Childhood poisoning is a common form of household accident and it remains a major and persistent cause of morbidity and mortality in children worldwide, despite the fact that it is preventable cause of death or injuries. Childhood poisoning has continued to be a burden to both parents and the heath care systems worldwide. A poison is defined as any substance that can produce toxic effects in the body when ingested wholly or partially while poison exposure is the ingestion or contact with a substance that result in bodily harm. It is considered accidental in children aged 1-4yrs and self poisoning in older children.
Ingestion is the most common route of poison exposure in children who accidentally take a drink and this account for about 80% of poison cases. Contact with the skin, eyes and inhalational of poisons accounts for the remaining 20% of poison cases in children. Children, especially those under age 5 years, are more likely to have unintentional poisonings than older children and adults. Adolescents are also at risk for poisonings, both intentional and unintentional. About half of all poisonings among teens are classified as suicide attempts.
Risk factors and causes of poisoning
- Illiteracy from the parents leading to careless placement of potential poisonous agents in the house
- low social economic status and small room space for proper storage of poisonous agents
- Child abuse and child neglect
- Cultural factors
- Age of the Child as accidental poisoning is commonly seen in children below the age of 5 years
- Mental retardation and sub-normality significantly increases the risk of poisoning in childhood
- Medical conditions e.g. pica, attention deficit disorder, bipolar and severe depression
Common household poisonous agents
- Drugs e.g. Aspirin, Ferrous sulphate, vitamins, analgesic drugs, stimulants and illicit drugs
- Caustic soda
- Others e.g. rodenticides, pesticides and herbicides
- Cosmetics and personal care products
- Cleaning products
Symptoms of toxicity
The symptoms of toxicity for poisoning depend on the agent. Common symptoms are:
- Increase thirst
- Flushed skin
- Constriction or dilatation of the pupils
- Hyperthermia or hypothermia
- Urinary retention
- Delirium, hallucinations, drowsiness, fainting, nervousness, irritability, lethargy and coma
- Tachycardia and hypotension
- Cough and respiratory insufficiency
- Anorexia, nausea, vomiting, abdominal cramps and pain, diarrhea, constipation
First aid measure
- The first step is to stop further ingestion of the poisonous agent.
- All contaminated clothing should be removed immediately.
- If it involves the eyes, the eyes should be washed immediately using clean tap water
- If the person appears sick, call 911 for emergency medical assistance.
- Monitor the patient for spontaneous breathing and if absent, commence cardiopulmonary resuscitation.
- The poisonous substance should be kept and handed over to the doctor or the poison control agency
In the treatment of childhood poisoning, basic principles are followed to reduce death associated with poison ingestion. These include:
- Identification of the poisonous substance
- Removal of poison to prevent further absorption from the stomach and the intestines
- Prevention of further poisoning
- Acidic and alkali substance can be neutralized or adsorbents like activated charcoal can be used
Poison education for parents
- Insist on packages with safety closure and learn how to use them properly.
- Keep household cleaning supplies, drugs and insecticide out of reach of children.
- Never store food and cleaning product together.
- Store chemicals and drugs in original container not in food or beverage container
- Avoid taking medicine in your child presence.
- Read label on all products and heed warning and caution.
- Know what your child can do physically e.g. crawling, walking and store poisonous agents accordingly
- Keep phone number of your doctor/ hospital poison centre, police and fire department or paramedic emergency rescue squad in your phone
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