Poison Smarts Webinar


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Hello, everyone. I’m Kristin Wenger, Education Coordinator for the Blue Ridge Poison Center. This presentation was recorded in August 2018 and lasts about 30 minutes. Poison centers are staffed with nurses and doctors who are specialists in treating poisoning from all kinds of sources.

But you don’t see them in person, you call them on the phone for fast, free, and confidential advice. Although there are many poison centers, we all share the same toll-free number, 1-800-222-1222. No matter where you are in the country, when you dial that number, your call is answered by the poison center closest to you.

If you do not live in a home with young children, you might be wondering why you need to care about poison centers. Well, it is true that we get a lot of calls about little kids. In fact, 42% of all of our calls are about children under the age of six– that’s almost half. But we also receive calls about teens and tweens, working-aged adults, and senior adults.

This chart shows you how many calls we get from each of those groups. However, even though we get so many calls about little children, the most serious poisoning cases involve adolescents and adults. In fact, 9 out of every 10 poisoning deaths in the US happen to an adult over the age of 20, not to children. So poisoning is a concern for anybody at any age.

With that in mind, here are the questions that I will answer during this presentation. First, how do poisonings happen? What are some of the most common poisons that you need to watch out for? How can you keep yourself and others safe from poisoning? This includes young children. And lastly, if someone is poisoned, what should you do?

There are three terms that you need to know from my talk today. An exposure is contact with a potentially harmful substance. This may include swallowing something, getting something in your eye or on your skin, or breathing harmful fumes, smoke, or particles in the air. A poisoning is an illness, injury, or death resulting from contact with a harmful substance. Injuries and illnesses vary from minor, such as a mild skin rash, some nausea, or coughing, to severe, such as vomiting, chemical burns, dangerous changes in heart rhythm, or loss of consciousness.

Lastly, what is a poison? How do you know if something is a poison or not? Well, a poison is any substance capable of causing harm if it gets into or onto your body in the wrong way or the wrong amount. Here’s what I mean by that. Most people won’t experience much harm from using soap on their skin unless they have a particular allergy.

However, if they swallow soap, they might become sick because soap is not supposed to be swallowed. It’s not safe for ingestion. So that would be a way of getting something in the body in the wrong way. Here’s another example– salt is a chemical that our bodies need a little bit of every day in order to properly function. But there’s an amount of salt that could harm you, or even kill you, if you’d get much of it into your body at the same time.

This is a news story about a young man who drank an entire bottle of soy sauce and then became extremely ill from salt poisoning. So whether or not something is a poison, or is going to cause harm, depends on whether it gets into or onto your body in the wrong way or the wrong amount. Under those circumstances, almost anything could be poisonous.

The leading causes of poisonings are common substances found in most of our homes and include medicines. Medicines, both prescription and over-the-counter, are the leading cause of poisons for all age groups. You can be poisoned by medicine when you take much, take the wrong thing, or take dangerous combinations of two or more drugs.

Cleaning products and personal care products. I put these two together because they’re the leading cause of poisoning for young children. Personal care products are non-drug products that we use on our bodies, such as mouthwash, cosmetics, fingernail polish remover, deodorant, skin creams, et cetera. Adults sometimes leave these products where children can easily reach them, such as on the bathroom countertop or in a diaper bag.

Pesticides. These are chemicals designed to kill living things. Examples include weedkiller, mouse bait, mosquito repellents, and products that we use on our pets to control ticks and fleas. Exposures to pesticides and other products happen when we don’t store them in a safe place, or we don’t follow the directions on the label about how to use them safely.

Alcohol is a leading cause of poisoning. Other household chemical products. This is a catch-all category for things like automotive products, including antifreeze and gasoline, paints or solvents, craft supplies, even chlorine that we might put in our pool or hot tub.

