8 Life-Saving Lessons from Real-Life Poison Control Centre Calls
We talked to poison centres across North America to discover the most common emergencies they handle. Here are the case-by-case dangers they shared—and their insider recommendations on avoiding accidental poisoning.
Cautionary tales from the poison control call centre
Poison control call centres are a great free resource for expert advice and help concerning poison emergencies. Let these calls be a lesson to you. Read on for safety lessons and how to prevent poisonings.
Lesson: Lock up laundry pods
The poison control centre calls: A two-year-old swallowed part of a laundry detergent pod before spitting out the rest. She was found to be very sleepy and drooling, and a scope of her airway and esophagus showed swelling and burns. Due to lung injury she remained on a ventilator for two days and in the hospital for four. In a separate instance, an 83-year-old female with dementia ingested a laundry pod and developed breathing difficulties and a swollen tongue. Because the family had decided to keep her comfortable and off life support, she died within 48 hours.
How to prevent laundry pod poisoning
“Cleaning products like laundry detergents are among our most common calls, but when laundry pods came out we suddenly saw very severe effects way out of proportion to regular detergents,” says Barbara Insley Crouch, PharmD, MSPH, executive director of the Utah Poison Control Centre. “People need to realize pods pose a greater danger than typical detergent because they’re more concentrated, plus they’re so colourful they look like candy.” From March 2012 to April 2013, the number of monthly laundry pod exposures leapt by 645.3 per cent, according to the journal Pediatrics. In fact, the danger of laundry pods has become so great that in 2015 Consumer Reports said “we strongly urge households where children younger than six are ever present to skip them altogether.”
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Lesson: Beware button batteries
The poison control centre call: A three-year-old was coughing, spitting, and pointing to his mouth, and his mother realized the button battery was missing from the TV remote. An X-ray showed the battery lodged deep in the esophagus, and the procedure to remove it took hours because the battery had caused so much damage (“blackened” tissue had to be flushed out). The child was hospitalized for three days, ate through a nasogastric tube for two weeks, and couldn’t return to a normal diet for three months.
How to prevent button battery poisoning
Batteries are in tons of easy-to-access places—greeting cards, kids’ light-up shoes, remote controls—and button batteries, particularly the lithium variety, are especially dangerous. “The chemistry of lithium batteries is such that damage can occur almost within minutes,” says Crouch. “Some can erode right through the esophagus if not removed in time.” One of the biggest problems is the delay in diagnosis because a parent seeing a child in distress can’t always know a battery is to blame. “The children who have died more often than not died because no one realized they swallowed a battery.” Keep kids safe by taping battery compartments shut and putting battery-powered devices up and out of reach.
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Lesson: Don’t put chemicals in other containers
The poison control centre calls: An adolescent went to an emergency room after taking a large swallow from a Snapple bottle that in fact contained concentrated pesticide. A family member had borrowed the pesticide from a friend and put it in the bottle to transport. In another case, some diluted Mr. Clean had been put in a cup to clean jewelry. The caller’s 86-year-old father later saw the cup and drank, thinking it was water. In another instance, after basketball, an 18-year-old male took two swigs from a Gatorade bottle found in his friend’s Jeep. It turned out to be windshield wiper fluid put in the bottle for portability.
How to prevent accidental poisonings
Accidental poisonings often result from chemicals being stored in alternate containers (especially Gatorade bottles because the drink comes in so many colours anything can look normal). “We recommend keeping chemicals in their original packaging,” says Michael Lynch, MD, medical director of the Pittsburgh Poison Centre, adding that packaging should ideally be marked with Mr. Yuk stickers that children have been taught to recognize. “If you do have to store a chemical in another container, label it and keep it on a high shelf away from food and drinks.” In addition, if you’re working with chemicals in open containers—for example, putting jewelry cleaner in a cup or draining chemicals in the garage—stay with them at all times, says Lynch.
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Lesson: Ask visitors to mind their meds
The poison control centre calls: A three-year-old was found unresponsive in the morning, and at the hospital she had very low blood glucose. It turned out the grandfather had dropped some pills—including a diabetes medicine—days earlier but he wasn’t sure he’d found them all. A urine test confirmed the child had put one in her mouth, and she was treated for three days. Another time, a babysitter set out her own anti-inflammatory medication to take with breakfast and stepped away long enough for a two-year-old to take a couple. The child was taken to the emergency room then pediatric ICU then by helicopter to Primary Children’s Hospital. She ultimately had no lasting damage.
How to prevent medication poisoning
Visitors don’t necessarily observe the same safe storage practices that parents do—and visiting seniors bothered by arthritis are especially likely to have transferred their pills to easy-to-open containers. “Invite your guests to store their pills in whatever safe place your household has identified for your own medications,” says Lynch. “Ideally a high cabinet out of the way, preferably locked.” (By the way, poison centres see children opening “childproof” pill bottles all the time.) Conversely, when you’re visiting a close family member, do a safety sweep. “Take a cruise through their bedroom looking for pill bottles on the bathroom counter, nightstand, or dresser,” says Alfred Aleguas Jr, BS Pharm, PharmD, D.ABAT, managing director of the Florida Poison Information Centre in Tampa. When visiting someone you don’t know as well, simply close bathroom and bedroom doors to keep your kids out of places where your hosts’ pills are most likely kept.
