A recent study provides parents with insights regarding accidental child poisonings with medicines. The purpose of the study was to identify the deep-rooted causes of accidental poisonings with medicines. To do this, the researchers conducted interviews with caregivers who reported child poisonings, asking questions that may have been overlooked in prior studies, such as:
• When did the poisoning occur in relation to the last proper dose?
• In what room did the poisoning occur?
• Was the medicine in its usual storage location when the poisoning occurred?
The most remarkable finding was that most child poisonings occurred when the medicine was not in its normal storage location when the child got into it. Instead, the medicine had been removed so it could be taken by an adult or given to a child. Then, the medicine was not immediately returned to storage. During this time, children were able to access the medicine. Thus, no matter how securely medicines are secured between uses, this study suggests that there is a period of great risk for child poisonings shortly after removing or taking medicines, before they are put away properly and securely. Children are at greatest risk when medicines in the home are in use.
The study looked at 220 cases of child poisonings involving over-the-counter (OTC) medicines reported during a 4-month period to McNeil Consumer Healthcare. McNeil is a company that markets a wide range of OTC products, including Tylenol (acetaminophen), Benadryl (diphenhydramine), Zyrtec (cetirizine), Imodium (loperamide), Motrin (ibuprofen), and Sudafed (phenylephrine and/or pseudoephedrine, may contain dextromethorphan).
All children involved in the poisonings were less than 7 years old. The children were the intended recipient of the medicine in about half of the cases. Children's medicines were involved more often than adult medicines, and liquid medicines were ingested more often than chewable tablets and regular tablets. At the time of the poisonings, about two-thirds of the medicines were not in their normal storage locations. Most of the medicines were in the kitchen or bedroom. More than half of the children climbed on a chair, toy, or other device to reach the medicine when an adult was not observing.
All the medicines were in their original containers. About half of the medicines contained a child-resistant closure, and the closure was intact on more than half of these containers. When the child-resistant closure was not on the medicine, it was most often due to removal of a recent dose. In a few cases, the closure was on but not secured properly. One in ten poisonings happened within 1 minute of the last correct dose of the medicine, and another one in ten poisonings happened within 15 minutes. Most of the remaining poisonings occurred within 24 hours of the last proper dose. One in 10 children was taken to an emergency room for evaluation. One child had his stomach pumped. However, most children experienced mild, self-limiting symptoms that resolved.
For more than 60 years, significant efforts in the US have been taken to prevent child medicine poisonings. One of the most recent efforts includes the Up and Away and Out of Sight educational program that reminds families of the importance of safe medicine storage.4 The campaign was developed through the PROTECT Initiative by the Centers for Disease Control and Prevention (CDC) and the Consumer Healthcare Products Association (CHPA). Another organization, Safe Kids Worldwide, has been working with more than 600 coalitions in the US to increase education, awareness, and planning to prevent child injuries from poisonings and other serious risks. This agency just issued an extensive report on Keeping Families Safe Around Medicine.
Despite extensive public education, child medicine poisonings remain a significant public health concern.
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