Friday, April 18, 2014
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What happens when a 2-year-old swallows a diet pill

I remember it like it was yesterday. My wife and I were with some friends and family at the N.J. shore when we decided to go out to dinner. Among the group was a 2 year old who was sitting in a high chair at an outdoor table when he began to fuss, then squirm and kick, then cry. He wouldn't eat and his behavior was becoming uncontrollable. It was clear that something was very wrong with him. He had no fever, nothing was sticking him, yet the crying had become a scream, almost like he was trying to jump out of his skin. After about 15 minutes of this we figured it was time for an ER visit.

What happens when a 2-year-old swallows a diet pill

I remember it like it was yesterday. My wife and I were with some friends and family at our shore house in Ventnor when we decided to go out to dinner at the nearby Euro Gourmet Café on Ventnor Avenue. Among the group was a 2 year old who was sitting in a high chair at an outdoor table when he began to fuss, then squirm and kick, then cry. He wouldn’t eat and his behavior was becoming uncontrollable. It was clear that something was very wrong with him. He had no fever, nothing was sticking him, yet the crying had become a scream, almost like he was trying to jump out of his skin.  After about 15 minutes of this we figured it was time for an ER visit, so we all went over to Atlantic City Medical Center off of Atlantic Avenue.

Puzzled and finding no reason for the child’s distress, the ER doc decided to draw some blood and get some urine for a drug screen. After about 3 hours in the ER, the little boy finally started improving. It was right about then the lab analysis was available. There was evidence that somehow he’d swallowed a diet pill or two.

Diet pill?  How could that be? We soon found out. One of our friends mentioned that she had some with her in her handbag back at the house. Sure enough, when we returned we found the bag opened with several pills loosely scattered among the contents. The prescription container cap was off. Apparently, the little boy always liked Tic Tac mints, which the pills resembled.

I’m not sure that everyone’s aware of the alarming growth there’s been in recent years in the number of childhood poisonings, but the facts are nothing short of frightening. The number of calls to poison control centers is up and so are ER visits, injuries and hospital admissions.  More than 60,000 children 5 and under end up in ERs every year because they got into medicine while a parent or caregiver isn’t looking. My grandson is among that statistic. 

More coverage

This past week the Center for Disease Control and Prevention and the Consumer Healthcare Products Association launched an important new campaign – Up and Away and Out of Sight, an educational program that’s part of the larger public–private partnership, the PROTECT Initiative, aimed at reducing unintentional medication overdoses in children. ISMP is a protect partner.  People who take medicines – OTC drugs too - generally aren’t thinking about the risks to children. Yet they can easily get into medications around your or someone else’s house like friends, relatives and even grandparents. They’ll find them on counter tops, near the bathroom sink, in drawers and handbags.  I hope that the Up and Away ongoing initiative will make the case for parents needing to keep medicines and vitamins up and away and out of a child’s reach and sight – every time they’re used.

Here are some additional thoughts: 

  • Keep medicines, even vitamins, up and away where kids can’t see or reach them when crawling, reaching for the counter, standing on a chair, etc.
  • Consider locking medications in a locked storage container or behind locked cabinets
  • Don’t take medicines or put them away in front of children.
  • Educate children early that although medicines may taste good, they aren’t like candy. Only an adult should touch them.
  • When visiting friends or family or when they visit you, don’t be shy about asking about medicine access
  • Always replace child-resistant caps on prescription containers, including liquids. Make sure you hear the click so proper closing is assured.
  • Know that children can sometimes defeat safety caps, so still keep medicines up and away
  • With oral liquids, never leave a syringe bottle adapter (makes it easy to withdraw liquids using an oral syringe) in place if it prevents you from replacing the child-resistant cap
  • Dual purpose prescription container caps that can be used as either a child-resistant cap or “flipped over” for use as a non-child-resistant cap can still result in child poisoning if the non-resistant side is used. Their use should be discouraged.
  • If you see your child acting strangely for any reason, don’t take a chance. Keep the possibility of a poisoning in mind.

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Michael Cohen
About this blog

Check Up covers major health events in our region and offers everything from personal health advice to an expert look at health reform. Read about some of our bloggers here.

For Inquirer.com. Portions of this blog may also be found in the Inquirer's Sunday Health Section

Michael Cohen id the president of the Institute for Safe Medication Practices in Horsham.

Daniel Hoffman is the president of Pharmaceutical Business Research Associates (PBRA) in Glenmoore, Pennsylvania, a healthcare research and consulting company specializing in key account positioning and messaging.

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