Monday, December 01, 2003
Poison? Forget the ipecac, grab the phone
By Susan Dodge
For decades, parents have stocked their medicine cabinets with a staple-syrup of ipecac. It was a standard for those panic-stricken moments if parents thought their child may have swallowed something potentially toxic.
But now comes the new recommendation that parents throw out the ipecac and pick up the phone instead because vomiting suspected poisons can cause children even more harm.
The American Academy of Pediatrics recently reversed its position on ipecac, saying parents should instead call poison control at (800) 222-1222 if they suspect their child has swallowed something toxic. The national toll-free poison control number routes callers to their local poison control center.
"We found that ipecac was actually causing more problems than helping," says Dr. Christina Hantsch, the Illinois Poison Center's medical director and attending physician in emergency medicine and toxicology at Loyola Medical Center. "It was bringing back up toxic substances that children could aspirate, and, in other cases, it simply wasn't necessary."
Pediatricians previously advised parents to have ipecac on hand to induce vomiting if they suspected a child had swallowed something poisonous. (Although, they had advised parents to first consult with a doctor or poison control.)
Inducing vomiting after a child has swallowed something poisonous sounds logical, but if, for example, a child swallowed something harmless on the bathroom countertop-say a speck of adult toothpaste-but the parent panicked and gave the child ipecac, the act of making them vomit could do more harm than swallowing the speck of toothpaste.
About 1.2 million young children swallowed potentially toxic substances such as household cleaning supplies, cosmetics and auto supplies in 2001, according to the American Association of Poison Control Centers.
A child who swallows something very acidic, like battery acid or bleach, could become sicker aspirating it into their lungs while vomiting than if the parent called a doctor or took the child to the emergency room to be evaluated, says Dr. Dana Gillespie, a pediatrician at River Forest Pediatrics.
"The best advice is just to call a doctor first or poison control and wipe out any confusion," Gillespie says.
Most emergency rooms have stopped using ipecac in favor of activated charcoal. But the Academy advises parents against trying to give children activated charcoal at home because it can be difficult to administer and the child may vomit after taking it.
Prevention is the best way to stop potential household poisoning, as well as posting the poison control phone number and a pediatrician's phone number near the telephone at home.
To prevent household poisoning, parents should follow these guidelines from the Academy:
• Keep potentially harmful products locked up and out of your child's sight and reach.
• Always re-engage child-resistant locks after using a pharmaceutical or consumer product.
• Never transfer a substance from its original to an alternate container.
• Safely dispose of all unused medications.
• Do not refer to medications as candy.
• Do not take medicine in front of small children since they tend to copy adults.
Keep it a safe holiday The holidays bring all the fun of trees, twinkling lights and new toys for children. But the trappings of the season also carry potential dangers for kids.
Even a big bowl of holiday candy or nuts on the coffee table can be a choking hazard.
"The brighter and more colorful it is, the more it's going to attract their attention," says Dr. Thomas DeStefani, pediatrics chairman at the Ronald McDonald Children's Hospital of Loyola University Medical Center. "Even babies who are just starting to pull up can reach into a bowl and choke on a handful of nuts or hard candy."
When visiting family and friends around the holidays parents should scan the home to make sure there is nothing that might be hazardous to their kids. If it's not feasible to move the unsafe items, parents need to make sure they are watching their small children constantly, DeStefani says.
Artificial Christmas trees are best, because they're less likely to catch fire, but if parents want a real tree they should make sure to get as fresh a tree as possible, according to the American Academy of Pediatrics' holiday tips. Parents should check all tree lights-even if they've just purchased them-to ensure that there are no frayed wires and all bulbs work, DeStefani says.
Flame-resistant decorations are best, and parents should avoid using lighted candles near a tree or using sharp or breakable decorations, according to the Academy's list of safety tips.
When picking out toys for children, first check the U.S. Consumer Product Safety Commission's Web site, www.cpsc.gov, for toys that have been recalled and potentially pose a danger to children. And while you should read and pay attention to the manufacturer's recommended age range for each toy, don't take that as a guarantee. Use common sense and look at the pieces and the sizes of toys. Children under 3 can choke on small parts.
For more holiday safety tips, go to www.aap.org.
Susan Dodge is Ben's mother and a writer living in northwest Indiana.