NNEPC notes increase in self-harm cases among young teens

The NNEPC has noted a significant increase in self-harm-related poisonings among children 16 years old and younger over the past several months in Maine, New Hampshire and Vermont.

From October 2020 to May 2021, the center managed 560 cases of self-harm among patients in this age range, more than 50% more cases than average for an eight-month span. The increase comes after self-harm cases in this age group fell slightly during the first few months of the COVID-19 pandemic.

The increase has been most significant among patients 13 and 14 years old, with the average number of cases per month during this period (30) nearly double the monthly average from 2017 to 2019 (16).

Graph showing increase in self-harm among 13-14-year-oldsMonthly cases among patients younger than 13 also nearly doubled, though the number of cases remained small (7 per month), while the number of cases involving 15- and 16-year-olds increased by a third (33 cases per month from October to May versus 25 per month from 2017-2019).

Graph showing increase in self-harm among 15-16-year-oldsThe increase in self-harm cases was mostly due to attempts by girls.

  • Girls accounted for 85% of the patients during this eight-month period.
  • The average number of cases per month involving girls during this period was 65% higher (59) than the average from 2017-2019 (36). The number of cases involving boys rose only slightly (11 vs 9 per month).

NNEPC self-harm-related poisonings have fallen overall since the beginning of the pandemic, and within most age groups the number of cases has remained well below 2017-2019 levels in recent months, making this increase among young people even more notable.

Young patients attempting self-harm are most likely to take medications that are easily accessible, such as their own medications for depression and over-the-counter medications found in the family medicine cabinet. Some over-the-counter medications can be dangerous in overdose. Parents and caregivers of youth in these age groups should consider keeping their medications locked up or otherwise inaccessible.

In addition, parents, teachers and others who work with youth in these age groups should be familiar with the risk factors and warning signs for self-harm and resources available for help.

The National Suicide Prevention Lifeline is available 24 hours a day to provide free and confidential support for people in distress, as well as prevention resources for those close to them. Call 1-800-273-8255 or visit suicidepreventionlifeline.org to chat online or get more information. Other resources include:

The NNEPC is available 24/7 at 1-800-222-1222 to provide fast, expert advice in cases of possible poisoning, and to answer questions about medications and other potential poisons.

Further reading: Similar national trends were noted in a June issue of the CDC’s Morbidity and Mortality Report.

 

 

 

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Preparing for a new baby: Steps for avoiding accidental poisonings

If you are expecting a new baby or have young children in your home, taking steps to prevent accidental poisonings is a crucial part of home safety. Many common items in and around your home may be poisonous, presenting risks for newly crawling or walking babies, who explore the world by touching things and putting them in their mouth.

The most common things babies get into while exploring like this are medications, vitamins and supplements, cleaning products, personal care products such as hand sanitizer and deodorant, toys and foreign objects, plants and mushrooms, and pesticides like ant traps and bug spray.

Some of the most serious poisonings involve prescription pain medications, marijuana, ADHD medications, cough and cold medications, and certain foreign objects like batteries, magnets and ammunition.

Following the safety tips below can help prevent many poisonings. Kids act fast, though, and sometimes despite our best efforts they will get into something, or we’ll make a mistake when giving them medication. That’s why it’s important to have the poison center number saved in your phone: 1-800-222-1222. The poison center is staffed by specially trained nurses and pharmacists who provide fast, expert help at no cost to you. With help from the poison center, 95% of poisonings involving young children can be treated at home. You can also reach us by text message by sending the word POISON to 85511 or by chatting live with our poison experts here on our website.

Making your home safer

Tips for home safety and medication safety:

  • Store all potential poisons up high, out of reach of children, in a locked cabinet if possible. Keep purses, luggage and diaper bags out of reach of children as well.
  • Store products in their original containers, and keep all nonfood items separate from food and drink.
  • Put the cap back on immediately and put products away as soon as you are finished using them.
    Be sure to replace the safety cap tightly right after using a product

    Image from the Up and Away campaign. Visit their site for more resources related to safe storage.

