the future. Carolyn, I know you had brought up a story where a patient who, what did they do while they were driving?
Carolyn: This person was driving down the road and a cleaner was in a water bottle, they were transporting and they forgot. They were so thirsty that they drank a huge mouthful, pulled into a stranger’s driveway and started throwing up. The call actually came from the stranger, the person who was the homeowner.
Chris: Good Samaritan!
Carolyn: Yeah, very strange case.
Karlee: Hmm, something is going on in my driveway…
Carolyn: Yeah, exactly. That person was very calm actually. Luckily we were able to figure out what happened, and luckily everybody was okay, but can you imagine? It’s bad enough if you do it sitting in your garage, like Chris was just talking about with the Gatorade, but imagine driving down the road and you do that? What if they were on the highway? That could’ve been…
Chris: And, these are all, they may come off as common sense when you’re listening but there’s a lot that goes into it when a situation occurs. Having a young child is arguably the most stressful thing in the world.
Karlee: So stressful, lack of sleep, multitasking…
Chris: Right! So just a few pointers we have. The CDC actually online has a couple more points you can look into at CDC.gov/medicationsafety, there are some other resources for you if you’d like to keep reading into what you can do to keep kiddos safe. And again, this is a brief overview of some of the substances kids get into. We could have an hour-long discussion on pretty much any one of these categories…
Chris: And we hope to down the line!
Carolyn: We have a lot to talk about!
Chris and Karlee laugh
Chris: Yes, we do. And we have plenty more anecdotes.
Chris: That’s about all we’re looking to cover today. We want to thank you again for listening to this episode of Poison Center Pointers. You can like, share and subscribe to us on Facebook and Twitter. If you want more information you can visit our website at nnepc.org. But, remember if there is an actual poisoning emergency, scenario or even just a question, you can contact the Northern New England Poison Center at 1-800-222-1222, you can text the word POISON to 85511, or you can chat with us online at nnepc.org. Thanks again for joining us, guys.
Carolyn: Thanks, everybody!
Chris: Next episode we’re going to get into some seasonal items.
Karlee: Stay tuned.