Curious toddlers can find household toxins in the 'safest' places

Dr.T.Berry Brazelton

October 30, 1990|By Dr.T.Berry Brazelton

DR. T. BERRY Brazelton and the New York Times Syndicat have been advised that the method for handling a poisoning emergency recommended in Dr. Brazelton's column "Childproofing Your Home" (published in Accent Tuesday, Oct. 30) is not the most up-to-date first-response method recommended by the American Association of Poison Control Centers Inc. and could be harmful to a child if misused.

The American Association of Poison Control Centers offers the following guidelines for handling a poisoning emergency:

* Never give salt water to a poisoning victim -- especially a child -- to induce vomiting. Often the child does not vomit and retains the salt. In a few cases the resulting medical condition, hypernatremia, can lead to convulsions and death.

* When vomiting needs to be induced, ipecac syrup is the correct method, but a poison-control center should be consulted before ipecac is administered. A teaspoonful of ipecac can be given to children one year of age or older. This dose may be repeated only once if vomiting does not occur in 20 to 30 minutes.

FOR THE RECORD - CORRECTION

* The important thing to remember is to call a poison center first before rushing to a hospital or administering an antidote.

In addition, according to the American Association of Poison Control Centers, baby aspirin is now an uncommon cause of childhood poisoning. Toddlers, however, will get into whatever they can find, so parents should be sure to keep poisonous substances out of reach at all times.

* The Maryland Poison Center operates a 24-hour emergency hot line to provide information and treatment advice about poisonings. Staffed by professionals from the University of Maryland School of Pharmacy, the center answered more than 50,000 calls in 1989. About 60 percent of those calls involved children under 5.

In case of a poisoning emergency, call the poison center at these numbers:

* In metropolitan Baltimore, 528-7701;

* Throughout Maryland, 1-800-492-2414.

If a poisoning has occurred, the caller should be prepared to tell the center the name of the product ingested; the amount taken; when the incident occurred, and the age, weight and condition of the victim.

In a column in Accent on Health Oct. 30 by Dr. T. Berry Brazelton on handling a poisoning emergency, the incorrect dosage was given for administering ipecac.

When vomiting needs to be induced, ipecac syrup is the correct method, but a poison-control center should be consulted before ipecac is administered. A tablespoon of ipecac can be given to children one year of age or older. This dose may be repeated only once if vomiting does not occur in 20 to 30 minutes. The Evening Sun regrets the error.

It is never too soon to start child-proofing your home. Active infants and toddlers will dream up all kinds of activities that can threaten their safety.

It's always a good idea to take precautions.

When a baby is old enough to crawl he will begin to explore the floors, the baseboards and lamp cords. He will explore and find things you will never have thought of. As he gets older he will become more and more resourceful and may find detergents, cleaning fluids and other hazards.

The house should be constantly searched for hazards. For example, electric plugs must be covered. Toxic substances must be kept under lock and key.

Parents should always be prepared for an emergency. Choking on small objects can certainly happen, and a parent should learn (from a doctor or hospital) the maneuvers necessary for clearing out a child's airway.

Since the Heimlich maneuver can cause internal damage in a small child, it is better to learn how to put him, head down, across your lap and slap him on his back between the shoulder blades. But prevention is the best treatment.

A young child's desire to experiment should not be overlooked. One mother of twin toddlers tells me she has spent some time "teaching" her children not to take pills and that this helps. While it may be worth the time trying to teach a toddler what he can do and can't, one must not rely on his rather whimsical memory.

In our present pill culture, poisoning by such commonly used pills as aspirin and contraceptives is a daily event. Far too many infant deaths can be attributed to it.

Baby aspirin is still the most frequent cause of poisonings in the ++ United States. It must be stored away in an unreachable place, preferably a locked one. Child-proof bottle caps are a major step toward prevention.

Some children manage to overcome even the most painstaking precautions parents take. One 3-year-old boy in my practice pushed a chair up to the medicine closet, unhooked the hook on the door, unscrewed the aspirin-bottle top, ate all the aspirin, screwed the top back on the bottle and returned it to the shelf, closed and latched the door and finally pulled the chair away. Not until his mother went to get him an aspirin four hours later when he was acting "queer" did she realize he had eaten all 50 aspirin in the new bottle.

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