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Prevention of poisoning  in children

Button Prevention of poisoning in children Button Bee & Wasp sting Button Common cause of childhood poisoning in India.
Button Snake bite & Scorpion sting Button Dog bite / Rabies

PREVENTION OF POISONING IN CHILDREN

POISONING

Small children aged 9 monhs to 5 years are extremely curious about the things around them. They regard the environment as a part of themselves. They are more prone for accidental poisioning because of curiosity, sponteneous activity, innocence, mouthing of objects, negativism and immitation of adults. Poisioning may be manifastation of insecurity, guilt feeling, protest to punishment or attention seeking behaviour of the children. Many time it may be due to over dosing of medicine by anxious parent. All this can lead to accidental poisioning.

A poison has been defined as a substance which when introduced into or absorbed by a living when introduced into or absorbed by a living organism causes injury or death. A varierty of substances may act as a poison including the medicine.

One and half year to two and half year old children are highly vulnerable for the unfortunate accidental poisionig event. Male children are predominate the poisoning accidents due to their greater degree of activity, It has been observed that there is some relationship between accidental poisoning cases amongst children and some or other type of family disturbances.

The incidence of poisoning tends to be higher among children from lower socio-economic class of society due to poor storage facility and parental negligence.


Basic Do's to Avoid Accidental Poisioning.

Ensure storage of detergents, cleaners, pesticides, insecticidals, toxic liquids in a storage cabinet with latches, which cannot be opened by small children.

Do store all medicines, alcohol/wine out of children reach, preferably in a locked cupboard.
Do mark all potentially dangerous substances prominently (symbol, label in local languages)
Recap the container of all hazardous substances immediately.

Basic Dont's to Avoid Accidental Poisning
Don't change the container of toxic liquid.
Do not store any hazardous substance in your regrigerator.
Never keep Kerosene, Gasoline or toher poisons in soft drink bottles because children may try to drink them.

Take care that your child do not touch pesticides with bare hands, as pesticides can be absorbed through the skin.

Do not take pills or medicines of any kind infront of children.

First Aid - Accidental Poisoning
If you suspect poisoning, do the following immediately.

Consumption of any hazardous substance in potentially toxic dose is best treated by emesis (substance which induce vomiting ) unless.

Button the child is comatose
Button the child has lost his gag reflex.
Button the child is convulsing.
Button the consumed substance is caustic in nature.

In a conscious child

Make the child vomit. Put your finger in his throt, or tickle the back of his throat, or tickle the back of his throat with a spoon, or make him drink warm water with salt.


In an unconsious child
Do not make him vomit. If he has stopped breathing, then give mouth-to mouth breathing. Seek medical help at once.

Do not make a person vomit if he has swollowed Kerosene, Gasoline, Petrol or strong acids or corrosive substances like Iye.

In the alert children, give syrup Ipecac instantly with water to induce vomiting.

Dose
Button 15 cc in case of 1-5 year of age.
Button 30 cc in case of 5 years & above.
If there is no effecct - Repeat the dose after 20 minutes.


Gastric Lavage is the best method for removing poison from the stomach in unconsious patients, convulsing patients. However, it is not indicated in hydrocarbon poisioning and comsumption of caustics.


Activated charcoal - In a dose 5-10 times the amount of poison ingested, given orally, absorbs most toxins and reduces their absorption.


Use of magnesium sulfate, 250 mg/ kg. 6 hourly, helps hasten excrection oof poisons.
Contact your doctor as early as possible.


COMMON CAUSE OF CHILDHOOD POISONING IN INDIA.
Poisons Incidence % (Appro)
Kerosine (Very Common), Petrol, Diesel etc. 30-60%
Household products like Insecticides, Rodent Poison,
Phenol, Caustic soda, Acids, Turpentine, Camphor, Moth Balls, Alcohol
12-30%
Plant and plants products like Dhatura, Castor seeds, Chandrajyoti seeds. 5-30%
Food Poisoning 5-15%
Venomous Snake Bite, Scorpin Sting. 6-11%
Medicine / Drugs like Paracetamol,. Aspirin, Barbiturate. Diazepam, Iron, Anithistaminics, Anticonvulsant etc. 15-30%

POISONS SIGNS & SYMPTOMS FIRST AID
DRUGS & MEDICINE
Acetaminophen [Paracetamol]
(Common Pain Killer)
Nausea, Vomiting, Sweating Syrup of ipecac or gastric lavage. Activated charcol effectively absorbs Acetaminophen.
Barbiturates / Diazepam (Depressent) Difficulty in breathing, body temperature, low B.P Gastric lavage within 4 to 6 hours
Phenothiazine / Chlorpromazine / Piperazine (Antidepresent) Dizziness, Drowsiness Gastric lavage within 4 to 6 hours. Activated charcol orally.
Salicylate (Common Pain Killer) Fever, Sweating, Nausea, Vomiting Give a pint of water or milk followed by butter. Suck a piece of ice. Ruch to hospital
Opium, Morphin (Rare Pain Killer) Difficulty in breating, Convulsion Gut decontamination
Tincture lodine (Antiseptic) Burning mouth, Gastric irritaion Gastric lavage with soluble starch solution.


