Child Care: First Aid During Poisoning in Children

The ideal thing is prevention. Potentially toxic things like adult medicines etc. should be kept well out of reach of the child. But surprisingly, this very obvious and common sense fact is overlooked in a vast number of cases, as is evident by the number of children brought to the emergency department of the hospital with some sort of poisoning.

After the consumption of anything toxic, if you can reach a doctor within 10-15 minutes, then it is best to go to him as soon as possible. In case medical facilities are not available at hand, the only first aid that parents can give is to induce vomiting. Remember inducing vomiting after 2 hours of ingestion is seldom of any use and should not be attempted if such a delay has occurred.

Also do not induce vomiting under the following circumstances:

1. If the patient is unconscious or convulsing.
2. In case of ingestion of acids, alkalis or hydrocarbons like kerosene, petrol etc.

How to induce vomiting?

Caution: The parents should do it only in case medical facilities are not at hand and a doctor cannot be contacted even telephonically. If you can contact a doctor on phone, then tell him the nature of the poisoning, how long before has the poison been consumed etc. and then follow his advice. Only in the absence of any medical guidance, should vomiting be induced by the parents, keeping all precautions mentioned above in mind.

The medicine of choice for induction of vomiting is Syrup of Ipecac, but its availability is very limited in India; while in western countries all parents are advised to keep this syrup at their homes. Syrup of ipecac is given in the following doses:

< 1 year : 10 ml
1-10 years : 15 ml
> 10 years : 30 ml

Since it is rarely available in India, the best way to make the child vomit is to make the child drink soap water in India (15 – 30 ml of liquid hand soap or powder for washing clothes in a small amount of water). Do not induce vomiting by giving hypertonic salt solutions as cases of salt poisoning due to it have been reported.

N.B. : The child may inhale cosmetic powder with serious consequences. The talcum powder is in the form of a very fine powder and if inhaled, it can spread as a thin sheet all over the lungs thus seriously hampering oxygenation of the blood. Parents should be careful while handling talcum powders and not let a child play with it.

Articles Ingested with no or Low Toxicity (No treatment required)

Ballpoint ink, Hair dyes, Bar soap, bathing soap, Hair oils, Battery (dry cell),Mascara,Candles, Toothpaste, Chalk. Cigarettes, Clay (modelling), Water colours, Crayons, Adhesives (glue), Teething rings, Detergents (anionic), Slaked lime,Eye makeup, Dry indoor paint, Hand lotion and cream Latex emulsion paint, LipstickHouse lizards in food, Newspaper, Fertilisers (non-nitrate), Pencils (lead and colouring),Shampoo, shaving lotions and cream Shoe polish and Thermometers

Things of Low Toxicity (removal/ treatment necessary if large amounts consumed)

After shave lotions, Body conditioners, Colognes, Deodorants, Fabric softeners, Hair dyes and sprays, Indelible markers, Perfumes, Suntan lotions, Nail polish, Nail polish remover,Skin lighteners, Bleaching lotions, Hair vitalizer and Toothpaste (fluoride)

Skin

Skin can be contaminated with poisons, both corrosive and non-corrosives. The treatment is washing the affected area copiously with a lot of water. A special mention is to be made about skin contamination with organophosphorus compounds e.g. compounds like insecticides, tick-20. They can be significantly absorbed through the skin and hence the skin should be washed thoroughly with soap and water for at least 30 minutes. The person who is washing should take care that he himself doesn’t get contaminated with the poison.

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