  • Read the label on medications, cleaners and other products, and carefully follow the instructions each time you use them.
  • When giving medication to a child, use the measuring tool provided with the medication or another marked measuring tool like a teaspoon or tablespoon. Do not use silverware or serving spoons.
  • Do not call medication “candy.”
  • Get rid of products you no longer need, such as expired medications or old pesticides, safely and promptly. Call your town office for guidance on disposal.
  • Be prepared for poison emergencies: store the poison center’s number, 1-800-222-1222, in your phone contacts and put a magnet on your refrigerator. Request a magnet online or by calling the hotline.

The NNEPC was pleased to assist Safe Kids VT with its Preparing for Baby booklet, which featured a modified version of this post. Download the booklet from the UVM Medical Center Safe Kids page.

 

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Calling the poison center can save you time and help our hospital workers

While vaccine rollouts promise some light at the end of the tunnel, the ongoing COVID-19 pandemic continues to take a toll on health care providers, with many hospitals stretched thin by the number of coronavirus patients they are treating, the extra precautions they have to take and other pandemic-related challenges.

Meanwhile, surveys indicate that fear of going to the hospital during the pandemic has led many people to avoid seeking the urgent or even emergency care they need. This is dangerous, and it’s important to seek appropriate care in a medical emergency, because the long-term effects can be much worse if you delay.

However, in many situations, emergency care is not necessary, and you can help our hospital workers greatly by avoiding an unnecessary trip. That’s where the poison center can help. Our poison specialists are available 24/7 to provide free, immediate, expert advice in cases of potential poisoning—and that includes a lot more situations than you might think. Here are just a few examples:

  • Your child swallowed a cleaning product, medication, vitamin, toy or other household item
  • You took your medication twice.
  • You took your spouse’s medication or your pet’s medication.
  • You took your nighttime medication in the morning.
  • You got a cleaning product in your eye.
  • Your skin feels irritated after you’ve used a cleaning product or spilled some on yourself.
  • You drank a cleaner or other product that was being stored in a juice bottle.
  • You feel sick after using marijuana or vaping a nicotine product.

Most of the time in cases of potential poisoning, our experts will be able to provide all the treatment information you need over the phone. In fact, 9 out of 10 times someone calls from home we are able to help them right there—and it’s 95% of the time when the case involves a child 12 or younger. In other cases, our experts will direct you to the best place for additional help, whether that’s the emergency department, your doctor’s office, your pharmacist or another health care provider. And in those cases we’ll work with your other providers to make sure you get the best and most efficient care possible.

Calling the poison center can help you avoid the time, expense and anxiety of a trip to the hospital, and it also helps our front-line hospital workers focus on those who need help the most. It’s a win-win. Save the poison center number, 1-800-222-1222, in your phone today. And remember you can also reach our experts by text message by sending the word POISON to 85511 or by chatting with us online.

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Lead poisoning is still an issue in Northern New England

Lead poisoning remains a concern in Maine, New Hampshire and Vermont, where we have some of the country’s oldest housing. Lead paint was widely used in houses built before 1950 and continued to be used in some houses until 1978.

When lead paint ages, it begins to peel and crack, turning into lead chips and lead dust. These can be swallowed by young children who are exploring their environment.

A child with lead poisoning may not show obvious signs of it, but there can be serious effects, including problems with learning, attention and behavior that can affect them throughout their lives.

Maine, New Hampshire and Vermont all now require that children be tested for lead at 12 and 24 months old. Contact your doctor to find out how to set up testing.

In addition, if your home was built before 1978, have it tested for lead. Visit your state’s lead program page for information on how:

Adults may also be at risk of lead poisoning, especially if they remove old lead paint without taking appropriate precautions. Visit your state’s lead program page above for information on safe remediation of lead paint.

If someone has swallowed or inhaled lead, call the poison center at 1-800-222-1222, text us by sending the word POISON to 85511 or chat online. We’re available 24/7 to help in poison emergencies or to answer other questions you have about lead poisoning.

You can also visit the lead page in our A-Z Poison Index for more details about lead and lead poisoning.


Chipping paint photo by Bart Everson. Creative Commons 2.0.

Hunting and fishing safety

With hunting season upon us, remember to keep all hunting and fishing products out of the reach of children at all times, even if you are just leaving the room momentarily.

