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UNINTENTIONAL POISONINGS

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Title: UNINTENTIONAL POISONINGS


1
UNINTENTIONAL POISONINGS
  • Information and Prevention

April 2009
2
TRAINING OBJECTIVES
  • Identify ways to prevent unintentional poisoning
    due to household chemicals.
  • Identify ways to prevent unintentional poisoning
    due to medications.
  • Recognize the dangers associated with kids taking
    prescription and over the counter (OTC)
    medications.

3
  • Identify ways to prevent unintentional poisoning
    due to prescription and over the counter
    medications.
  • Identify the dangers associated with carbon
    monoxide poisoning.
  • Identify ways to prevent carbon monoxide
    poisoning.

4
UNINTENTIONAL POISONING
  • Every year children die as a result of
    unintentional poisonings.
  • These poisonings are due to children receiving
    accidental overdoses of medications, ingesting
    medications not prescribed for them, carbon
    monoxide or ingesting household items such as
    cleaning supplies.

5
  • According to Safe Kids USA, more than one million
    children, ages five and under, are accidentally
    poisoned each year 40 percent of these are from
    prescription drugs and other medications. 

6
  • Non-pharmaceutical products such as cosmetics,
    cleaning substances, plants, foreign bodies,
    toys, pesticides, art supplies and alcohol are
    responsible for 56 percent of poisoning exposures
    for children under five years of age.
  • (Safe Kids USA)

7
UNINTENTIONAL POISONING
  • According to the Centers for Disease Control
    (CDC), 23,618 (72) of the 32,691 poisoning
    deaths in the United States in 2005, were
    unintentional and 3,240 (10) were of
    undetermined intent. Unintentional poisoning
    death rates have been rising steadily since 1992.
  • In 2006, unintentional poisoning caused about
    703,702 emergency department (ED) visits (CDC
    2008).

8
UNINTENTIONAL POISONING IN YOUNG CHILDREN
  • Many children who are unintentionally poisoned
    have accessed medicines and household chemicals
    that are not locked up.
  • Many children who are unintentionally poisoned
    have ingested prescription medications from
    someone who was visiting their home such as a
    grandparent.

9
UNINTENTIONAL POISONING IN MISSOURI
  • In 2007, 11 Missouri children died of
    unintentional poisoning one eight-year old died
    of toxic doses of over-the-counter medications.
    The remaining 10 children were teens ages 12-17.

10
  • In 2007, an eight-year old child overdosed on an
    over-the-counter pain reliever/fever reducer. He
    apparently was self-medicating. He was taken to
    the hospital with high levels of acetaminophen
    and eventually died of liver damage.

11
  • A 15-year-old boy died of an overdose of
    prescription medications. He had a history of
    abuse of prescription drugs.
  • A 17-year-old girl died of a cocaine overdose.
    She had extensive history with police and EMS for
    prior drug abuse and delinquent behavior.

12
WAYS TO PREVENT UNINTENTIONAL POISONING
(Household Chemicals)
  • The Soap and Detergent Association lists the
    following guidelines to protect children from
    household chemicals
  • Store cleaning products in a locked closet or
    cabinet away from food and inaccessible to young
    children.
  • Store products in their original containers and
    never remove product labels.

13
  • Schedule routine cleaning of surfaces and
    dishwashing when there is a lull in activities,
    such as nap time or when children are not in the
    room.
  • Put products away immediately after removing
  • The amount needed for the cleaning job at hand.
  • Dispose empty cleaning product containers
    carefully and promptly.

14
  • Dont mix cleaning chemicals. This can be
    dangerous.
  • Dont ever mix chlorine bleach or any product
    containing chlorine bleach (like some tub and
    tile cleaners, mildew removers, all-purpose
    cleaners, automatic dishwashing detergents) with
    ammonia or products which contain ammonia or
    ammonia-containing compounds (some hand
    dishwashing detergents and window cleaners).

15
  • Dont mix chlorine bleach with acidic products
    (toilet bowl cleaners, rust removers).
  • Dangerous gases can be released due to the mixing
    of any of these products.

16
WHAT TO DO IF A CHILD HAS INGESTED POISON
  • The Soap and Detergent Association gives the
    following guidelines adults can follow, if a
    child has been poisoned by household chemicals
  • Quickly try to find out what the child has
    ingested. Unfortunately it may not be known what
    has been ingested.

