A child who has ingested a toxic substance or an excessive amount of a therapeutic medication may or may not be able to tell you what has happened; this will depend on the child’s age, her condition after the episode (that is, alert, drowsy, or unconscious), and her emotional state.
Indications that your child has swallowed a toxic substance (or an overdose of medication) could include the following:
- Sudden illness for no apparent reason
- Being in close proximity to a potentially toxic substance such as a household cleaning product or a medication, especially if the container is open and pills or liquid are spilled
- The presence of unusual liquids, stains, or powder on the skin, clothing, or around the mouth
- Dizziness, weakness, stupor, confusion, or coma
- Blurry vision, double vision, or a change in the normal size of the pupils
- Rapid heart rate
- Fever, headache, irritability
- Rash or changes in skin color (blue, flushed, or pale)
- Depression or unusual shifts in mood
- Ringing in the ears
- Coughing, chest pain, or difficulty breathing, with or without increased noise during breathing
- Nausea, vomiting, abdominal pain or cramping, or diarrhea, twitching muscles or unexplained muscle pain or cramping excessive saliva
- Inability to control urination or bowel movements
- Loss of appetite
- Abnormal breath odor
Check the ABCs, airway, breathing, and circulation and begin rescue
Try breathing or CPR if necessary. If CPR has been initiated, have someone call 911. (If you are alone, call 911 after you have carried out CPR for approximately one minute.)
- If CPR is not needed, call your child’s physician, the nearest emergency room, or a local poison control center. If you can’t find a number for a poison control center, call 1-212-POISONS.If the child is having seizures, protect him from injury.
- If the child vomits, try to protect the airway. Position him so that whatever is vomited will exit away from the mouth and not accidentally be inhaled into the airway. If necessary, gently remove any remaining material from his mouth.
- If the exposure was a skin contamination, remove all contaminated clothing and wash skin, hair, and nails.
- If he has been exposed to fumes, remove him from the area in which the fumes are present.
- If the material went into the eye, irrigate it thoroughly with tap water.
- Take the substance and its container with you to the doctor’s office or emergency room and be prepared to answer some questions: Where was the child found? What and how much was ingested? When did symptoms (if any) begin? Did symptoms begin gradually or abruptly? What treatment was done at home and when?
- DO NOT wait for dramatic signs of illness before seeking medical assistance.
- DO NOT give anything as an antidote or attempt to neutralize a poison unless you have been told to do so by a physician or poison control center.
- DO NOT attempt to give the child anything by mouth if he is unconscious.
- DO NOT induce vomiting unless directed to do so by a physician or a poison control center.
- DO NOT rely on the label of a medication or other substance to tell you whether or not it is potentially hazardous.
Ipecac is a medicine used to induce vomiting, thereby reducing the amount of toxic material available to be absorbed into the bloodstream. Some substances should not be vomited because they will cause even more damage to body tissues on their way up. Do not use Ipecac unless you know what has been swallowed and you have been instructed by a doctor or poison control center to use it.
The best results are obtained if Ipecac is given within thirty minutes of the ingestion. If a number of hours have passed since the material was swallowed, in most cases it is not likely that any of it will still be present in the stomach.
DO NOT use Ipecac when the child has swallowed the following:
- Alkaline materials: detergents, drain cleaners, oven cleaners, bleach, and flat circular batteries. Chemical names to look for include lye, sodium hydroxide, potassium hydroxide, ammonia, calcium oxide, trisodium phosphate, and wood ash.
- Acids: automobile battery fluid, toilet-bowl cleaners, soldering fluxes, antirust compounds, and slate cleaners. Chemical names include sulfuric, hydrochloric, phosphoric, hydrofluoric, and oxalic acids.
- Petroleum products: cleaning fluid, gasoline, kerosene, coal oil, fuel oil, or paint thinner.
- Sharp or solid objects: glass, nails, razors, a thermometer.
- DO NOT use Ipecac when a toxic substance is swallowed by
- A child less than 6 months of age
- A child who has a hereditary tendency to bleed (i.e., hemophilia)
- A child who has had significant vomiting already
- A child who is in a stupor, unconscious, or having a seizure
Directions for giving Ipecac
- For a child between 6 and 12 months of age, give one to two teaspoons (5 to 10 m1).
- For a child 1 to 12 years of age, give one tablespoon (15 ml).
- For a teenager, give one to two tablespoons (15 to 30 ml).
- Give the dose with one or more glasses of water or juice (no milk products).
- If vomiting does not occur in 20 to 30 minutes, repeat the dose.
- If vomiting does not occur after a second dose, contact your doctor or emergency facility for further advice.