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Ways to reduce ER visits for accidental medication overdoses by kids

Here are tips to avoid an accidental medication overdose by a child. Also, remember your local Poison Control Center is there to help in less serious situations.

    by Jeanette Trella, Pharm.D and Blair Thornley, PharmD, CSPI
    Published 

Blogging with Jeanette Trella, Pharm.D, Managing Director at The Poison Control Center at the Children's Hospital of Philadelphia is  Blair Thornley, PharmD, CSPI, a pharmacist at the Poison Control Center at the Children's.

It was estimated that 640,000 emergency department visits were made in the United States from 2004 through 2013 resulting from children accessing a medication without caregiver consent or supervision, according to a study recently published in Pediatrics. Fortunately, the visits have decreased by 22 percent since 2010.

The study's authors also found that the number of estimated ED visits for accidental medication exposures increased by an annual percentage of 5.7 percent from 2004-2010; peaking at over 75,000 visits in 2010.

The most common solid medication exposures were:

  1. Opioids (buprenorphine, oxycodone-containing, tramadol, hydrocodone-containing)

  2. Benzodiazepines (clonazepam, alprazolam)

  3. Vitamins/minerals or herbal/alternative remedies

  4. Acetaminophen alone or in combination with other active ingredients

Nearly all of the OTC liquid exposures involved very common over the counter preparations:

  1. Acetaminophen

  2. Cough and Cold remedies

  3. Ibuprofen

  4. Diphenhydramine

What do all of these substances have in common? Accessibility. These medications whether OTC or prescription are widely used, and available in many homes throughout the US.

The Healthy People 2020 initiative is targeting a reduction in emergency room visits for unintentional pediatric medication overdoses. So how can we achieve this?

1. Clean out unnecessary and prescribed medications in your medicine cabinets. If they aren't there, our kids can't get into them.

2. Keep all medications up high and out of sight of little ones.

3. Store medications in original child resistant packaging. Keep all pill minders (often not child resistant) out of reach.

4. Consider use of slow flow adapters for liquid medications. We love these!

  1. They may reduce the amount your child may get out of the bottle during an unsupervised attempt at drinking the medication (by reducing flow)

  2. They ease use of oral syringes, which should always be used over a house hold teaspoon for increase dosing accuracy as indicated in another study in Pediatrics.

  3. Watch this short video to see how use slow flow adapters and oral syringes. If your local pharmacy doesn't have the adapters available you can order from us.

Call your local poison center! We are the quickest way to decrease ED visits as tasked by the Healthy People 2020 initiative — unless your child is showing serious symptoms warranting a 911 call….Then ask us first.

In 2013, 70 percent of the 2.2 million poison emergency calls for children, were treated at home. As a result, Americans saved millions of dollars in healthcare expenses.

To continue to reduce preventable harm from pediatric medication exposures, we must keep working together to educate the public about various harm reduction strategies, and make sure they know they can always contact the Poison Control Center at 1-800-222-1222 with any questions or concerns, and a pharmacist or nurse will be happy to help.

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