Every year the NNEPC manages cases of children swallowing lead sinkers, lead pellets or other lead ammunition, which can result in lead poisoning.

Products that do not contain lead can also cause problems if swallowed. They may get stuck in the child’s food pipe or intestines and require medical help to remove.

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Practice safe canning to avoid botulism

The COVID-19 pandemic appears to have sparked a renewed interest in canning as Americans spend more time at home. While canning can be a good way to preserve food for future use, it’s critical to take steps to prevent botulism.

What is botulism?

Botulism is a rare but potentially deadly illness caused by a toxin produced by certain germs, most notably the bacteria Clostridium botulinum. Foods that have been improperly canned, preserved or fermented are among the most commons sources of this toxin, which affects the nervous system.

Low-acid foods are more likely to contain this poison when they are not preserved in the right way. Some examples are:

Image by Lolame from Pixabay

  • Asparagus
  • Beets
  • Corn
  • Green beans
  • Mushrooms
  • Potatoes
  • Spinach
  • Some tomatoes
  • Meats
  • Fish and seafood

You cannot see, smell or taste the toxin, making prevention essential.

While foodborne botulism is not common, it can be fatal if it is not caught early and treated effectively.

What are the symptoms of botulism?

Symptoms typically appear 12 to 36 hours after exposure, but can begin as early as 6 hours after or as long as 10 days later.

Early symptoms often include nausea or stomach ache, sometimes with constipation.

The effects on the nervous system usually begin in the head and face. Symptoms can include:

  • Blurred vision
  • Drooping eyelids
  • Dry mouth
  • Trouble swallowing and speaking

The illness can go on to cause muscle weakness, including in your arms and legs and in the muscles used to breathe, making breathing difficult.

How can I prevent botulism?

The best way to prevent foodborne botulism is by carefully following the instructions in the USDA’s Complete Guide to Home Canning. We recommend taking a canning or food preservation course with your local university extension, as well.

When canning low-acid foods, it is important to use a pressure canner, according to the CDC. Do not use an electric, multicooker appliance, even if it has a canning button. It is unclear if these are effective in preventing botulism. Carefully follow the processing times given in the USDA guide.

Pay close attention to your cans when you are ready to open them. Throw out any canned food—whether it’s store bought or home canned—if it is leaking or bulging or if it looks damaged or cracked. Throw out the food if the container spurts liquid or foam when you open it or if the food is discolored or smells bad.

Store any opened canned or pickled foods in the refrigerator.

The CDC recommends caution when you are throwing out possibly contaminated food. Use rubber or latex gloves before you handle it. Put the food in a sealable plastic bag, then wrap another plastic bag around it and tape it shut. Place the bags in a trash receptacle outside the house. Use a bleach solution to wipe up any spills. Wash your hands with soap and water for at least two minutes afterwards.

What should I do if I think I have botulism?

If you are showing signs of botulism, contact the poison center right away. The poison center’s experts can tell you what steps you need to take immediately and direct you to the best place for further care. Call us at 1-800-222-1222, chat with us online or text POISON to 85511.

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Poison safety during a pandemic: Guidance for school nurses, teachers and daycare providers

During the COVID-19 pandemic, poison centers across the country have seen increases in certain types of poisonings. These poisoning risks will be of concern to teachers, nurses and other staff members as they return to school under unique circumstances. The NNEPC has prepared this post to help school staff members, daycare providers and others working with children and teens safely manage the increased levels of cleaning, disinfecting and sanitizing brought on by the pandemic.

Hand sanitizer safety

Proper hand hygiene is important in preventing the spread of illnesses such as COVID-19. Washing your hands with soap and water is best, but alcohol-based hand sanitizers are a good alternative when soap and water are not available or not practical.

However, increased availability of hand sanitizer increases the risk of ingestions:

  • Pre-school-aged children may swallow hand sanitizer unknowingly or accidentally.
  • Young school-aged children and preteens may swallow hand sanitizer in response to dares or to show off.
  • Teenagers may swallow hand sanitizer deliberately for the alcoholic effects.

