Today's guest blogger is Blair Thornley, PharmD, CSPI, a pharmacist at the Poison Control Center at the Children's Hospital of Philadelphia. This is the second of two posts during National Poison Prevention Week.
Yesterday, we addressed ways to avoid double dosing your children. While dosing is a very important part of the picture, 86 percent of emergency room visits for poisoning through medications were due to the child getting into an adult medication. So how might our young kids gain access to some of these medications? To illustrate this, let's look at an example:
Grandma has a history of multiple conditions that require several prescriptions, including diabetes, high blood pressure, and arthritis. She keeps all of her medications in a 7-day pill minder with easy-open tops. It's on her kitchen table as a reminder to take them every day. While she was watching her 2 year old grandson one day, he opens her pill box and eats a few pills thinking they're candy when she briefly turns away to make a grilled cheese. Little Tommy has to be rushed to the hospital after eating three tablets of grandma's Glipizide, a medication used to help lower blood sugar.
This is not an uncommon scenario here at the Poison Control Center. Of the 86 percent of cases mentioned above, 38 percent accessed the medication at a grandparent's house. Here are some tips that can help limit a child's access to harmful medications:
General access: All medications should be kept on a high shelf, out of sight and out of reach of children.
This includes all over-the-counter products as well. Just because you can buy something over-the-counter, doesn't mean it's completely safe. Ear and eye drops, topical creams, vitamins (especially those containing iron), and OTC pain relievers, cold remedies and allergy medicines should also be stored out of reach.
If possible, install child-safety locks on these cabinets to make them harder to get into, especially if you have a climber on your hands.
Don't forget to put them away and out of reach after every use, even if it is something that is being used every few hours. Accidents happen quickly, and it only takes a few seconds for children to get into a medication that could make them very sick. If you need an extra reminder, you can set an alarm on your watch or cell phone, or write yourself a note.
If possible, do not take your own daily medications directly in front of your children. Children are very observant and try to mimic their parents' behaviors. They don't understand that these medications could be dangerous.
Child-resistant caps: Whenever possible, use child-resistant caps on your medications, but beware: child-resistant does not mean child-proof. With enough determination, some children may still be able to get into the medication. For liquid medications, consider using a slow flow adapter, an insert that you put inside the rim of the bottle that prevents large amounts of medication from pouring out, but still allows you to replace the child resistant closure. It also doubles as a syringe adapter, so you can insert a compatible dosing syringe, invert the bottle, draw up the dose, and replace the children resistant cap. A win for all! The PCC offers a oral dosing syringe with slow flow adapter for purchase.
Purses and suitcases: 20 percent of children who came to the emergency room following an exposure had accessed the medication from a purse or a suitcase left within their reach. Keep any bags or suitcases that may contain medication in a place where a curious child won't be able to access them.
Old Medications: Clean out your medicine cabinet and dispose of expired or unused medications to reduce the risk of children getting into them. If you're unsure how to properly get rid of old prescriptions, you can find more information here. You can find authorized collectors in your community by calling the DEA Office of Diversion Control's Registration Call Center at 1-800-882-9539.
Educate Grandparents: Grandparents are much more likely to make use of pill boxes and non-child-resistant caps. If the children will be going to grandma and grandpa's house, make sure you talk to them about the importance of keeping their medications out of reach to prevent easy access.
Kids are very curious, and one of the major ways they try to explore their world is by putting things in their mouth. Because they're much lower to the ground, they also might find dropped pills or button batteries that we didn't even know were dropped. With this in mind, we just need to be very careful about how and where we store things. For more tips, check out this helpful guide from Safekids.org.
No matter how many precautions you take, we know that kids act quickly and that accidents happen. If your child swallows something he shouldn't, don't ever hesitate to call the Poison Center (1-800-222-1222) for advice. Pharmacists and nurses are available 24/7 to help the caregiver assess the risk of toxicity.