Lesson: Monitor for carbon monoxide
The poison control centre calls: A family of two adults and five children awoke at night with headache, nausea, confusion, loss of balance, and episodes of passing out. It turns out the furnace was leaking carbon monoxide. At the hospital all seven family members were found to have elevated levels of carbon monoxide. The children underwent hyperbaric oxygen therapy, during which they were placed in a coffin-sized glass enclosure filled with pressurized oxygen. Fortunately, the entire family did well. In another case, an elderly couple with a history of dementia accidentally left their car running in the garage then went to sleep in their bedroom above the garage. Family members were unable to arouse them the following day. The husband had passed away, and the wife required treatment with a ventilator and hyperbaric oxygen, but suffered severe, permanent brain injury.
How to prevent carbon monoxide poisoning
This is an insidious type of poisoning because you can’t taste, see, or smell carbon monoxide, and early symptoms are similar to the flu—symptoms that often prompt you to go to bed. However, if your “flu” improves when you leave the house, hits all family members at once, and even effects your pets, suspect carbon monoxide and leave the scene before you suffer life-threatening problems, including heart attack, stroke, and coma. “We don’t have great treatment for carbon monoxide poisoning; once it’s happened there’s not much we can do to reverse the effects, and severe toxicity can be permanent,” says Lynch. “There should not be a house or apartment in the country without a working carbon monoxide detector, because anything that burns fuel—your car, your furnace—can release carbon monoxide that you won’t know about until you’re sick.”
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Lesson: Ward off wild mushrooms
The poison control centre calls: A 22-year-old male went morel mushroom hunting, picked a bunch, and sauteed them. Later that day, he became ill with vomiting. His liver tests were abnormal and he required hospitalization overnight for IV fluids. Another time, a 55-year-old male ate three wild mushrooms in a salad and had severe vomiting. He developed acute renal failure and was started on dialysis. He was discharged from the hospital for outpatient dialysis on day 10, and the dialysis catheter was removed 39 days after ingestion.
How to prevent severe food poisoning
Anyone interested in harvesting wild mushrooms for salads and sauces should realize that identifying safe varieties is challenging even for experts. “We’ve had people put wild mushrooms in spaghetti sauce thinking they were edible,” says Lynch. “But even experienced mycologists have a hard time differentiating the non-toxic from toxic.” Although potentially fatal mushrooms are rare, once ingested there are very few adequate treatments. But even non-lethal species can cause significant problems, such as vomiting, diarrhea, muscle cramping, and neurologic toxicity. “I recommend not collecting wild mushrooms to be on the safe side,” says Lynch.
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Lesson: Don’t combine cleaners
The poison control centre calls: A caller trying to unclog a stubborn drain poured drain cleaner and bleach into the sink at the same time. He immediately began having nose and eye burning and coughing. In another instance, a 26-year-old male mixed chlorine bleach and ammonia to clean his toilet. The bathroom filled with fumes and he started to cough.
How to prevent poisoning problems when you clean
By mixing cleaners you can inadvertently create gas. For example, bleach (which is sodium hypochlorite) plus acid forms chlorine gas. Bleach plus ammonia makes chloramine gas. “Often when you buy a cleaning product you don’t know everything that’s in it, so you may not know you’re mixing two substances that aren’t compatible,” says Crouch. “Plus most bathrooms are small and poorly ventilated, so it’s easy to get high concentrations of fumes.” The first symptom is typically coughing, which can worsen depending on the circumstances. “If someone has underlying respiratory problems like asthma it could be very serious. But even if you’re healthy, being in there long enough could really burn your lungs.” When it comes to mixing cleaners, Crouch’s recommendation is simple: “Don’t do it.”
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Lesson: Watch for lead poisoning
The poison control centre call: A 2-year-old was found to have markedly elevated lead levels. An abdominal X-ray showed multiple densities, and the mother reported she liked putting things in her mouth. The apartment was found to have peeling paint and the densities were leaded paint chips. The child was treated for lead poisoning, and because the home was filled with lead paint and dust, they had to move to a shelter while looking for a new home.
How to prevent lead poisoning
“The most common source of lead is old houses and old paint, and this type of exposure is especially dangerous for young kids,” says Aleguas. Lead paint in areas that are regularly rubbed—such as windows and door jams—are of particular concern because that friction generates dust. “A huge source of poisoning is kids crawling around and handling things that contain lead paint dust,” says Aleguas, who suggests testing surfaces for lead with simple kits from the hardware store. “If you have lead paint and you’re waiting for abatement, keep the dust down by wiping molding, window frames, and base boards once a week with a damp sponge.”
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