Swallowing enough hand sanitizer can lead to intoxication and related effects. For young children this may take only a little more than a mouthful. These effects can include:

  • Drowsiness
  • Difficulty breathing
  • Vomiting, with a risk of choking on vomit

In addition, the FDA has identified certain brands of hand sanitizer that inappropriately contain methanol or 1-propanol. These toxic alcohols are not safe ingredients for hand sanitizer and can cause more severe symptoms and even death if they are swallowed.

Because of these risks, keep hand sanitizer in a safe place where students cannot access it and supervise all use of hand sanitizer  .

Cleaner and disinfectant safety

Classroom

Classroom photo by Flickr user alamosbasement. Creative Commons 2.0.

Most accidental exposures to chemicals such as cleaning products and disinfectants involve splashes in the eye, skin irritation or burns, or breathing in fumes—either from using the product without ventilating or from mixing chemicals together. Swallowing may also be an issue, especially with young children who are exploring.

Things to consider:

  • Effects of these exposures may be immediate but they can also be delayed for minutes or even several hours.
  • Many products that do not cause irritation from a single use may be more irritating when used frequently.
  • Some people are more sensitive to chemicals than others are. Fumes may cause breathing difficulty for people with asthma or other lung conditions.

When using cleaners and disinfectants, take these safety steps:

  • Read and follow the label instructions each time you use a product.
  • Use gloves and ventilate the area while cleaning. Goggles may be appropriate if the product could splash in your eyes.
  • Avoiding mixing cleaning products—use only one product at a time.
  • Avoid using cleaning products while students are present.
  • Store cleaning products in places where students cannot access them.
  • Keep products in their original containers whenever possible. If you must put a cleaning product in a different container, be sure it is clearly labeled and stored far away from food, drinks and medications.

The poison center is a 24/7 resource

The NNEPC is here 24 hours a day at 1-800-222-1222 to provide fast, expert advice, whether a student has swallowed hand sanitizer, someone is having symptoms from a cleaning product exposure, or in any other case of potential poisoning. These situations can include cases of students eating plants or berries on school grounds, medications errors or deliberate misuse of medication, mishaps in chemistry classes, gas leaks and many others.

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NNEPC welcomes new medical director, attending physician

Dr. Mark Neavyn, NNEPC Medical Director The Northern New England Poison Center is pleased to welcome Dr. Mark Neavyn as our new medical director.

Dr. Neavyn comes to us from Worcester in his home state of Massachusetts, where he was an emergency medicine physician for UMass Memorial Medical Group and an associate professor for UMass Medical School, mentoring toxicology fellows.

Dr. Neavyn earned his MD from Jefferson Medical College in Philadelphia in 2006 and completed his residency at Drexel University/MCP-Hahnemann. He trained as a medical toxicologist at UMass Medical School before serving as the director of medical toxicology at Hartford Hospital in Connecticut. While in Connecticut he provided toxicology consultation for the Connecticut Poison Control Center and led residency education in toxicology.

As the NNEPC’s medical director, Dr. Neavyn will oversee the clinical management of calls to the center, provide toxicology consultation to other health care providers and provide toxicology education to physicians in training. He will also practice emergency medicine at Maine Medical Center.

The NNEPC is also pleased to welcome Dr. Caitlin Bonney as an attending physician for medical toxicology. Dr. Bonney has joined Maine Medical Center as an emergency medicine physician, and will assist in providing toxicology consultation for the NNEPC.

Dr. Bonney completed emergency medicine training at UMass in 2017 and a medical toxicology fellowship at the Rocky Mountain Poison and Drug Center in Denver in 2019.

She joins us from UNLV in Las Vegas, where she was an attending physician and toxicologist.

Dr. Tammi Schaeffer, former NNEPC Medical DirectorWhile we are excited to welcome Dr. Neavyn and Dr. Bonney to our team, we are saddened by the departure of Dr. Tammi Schaeffer, who has taken a position with Johnson & Johnson in her home state of New Jersey.

Dr. Schaeffer joined us as medical director in 2013 and is leaving very large shoes to fill. Fortunately for us, Dr. Schaeffer will continue to provide toxicology consultation for the NNEPC. We wish her all the best in her new role!

