Thursday, May 30, 2013

On Medications and Child Safety

Peracelsus, who is considered the father of toxicology, said, "All things are poison, and nothing is without poison; only the dose permits something to not be poisonous."

Last night I had a huge panic attack. Bedtime was late since I had pajamas still drying in the dryer. My children were playing around the house. I found my 3 1/2-year-old in the bathroom where he had discovered a bottle of liquid children's allergy medication that had a cap that had been shattered (the inner safety cap was still in place and functioning). He had in his hand, another bottle cap that he was trying to fit in its place. He told me that his younger brother had broken the lid. He was trying to put this new one on it. I took the bottle from him and found the pieces of the shattered lid and placed it back in the drawer they belonged in, taking inventory of the drawer and discovered that the extra cap had belonged to a missing bottle of acetaminophen.

Panic ensued at that point as I frantically rushed around the house trying to seek out that missing bottle of medication. All kinds of horrible thoughts filled my mind as I considered the repercussions of somebody getting a hold of that bottle. What if the kids actually got a hold of it and drank it? I was terrified of not finding it last night and leaving the bottle in the house if we left and letting one of our pets get to it. It's toxic to the dog and deadly to the cat. I tried to recruit the kids to help find the bottle, but that proved to be futile.

I eventually found the bottle set atop the bar in our kitchen. There were only a few drops at the bottom and I began to panic even more. I knew that the bottle had not been full, but it only had a few doses doled out from it. It had at least more than half of the medication originally.  

Aside from being a little cranky my little one was acting fine so I decided to call the after hours pediatrician number to see what they suggested I do. They took my information told me they would write it up and give me a callback. The wait between the initial call and the time they called me back with horrible. I tried to be patient and calm and continue bedtime, but really what was running through my head was getting the kids dressed in case we need to run to the emergency room. The callback basically told me that they weren't sure what to suggest since he wasn't showing any signs or symptoms of a problem. They instructed me to call poison control because they would have more data on the toxicity and what sort of things I needed to be concerned about. The call to poison control certainly put my mind at ease. As it turns out, even if the bottle had been full,  my little one would not have been able to consume what's considered a toxic dose. They told me that since he wasn't showing any adverse reactions that I should just keep an eye on him and call the pediatrician with an update in the morning. 

I was almost afraid to put him to bed last night, but I eventually did and this morning he still seems fine. I've been mulling the whole ordeal over in my head and I've come up with a few tips that may help other parents to avoid a situation like this.

Tips for Medicine Safety:

Somehow, my kid busted the safety cap.
1. Don't trust the child safety caps. Sure, they may be hard for us to open, but kids like a challenge. It's best if medications are completely out of reach or in a locked box where children can't access them. One of the biggest flaws in the design of my second bathroom is that there's no medicine cabinet so I had the kids' medications in the drawer. I will certainly be looking into other places to keep medications for the children and finding a safer alternative than just trusting the safety caps, because obviously, my two year old can get them open - and I always make sure the caps are secured properly.

2. Keep track of the quantity in the bottle. Yes, it seems anal, but it's important to know how much is in any particular bottle in the off-chance your kid gets in it. It can be as complicated as keeping an inventory and marking it anytime a dose is given or keeping a marker handy to mark the liquid level for liquid medications. Just make sure you know how much the initial quantity filled the bottle so you have an idea of the remaining amount comparatively.

3. Buy smaller bottles. It may not be cost effective, but it's safer. The less there is available, the less there is the potential to accidentally consume. Kids' medication is purposefully made to taste good and young kids have little concept of dosing. I was so relieved to learn that the full bottle did not contain enough for a toxic dose for my child's size and thankful that a larger bottle hadn't been available at the time I had purchased it. Normally, I go for the deal of bulk and larger sizes, but this is one area where I'm changing my tune.

4. Know your child's weight. Kids grow rapidly and just keeping track of weights from regular pediatrician wellness visits every six months is not accurate enough.  Poison control will need to know an accurate weight so they can calculate safe dosing and toxicity levels. Make sure to have a scale and weigh your kids regularly. For my kids it's a game, taking turns and watching the numbers come up. I've also figured out that doing this regularly helps them hold still better when being weighed at the doctor's office. Not to mention, it's a good thing to keep close tabs on so we are using car seats, carriers, and other children's equipment properly and safely.

5. Keep the number for Poison Control in an easily accessible location. I got the number from the pediatrician's office, but it's good to have if you call them first. I now have it stuck to the side of the fridge should I need it again, which I hope I don't. Poison Control varies by state, so make sure to have the number for your state.

6. Don't try to treat on your own. It is not recommended that you induce vomiting or try to address the problem on your own unless you are medically trained to do so. The time since they consumed the drug matters and inducing vomiting may have little effect or it may be more dangerous than letting the medication process through their system as I was told. Call for help immediately and wait for and follow instructions given.

I'm very thankful my little one is ok, but the experience opened my eyes. I certainly have learned from it and I hope others can as well. Please share these tips and if you have more, comment below!