Ellen Campbell-Grizzle
CARIBBEAN POISON Prevention Week, May 8-13, falls within Child's Month. This is appropriate at this time because in 2003, 77 per cent of the 520 cases of confirmed accidental poison cases in Jamaica were children under five years old. Most victims ingested kerosene oil and pharmaceuticals. According to data from the Ministry of Health, in this age group, accidental poisoning from bleach is an increasing concern.
A poison is anything that kills or injures through its chemical actions. Most poisons are ingested, but they can also enter the body by breathing, through the skin, by intravenous injection or from exposure to radiation. If you, a family member, or a friend has swallowed or breathed in a poison and you have serious signs or symptoms, such as
nausea, vomiting, pain, trouble breathing, seizure, confusion or abnormal skin colour, then you need help. If the person has no symptoms, but has taken a potentially dangerous poison, you must call for medical help immediately.
VOMITING
Parents frequently ask whether vomiting will rid the body of poison. This is likely only for an hour or two after ingestion. After that time, the poison has either been absorbed in the stomach or has passed farther down the intestinal tract where it cannot be vomited. You should not induce vomiting if the child has swallowed:
A caustic substance the mouth and oesophagus may already be chemically burnt and vomiting will increase the damage.
Petroleum products, such as gasoline, kerosene or paint thinners. These liquids may
easily enter the lungs and cause severe damage. Vomiting increases the chance of this happening.
A solid foreign object, such as a pin, needle, fishhook or coin.
Remember, if the child is unconscious, there is a very high risk of aspirating the vomit. Aspiration means breathing the vomit into the lungs and possibly drowning. The doctor will put a flexible, soft, plastic tube into the windpipe to protect the person from suffocating and to provide artificial breathing.
ANTIDOTES
Some poisons have specific antidotes. These either prevent the poison from working or reverse the effects. A common substance used to neutralise the effect of acetaminophen overdose is N-acetylcysteine. Acetaminophen, in normal doses is very safe, but this drug, in massive doses, can damage the liver. Symptoms of acetaminophen toxicity are usually delayed. However, if you
suspect that your child has taken too much of this substance, seek medical help immediately.
Two commonly used antidotes are ipecac, to induce vomiting, and activated charcoal, the 'super absorber' of many poisons. Once the poison is stuck to the charcoal in the intestine, it cannot be absorbed into the blood stream. Activated charcoal has no taste, but the gritty texture often causes vomiting. To be effective, this antidote needs to be given as soon as possible after the poisoning. It does not work with alcohol, caustics, lithium or petroleum products.
Remember, if you are instructed by your doctor to use ipecac, it will cause vomiting within 20-30 minutes. Give the child a full glass of water just before or after the prescribed dose of ipecac.
The Ministry of Health reports that there is a real increase in incidents of accidental poison in Jamaica. The Caribbean Poison Information Centre (CARPIN), now located at the University of Technology, represents an attempt to provide life-saving information. Sentinel sites are to be located all over the country. Remember, your prompt action can save your child's life. Know the common poisons, their antidotes and keep the CARPIN number, 323-8909, handy!
Ellen Campbell-Grizzle, president, Caribbean Association of Pharmacists; director, Information and Research, National Council on Drug Abuse; email: yourhealth@gleanerjm.com.
