Real Life Stories: A perspective on poisoning from the floor of Accident and Emergency

Case 1
The family had returned from holiday late on the Sunday evening. Mum had put Emma and her older brother to bed and after dealing with the washing and cleaning she had herself gone to bed late. She woke at 07:30 hearing the children playing in their room. When she went through to see them she found that they had been very creative in getting all the toys together and making a party for them. As part of the party food they had shared out ‘sweeties’ to the toys. Mum looked at the ‘sweeties’ and asked where they had come from. She was told that they had found them in the luggage. This was her wash bag from the holiday. It had a combination of ibuprofen, paracetamol and oral contraceptive pills present. Most of the tablets were out on the side. Mum was shocked, became angry with the children, and brought Emma and her brother Tom to our Children’s A&E department.

We examined the children, observed how they were and checked the possible amount of tablets taken with the local Poison’s advisory service. This helps to confirm the likely side effects and problems anticipated with any known medication, poison or chemical substance taken. Both children were fine and able to be discharged from the hospital.

Mum was still upset and understandably preoccupied with thinking about what could have happened. She was surprised that the children could open the tablet bottles that she thought were childproof. We clarified with her that though these bottles often make it harder for children to get into them, they are not full-proof, and children if determined to get access will get into the bottle. We arranged for a health visitor to come by to talk through some of the accident prevention and home safety issues who reiterated the importance to Mum of keeping all medications away from children at all times.

Case 2
Later that day we had a Dad come in with his son Zak who had been visiting grandparents and had been playing in the garden shed when he returned with a bottle of cleaning liquid that he’d opened and had a drink from. He had developed some abdominal pain and vomited but was now feeling better and improved while in the A&E department. Again, the importance of understanding the risks present in other people’s houses became a point of discussion with Dad.

He had also been concerned about whether he should have made Zak vomit when he found him - but we reiterated the importance of not doing this - best to let the child drink some water or milk. If he or she does vomit- that’s fine but do not induce this as if the substance causes any damage, it will only do so again as it comes back up to the mouth. Fortunately, the substance that Zak took was mild and apart from giving him some tummy ache would do no harm in the small amount that he took.

Some cleaning substances, rat killers and poisons that are a risk around a house have additional taste agents added to make it taste so bad that no-one would continue eating or drinking it. However, these are not standard - though they are a good additional security as however hard you try their will always be some risk that children will gain access to these bottles.

Fortunately, both these children were able to go home with their parents rather than need any other treatment. The key to this is prevention and having a range of blocks to children gaining access to potentially dangerous drugs or chemicals.

Information

All names mentioned are fictitious and any resemblance to real people is purely coincidental.