And lastly, gases or fumes are a leading cause of poisoning. Carbon monoxide gas is probably one of the most common gases involved in poisoning and it is also one of the deadliest. Carbon monoxide poisoning takes the life of about 500 people in our country every year. It’s produced every time you burn a fuel, so wood in your wood stove, or oil in your furnace, gasoline in your car engine, et cetera.

And it’s called a silent killer because you can’t see it and you can’t smell it, so you don’t know when you’re breathing it. The symptoms of carbon monoxide, such as headache, dizziness, nausea, passing out, they mimic the flu. The number one reason for carbon monoxide poisoning, by the way, is power generators. If people place their power generator in the wrong spot, such as under the window or on the porch, the carbon monoxide gas can seep into the living spaces in the home.

Poisons in nature are less common, but still dangerous and often frightening. There are poisonous plants and mushrooms in Virginia and animals that are venomous, meaning that they can inject poison into your body through a bite or sting. Keep in mind that our nurses are experts in poisons that are found in nature , and are happy to help you any time with these exposures.

Most bites and stings happen when somebody is trying to catch or kill the animal, such as a snake or a spider. Trust me, these animals prefer to hide from us and avoid human contact. They only bite or sting when provoked. To prevent harm, simply leave the animal alone.

Most poisonings are unintentional or in other words, accidents. So what causes an accidental poisoning? Well, I have broken everything down into four main categories. First, the accidental spilling or spraying of a substance onto your skin, into your eye, or into the air that you’re breathing. For example, knocking over a whole container of gasoline inside your car, which could result in fumes building up inside the air that you’re breathing in the car.

We’re all guilty of this, including me, not reading or following the label instructions on our products or our medicines. Poor interactions. This is when two things combined together create a third dangerous thing. It could be two different medicines that you’re not supposed to take together. It could also be two different cleaning products that you’re not supposed to combine in the same container.

And lastly, accidental poisonings happen when we make a mistake with look-alikes. Let me show you what I mean. At first glance, what did you think that this was? You probably thought to yourself, a glass of water. If you saw it sitting on the counter, would you drink it? You might. You might not. You might smell it first. But what about a 3-year-old? What about Grandma who perhaps doesn’t see, or smell, or remember as well as she used to? That would be a tragedy, indeed, because this is what was in that glass.

Here’s some other examples of look-alikes. See how much the poison resembles the non-poison? It’s very easy to make a mistake, particularly when someone has limited vision, and particularly when children are involved. Look at these bottles. They’re so similar. From left to right, we have liquid glue, ear drops, and eye drops.

And would you believe, the poison center routinely receives calls from people who have just accidentally put glue into their eye or eye drops into their ear because they picked up the wrong thing and they weren’t paying attention? Medicine and candy look very similar, especially to children. In each of these photos, the candy’s on the left and the drug is on the right.

Before I move on, I just want to share a few more real stories about real people who suffered unintentional poisoning with the hope that you can learn from their mistakes. A toddler was hospitalized with difficulty breathing and severe vomiting after biting into a concentrated laundry detergent pod. The laundry machine was set on a timer and the child discovered the pod in the soap compartment long after her parent placed it there.

A high school football player was in pain after injuring his shoulder during a football game. At home, he found extra strength acetaminophen in his family’s medicine cabinet. One brand name for acetaminophen is Tylenol. He k two of these, but an hour later, he was still in pain, so he k two more.

He continued to self-medicate like this throughout the night. In the morning, he had abdominal pain and was vomiting. They rushed him to the hospital. And in the emergency room, they tested his blood and discovered he had overdosed on acetaminophen, and had suffered permanent damage to his liver, and now might need a liver transplant.

A man was a weekend guest in his brother’s home. He wakes up late at night and he’s thirsty. He doesn’t want to bother anybody else or wake anybody else up in the house so he wanders downstairs and goes into the pantry and finds a bottle of water on the shelf. He helps himself to a big swallow. It tastes horrible.