SNAKE BITE & SCORPION STING

In India the number if facilities are very high due to snake bite. Nevertheless deaths due to scorrpion sting or other venomous animals are negligible.

Out of 236 species of snakes found in India about 50 are venomous. However, all these venomous snakes are not a threat to man. Cobra, Krait, Russell's Viper and saw scaled viper are the four deadliest snakes found in India.

Snake venom is actually a type of saliva, which the snake uses to kill and digest its prey. There are two kinds of snake venoms- one affects the nerves ( Cobra, Krait) the other affects the circulatory system (Vipers)


Regarding snake bite we must remember a few facts -
Button Every snake bite many not be from a venomous snake.
Button All bites from venomous snakes are not fatal.
Button Highly potential antivenin is now available against most of the snake venom.

These facts explain the importnnce of not getting panicky or over excited. Excitement results in faster cirulation as if the bite is from a venomous snake he venom will circulate speedily.

Nevertheless, we should not ignore any snake bite and try to rush the patient to a hospital as early as possible.

Do's to avoid snake Bite
The best treatment for snake bite is prevention.
Button

The frequency of snake bite is at peak in the rainy season in farmland open country areas. One must wear long mud shoes, gloves and thick long clothese in such surroundings.

Button

The chances of snake bite are at the highest at dusk or in the night hours. hence one should not go out without a poweful torch.

Button While trekking in a jungle, always use high shoes, glovesand wear thick clothing.

Don't to Avoid Snake Bite
Button Sleeping on the ground increases the chances of snake bite. It should be avoid
Button swimming in the sea snake harboring areas of sea.

FIRST AID
Button Keep the patient in a head high and legs low position.
Button Don not form a crowd around the victim.
Button Do not form a crowd around the victim.
Button

Apply a constricting band two to three inches above the bitten area. The band should not be very loose or tight, it should be nearly be nearly four inches wide.

Button

Immobilization of the victim is of paramount importance, Keep the bitten area in an absolutely standstill position.

Remember, anti-venom is the only solution for snake bite and not mantras or any local medicine. such efforts may cost the life of the victim.


Scorpions Sting

Scorpions are notorious for their painful stings. Of about 650 known species of scorpions many are found in the tropical. They are often seen in fields and jungles and even in dwellings. During the day they shelter into crevices and emerging at night. They often get into shoes and clothing even into bedding Hence scorpion stings, are quite a common occurrence.


Do's to Avoid Scorpion sting
Button Beware of scorpion in infested areas. Particularly in evening and night hours.
Button Wear thick socks and shoes in those dwellings where scorpions are commonly seen.
Button Never go out barefooted and without torch in eveing hours.
Button Take care of yourself while gardeing and cleaning crevices.
Button

Spray the mixture of kerosene and small amount of creosote in probable retreat of scorpions in a scorpion infested house. Spraying with 10 % DDT kills the scorpion.


Don'ts to Avoid Scorpion sting
Button Make a habit of shaking all clothes and shoes before using.
Button Avoid sleeping on gournds.

FIRST AID
Button Keep the victim lying quitely.
Button Scorpion sting is rarely fatal.

Assure this fact to the victim, make him relax. medical aid should be made available to the victim as soon as possible.

Button

Apply firm pressure bandage to limit the spread of poison wherever possible (area of the sting). Remove this bandage in five to ten minutes.

Button

The wound should be washed with plane water or Potassium permanganate followed by cooling of the affected part with ice. It helps to slow down the spread of the poison. This can be continued for two hours, taking care not to create freezing injuries.

Administration of antivenin and other supportive therapy can be availed from medical speciaist.


BEE AND WASP STING
Local application of Ice packs will retard absorption of venom.

Lizard Bite
Band application, cooling of the beitten area and tetanus toxoid.

Spider Bite
The site of bite should be throughly wash with hot water which gives prompt but temporary relief.


DOG BITE / RABIES
Rabies comes from the bite of a rabid mad dog or cats.

Do's to Avoid Dog Bite
Button Kill & burry rabid dog.
Button Vaccinate your pet dog.
Button Keep children far away from any mad, sick dog.
Button

Take great care in handling any sick dong. Even if it does not bite anyone, the saliva can cause rabies of it gets into a cut or scratch.


Don'ts to Avoid Dog Bite
Button Do not let a child distrub an eating or sleeping dog.
Button Never allow your allow your child to play with strage dog.
Button Never allow your child to hold his face with any dog.

First AID
Button Clean the bite area with soap, water & hydrogen peroxide.
Button Do no close the wound; leave it open.
Button After clening apply tincture of iodine.
Button Contact your Doctor.
ACKNOWLEDGMENTS
Prevention of Poisoning in Children
Publication of IAP Parent Educational Cell


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