17
  • If possible, quickly find the product container,
    check the label for first aid advice and call the
    Poison Control Center (PCC) immediately
    (800-222-1222).
  • If the substance ingested is known, the PCC will
    need to know information such as the brand name
    of the product, what time it was ingested, the
    age and weight of the child and their current
    condition.

18
  • The PCC will give instructions as to how to
    handle the situation. If they think the child
    should be taken to a hospital, they should be
    taken immediately along with the product
    container and any vomit the child has expelled.

19
WAYS TO PREVENT UNINTENTIONAL POISONING
(Medications)
  • Keep all medicine locked and out of the reach of
    children
  • Dont put medicine on a kitchen table or bedside
    table.
  • Read labels to find out what can be poisonous.
  • Never leave medicines or potentially poisonous
    household products unattended while you are using
    them.
  • (Safe Kids USA)

20
  • Buy child-resistant packages when available. Keep
    products in their original packages to
  • avoid confusion.
  • When administering medication always read labels,
    follow directions and give medicines to children
    based on their weights and ages. Only use the
    dispensers packaged with childrens medications. 

21
  • Never leave out loose pills.
  • Avoid confusion by keeping all medicines and
    potentially poisonous household products in their
    original packages.
  • Dont take medicine or vitamins in front of kids,
    and dont call them candy.

22
  • Dont involve children as helpers with
    medication. They should not remind adults to
    take medicine or bring water, for example.
  • Tell grandparents and friends about avoiding
    medication poisoning, when their family visits
    their homes.
  • (Safe Kids USA)

23
KIDS AND PRESCRIPTION DRUGS
  • Kids as young as 12 are trying or using
    prescription medications non-medically. These
    medications are used to get high or for
    self-medication. Teens are also using over the
    counter medications such as cough medicines.
  • According to Parents, The Anti-Drug, teens often
    take prescription medications from their parents
    medicine cabinet or from other family members.

24
  • According to Kids Health, the most commonly used
    prescription drugs fall into three categories
  • Opioids such as OxyContin, Vicodin, and Demerol
    are used for pain, cough, or diarrhea.
  • Central Nervous System Depressants such as
    Nembutal, Valium, and Xanax are used to treat
    anxiety, panic attacks, and sleeplessness.

25
  • Stimulants such as Ritalin, Adderall and
    Strattera are used to treat narcolepsy, ADHD,
    depression, obesity and asthma.
  • Many kids dont see the dangers of these
    medications, because they think if they are
    prescribed by a doctor, they are safe to use.

26
DANGERS OF PRESCRIPTION DRUGS
  • Abusing prescription drugs can have serious
    consequences. According to Kids Health, a single
    dose of an opioid can lower someone's breathing
    rate and even kill, when it's taken by the wrong
    person in the wrong circumstances. The risk is
    higher when opioids are taken with other
    substances like alcohol, antihistamines and CNS
    depressants.

27
  • According to Kids Health, taking CNS depressants
    with other medications, such as prescription
    painkillers, some over-the-counter cold and
    allergy medications, or alcohol can slow a
    person's heartbeat and breathing. This can lead
    to death.

28
EFFECTS OF STIMULANT USE
  • Kids Health states the following effects of
    taking stimulants
  • Heart failure or seizures.
  • Development of a dangerously high body
    temperature or an irregular heartbeat.
  • Taking several high doses over a short period of
    time, may make a drug abuser aggressive or
    paranoid.
  • May be habit forming.

29
TEENS AND OVER-THE-COUNTER (OTC) MEDICATIONS
  • Dextromethorphan (DXM) can be found in cough
    medicines. High doses can cause problems with
    the senses (especially vision and hearing), and
    can lead to confusion, stomach pain, numbness and
    even hallucinations. Teens are using these OTC
    medications to get high.

30
PREVENTING PRESCRIPTION AND OTC DRUG ABUSE
  • The Partnership for a Drug Free America lists the
    following guidelines for parents in preventing
    teen drug use
  • Adults must be educated as to what drugs teens
    are abusing. Information should be shared with
    other parents and other adults, such as teachers,
    coaches, and school administrators.

31
  • Parents must communicate with their children.
    They should ask children what they know about
    prescription and OTC drug abuse.
  • Parents should set clear expectations by letting
    their teens know that they should never take any
    medications without their knowledge.