He quickly realizes that the bottle was actually storing some other type of liquid. He wakes up his brother to tell him what happened and find out what was in the bottle. It turns out, his brother was storing grout cleaner in it. Grout cleaner is very caustic. At the hospital, his condition deteriorates quickly as his body reacts to the chemical burns that he suffered in his throat and his esophagus.

These are just a few of the 20,000 phone calls that the Blue Ridge Poison Center handled last year. In a minute, I’m going to share my tips for preventing poisoning to help keep these and other accidents from happening to you or people in your family.

But first, let’s talk about protecting those who cannot protect themselves. Young children cannot be expected to make safe choices. They explore their world by opening cabinets and drawers, emptying purses, taking things apart, and putting everything that they find in the mouth. This is normal developmentally appropriate behavior for a child. It is up to the adults in their life to provide a safe environment. By the way, the safety tips that will prevent childhood poisoning will work to help prevent your pets from getting poisoned .

Medicines intended for adults are among the most dangerous poisons for children. There are a few that our nurses call quote, “deadly in a dose” medicines, because even just one adult dose, one or two pills, could be enough to cause serious harm to a child. In particular, drugs that we take for various cardiovascular conditions, some diabetes medications, and some types of antidepressants could all be “deadly in a dose” medicines.

If you have a young child, this is probably not a surprise to you. We use the term child proof all the time, but there is no such thing as a child proof container. Given enough time, many children can figure out how to open child quote, “proof” containers, especially after they watch you do it a few times.

The correct term for medicine bottles like these, and others, is child resistant, not child proof. Using child resistant containers and child resistant cabinet locks is still a good idea because they will prevent some children from getting in, or at least slow them down and give an adult an opportunity to catch them in the act. But it isn’t enough by itself.

If there are any young children around, you also need to keep everything up and away, out of sight, and out of reach. Keeping poisons up and away may mean giving visitors a safe place to store their belongings. Think for a moment about all the harmful things that people may carry around in a backpack, a suitcase, or a purse.

Prevention works. It is much easier and much cheaper to prevent a poisoning than it is to treat one. Here are my tips to help keep yourself and your loved ones safe. First, before you swallow anything, before you put anything in your eye or on your skin, stop for a minute and look at it.

Make sure you have the correct thing. Turn on the lights and put on your glasses if you need them to see. You would be surprised how many calls the poison center receives after someone has just attempted to take medicine in the dark, and then they discover it wasn’t what they thought it was.

Follow the recommended doses on all your medicines, both prescription and over-the-counter. Read labels on all the products that you use and follow the safety instructions there. Keep products in their original containers. And if you do transfer contents into something else for instance, if you put grout cleaner in a water bottle, be sure to label it in big letters. And then store it up and away, out of the sight and reach of children.

Install carbon monoxide alarms in your home because again, you can’t tell when you’re breathing it. And of course, to protect children, keep all medicines and products up and away, out of sight and out of reach.

As I mentioned before, some poisonings well, most poisonings actually, are unintentional or accidents. However, some are intentional. In other words, a person misused or abused a substance on purpose with the intent of causing harm to themselves or altering their mental state. In other words, getting high.

Prescription drug abuse is one of the most common types of intentional poisoning. It is a huge problem in our country right now. The CDC estimates that one person dies from an overdose of prescription medicine every 19 minutes. Many studies have shown that most prescription drug abusers get their drugs from family and friends. Sometimes, it is with that person’s permission, but often, it’s not.

Pills also are stolen by strangers. To use my own family as an example, this actually happened to my mother. She had her pain medication stolen by the house painters while she was at home. The person who takes someone else’s medicine might have a problem with addiction. They might plan to use them recreationally. Or they may plan to sell the medicine. But in all those cases, someone’s health and safety could be at risk.

Help prevent medicine abuse by taking steps to make sure that the medicines in your home don’t become part of the problem. Never share your medicine. Your medicine may not be safe for someone else, even if they have the same symptoms. Secure all the medicines in your home in a safe place known only to you. The medicine cabinet is a terrible place to store medicine, because someone who is looking to take medicine without your permission, that’s probably the first place you’re going to look.