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NNEPC releases presentation on COVID-related poisonings

In this 10-minute presentation, NNEPC educator Gayle Finkelstein discusses some of the types of poisonings we’ve been seeing more frequently since the pandemic started and provides some prevention steps you can take to keep yourself and your family safe at home.

We also have a fact sheet available as a free download from our shop covering COVID-related poisonings.

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NNEPC sees uptick in false hellebore poisonings

Young false hellebore photo by Lindsey (Flickr user eccentric virgo), Creative Commons 2.0.

Every spring the Northern New England Poison Center manages a number of poisonings resulting from foragers eating false hellebore by mistake, and we’ve seeing a particular spike in cases this year. Most of these patients end up in the hospital for evaluation and treatment. Many end up needing heart medications for hours or even days.

False hellebore (Veratrum  viride) is a highly poisonous plant that can be mistaken for a prized wild edible, the wild leek, or ramp (Allium tricoccum). False hellebore grows wildly in wet soil throughout our region, often in the same areas as ramps, and the two can look especially similar early in the season. False hellebore grows 2-8 feet tall with a thick green stem, large, ribbed leaves and hairy, star-shaped flowers. Ramps, on the other hand, do not have ribbed leaves, and they have an onion-like smell.

Visit our false hellebore A-Z page for more information.

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Staying safe while staying home

For more information, see our COVID-related poisonings fact sheet

“My daughter licked some hand sanitizer. Should I be worried?”

“I mixed bleach with vinegar and now I’m having a hard time breathing. Will I be okay?”

“I got disinfectant on my food. Is it safe to eat?”

“My grandson got into my purse and ate some of my joint cream. What should I do?”

The poison center gets calls like this every day—and we’ve been getting even more of them since we all started social distancing because of the COVID-19 pandemic. This includes more calls about young children getting into potential poisons, but also an even bigger increase in calls about possible poisonings in adults.

Most poisonings happen at home, and with families spending more time at home, that means even more opportunity for poisonings—and that’s without adding in all the other changes we’re making during the pandemic. Here are just a few examples of new situations that can make poisonings more likely:

  • Having to working from home while also taking care of young children
  • Having extra medications, cleaning supplies and other products on hand to be sure to have a sufficient supply
  • Trying to be extra careful about cleaning our hands and surfaces in our home

With all the changes, know that the poison center is still here for you 24/7 if there is a possible poisoning in your home. You can call us at 1-800-222-1222, chat with us online, or text POISON to 85511.

There are also some simple steps you can take to prevent poisonings in your home.

Store products safely

  • Keep all medications, cleaning products, hand sanitizer and other potentially poisonous products up high, out of the reach of children—in a locked cabinet if possible.
  • Store products in their original containers. Make sure the tops are on tight and that spray bottle nozzles are turned to the off position. If you make your own cleaning products at home, be sure to clearly label the container.
  • Put products away as soon as you get home from the store, and put them away immediately after using them every time.
  • Pay special attention to products that may not usually be in the house, such as medications you keep in your work bag or purse. Maybe you have an older relative staying with you who has medications in their suitcase. See the Poison Purse graphic below for some examples of additional products.

Use products safely

  • Read and carefully follow the directions on the label every time you use a medication, cleaner or other product. Only use a product for the reasons listed on the label. Do not use someone else’s prescription medication or let others use your prescriptions.
  • Do not mix cleaning products unless the label tells you to. Mixing products, such as mixing bleach with vinegar or ammonia, can create harmful fumes.
  • Do not use bleach, disinfectant sprays or disinfectant wipes on skin. Do not drink or inhale bleach or disinfectants. These products are for cleaning surfaces in your home and it is neither safe nor effective to put them in your body.
  • Wash your hands frequently with soap and water, especially before and after removing food from packaging, before preparing food and before eating. When you can’t use soap and water, alcohol-based hand sanitizer is a good second choice. Be sure to supervise young children when using hand sanitizer.
  • Store the poison help line, 1-800-222-1222, in your phone—mobile readers can download a contact card from our website. We are here to help 24/7, both in poison emergencies and when you have questions about medications, product safety or other poison-related topics.
Poison Purse

Image copyright 2007 University of Wisconsin Hospital and Clinic Authority Board

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