32
  • Parents should ask healthcare providers if
    medications prescribed for their family can lead
    to abuse.
  • Parents should know what prescribed and OTC
    medications exist in their home. They should keep
    track of the quantities.

33
  • Parents should keep medications out of reach and
    out of easily accessible places like the medicine
    cabinet.
  • If a child needs medications during school hours,
    parents should speak with school officials about
    policies for distributing medications to
    students. If possible, parents should take the
    medications to the school nurse and make sure any
    unused medications are returned to them.

34
CARBON MONOXIDE POISONING
  • Carbon monoxide is another form of unintentional
    poisoning. It can not be seen, nor smelled.
  • It is produced when any fuel such as gas, oil,
    kerosene, wood or charcoal is burned.
  • If appliances that burn fuel are not working
    properly, dangerous levels of carbon monoxide can
    be emitted.

35
  • The U.S. Environmental Protection Agency (EPA)
    points out that people die each year from carbon
    monoxide produced by idling cars.
  • The EPA lists fetuses, infants, elderly people
    and people with anemia, or with a history of
    heart or respiratory disease, as being especially
    susceptible.

36
  • According to the EPA, low levels of carbon
    monoxide can cause shortness of breath, mild
    nausea and mild headaches.
  • Symptoms of exposure to moderate levels of carbon
    monoxide include severe headaches, dizziness,
    mental confusion, nausea or fainting.

37
PREVENTING CARBON MONOXIDE POISONING
  • The EPA suggests the following guidelines in
    preventing carbon monoxide poisoning
  • Choose appliances that vent their fumes to the
    outside. Whenever possible, have them properly
    installed and maintain them according to
    manufacturers instructions.

38
  • Fuel-burning appliances (including oil and gas
    furnaces, gas water heaters, gas ranges and
    ovens, gas dryers, gas or kerosene space heaters,
    fireplaces and wood stoves) should be inspected
    by a trained professional at the beginning of
    every heating season. Make certain that flues
    and chimneys are connected, in good condition,
    and not blocked.

39
  • Read and follow all of the instructions that
    accompany any fuel-burning device. If an
    un-vented gas or kerosene space heater has to be
    used, carefully follow the cautions that come
    with the device. Use the proper fuel and keep
    doors to the rest of the house open. Crack a
    window to ensure enough air for ventilation and
    proper fuel-burning.

40
  • A car should not be idled in a garage even if
    the garage door to the outside is open. Fumes
    can build up very quickly in the garage and
    living area of a home.
  • Dont use a gas oven to heat your home, even for
    a short time.
  • Dont ever use a charcoal grill indoors even in
    a fireplace.

41
  • Dont sleep in any room with an un-vented gas or
    kerosene space heater.
  • Dont use any gasoline-powered engines (mowers,
    weed trimmers, snow blowers, chain saws, small
    engines or generators) in enclosed spaces.
  • Dont ignore symptoms, particularly if more than
    one person is feeling them.

42
  • The EPA suggests buying a carbon monoxide
    detectors as a back-up, but they point out that
    it is not a replacement for proper use and
    maintenance of fuel-burning appliances.

43
Additional Resources
  • Centers for Disease Control, http//www.cdc.gov/nc
    ipc/factsheets/poisoning.htm
  • Safe Kids USA, http//www.usa.safekids.org/poison/
    index.html
  • Environmental Protection Agency,
    http//www.epa.gov/iaq/pubs/coftsht.html
  • Poison Prevention.org, http//www.poisonprevention
    .org/pdf/Safe_Clean9_18_04.pdf

44
  • Kids Health, http//kidshealth.org/teen/drug_alcoh
    ol/drugs/prescription_drug_abuse.html
  • Parents, The Anti Drug, http//www.theantidrug.com
    /
  • The Partnership for a Drug Free America,
    http//www.drugfree.org/Parent/Resources/Prescript
    ion_Medicine_Misuse

45
Missouri Department of Social Services State
Technical Assistance Team
  • Address
  • PO Box 208Jefferson City, MO 65102-0208
  • Telephone (573) 751-5980(800) 487-1626(8 a.m.
    to 5 p.m. CST, Monday Friday)
  • Email
  •  dls.stat_at_dss.mo.gov
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