A lock box, like the one in the picture on the bottom left, might be a great option for you. They are available in almost every pharmacy and you can buy them online. Keep track of your medicines. You should know what your pills are supposed to look like. You should be able to notice if any are missing or if you find yourself filling the prescription sooner than expected. And lastly, dispose of any leftover or expired medicines. Removing them from your home entirely is the only way to guarantee that nobody else can take them.

Many people have no idea what to do with their leftover or expired medications. Here are the steps recommended by the FDA for getting rid of them. First, mix the medicines with something very unappealing like dirty cat litter or used coffee grounds. Then place them in a container, such as a sealed plastic bag or a coffee can. Throw the container out with your regular household trash.

And before you throw out the bottles that the medicine came in, scratch out any personal information that may be on the label. Medicine take-back receptacles are becoming more common in hospitals and pharmacies around the country. Also, the Sheriff’s office in many cities host a take-back day twice a year, usually in April and October. To find a collection site near you, visit www.dea.gov and then search drug take-back.

Well, as I said, prevention does work. But we’re human, mistakes happen. We can’t control everything around us all the time. Children are quick and unpredictable. Now if someone is not breathing, or won’t wake up, or is having seizures, call 911 right away, because that person needs hands-on medical care as soon as possible. But if there are other symptoms, or no symptoms, or if you just have questions, call poison control for help. Don’t wait for symptoms to develop and don’t Google the problem. The internet is notoriously bad at giving medical advice.

What are the benefits of calling poison control? Why should you call us instead of 911, or calling your doctor, or just loading up the car and heading into the emergency room right away? Well, remember, the poison center is staffed with specially trained nurses and doctors. Our staff know so much about treating poisons that other nurses and doctors call us for our advice.

The nurse is the person who answers the phone when you dial the number so you get immediate help. You don’t have to wait for someone to be paged or wakened in the middle of the night. And we’re always open. You can call us Christmas day. You can call us at 3:00 in the morning. And when you do, a real live person is going to answer the phone.

Our services are completely free. And we protect your privacy, just like any other health care provider that you share information with. It’s true that the poison center saves lives, but we save money , because most of the time, our nurses are able to tell you what to do to take care of your poisoning exposure right there at home instead of rushing into the hospital.

We encourage you to program the poison control number into your smartphone so that you can find it easily and quickly. Here’s a neat trick. Text the word poison to 797979 from your smartphone to have the number automatically saved in your contact list. I’m excited to share with you another new tool. Www.poisonhelp.org is a website designed by toxicologists and poison center specialists that you can visit for advice if you think someone may have been exposed to something harmful.

The website is free and confidential, just like our phone service. Now if you go to the website and you start answering the questions and it’s determined that your exposure is complicated, or potentially serious, or if the person is experiencing troubling symptoms, then you’ll be directed to the toll-free number so that you can call right away and talk to a specialist at a poison center near you about your unique situation. But this website might be a great place to start.

Here on one screen are all of the important numbers I talked about today. You may want to take a screenshot, or pause the presentation so you can write them all down, and you’ll keep this information at your fingertips. 1-800-222-1222 connects you instantly to a poison center specialist near you. If you text the word poison to 797979, you can have that number saved in your smartphone.

Www.poisonhelp.org is a new website designed to help you with your exposure. At the bottom of your screen there is my contact information in case you need to contact me about education and outreach or this presentation. And the very next slide will present you with a link to an anonymous survey so we can get your feedback about today’s presentation and also, see if we were successful in helping you learn anything.

You’ll also be able to print a certificate of completion. Even if you don’t need the certificate, please take a moment and fill out the survey. It only has a few easy, quick questions and your feedback matters a great deal to us. Thank you in advance. Have a safe day.