Toxic ingestions in children

Accidental toxic ingestions can be prevented using appropriate precautions to prevent access to toxic substances. Chemicals should be stored out of reach of children. Liquid chemicals should be stored in their original containers, because there are several beverages that may appear similar to toxic liquids (e.g., torch fuel and apple juice; ethylene glycol and neon-green drinks). Medications should be stored in a lockable box or behind a locked cabinet. Education of primary carers regarding these interventions should be provided.

Be aware of household dangers that may not be obvious, or that have unexpectedly evolved.

For example, alcohol-based hand sanitiser is frequently used as a substitute for handwashing with soap and water. Data have shown that unintentional and intentional ingestion of these hand sanitisers can cause adverse health effects, such as hypoglycaemia and seizures; therefore, close supervision of children who are using these products is needed.[30]Santos C, Kieszak S, Wang A, et al. Reported adverse health effects in children from ingestion of alcohol-based hand sanitizers - United States, 2011-2014. MMWR Morb Mortal Wkly Rep. 2017 Mar 3;66(8):223-6. http://www.ncbi.nlm.nih.gov/pubmed/28253227?tool=bestpractice.com Although many ingested household foreign bodies are benign, others such as objects containing lead, magnets, and button batteries may lead to catastrophic damage.[21]Royal Children’s Hospital Melbourne. Foreign body ingestion. Apr 2020 [internet publication]. https://www.rch.org.au/clinicalguide/guideline_index/Foreign_body_ingestion See our Foreign body ingestion topic for further information.

Both young children (in the course of exploring their environment) and adolescents (due to the phenomenon of the 'Tide Pod Challenge') have been reported to ingest laundry detergent pods.[22]Gurevich Y, Sahn B, Weinstein T. Foreign body ingestion in pediatric patients. Curr Opin Pediatr. 2018 Oct;30(5):677-82. http://www.ncbi.nlm.nih.gov/pubmed/30036203?tool=bestpractice.com [31]American Association of Poison Control Centers. American Association of Poison Control Centers warn about potential poison exposure to single-load laundry packets. Jan 2018 [internet publication]. https://piper.filecamp.com/uniq/gc5wyYpRXWQeNjFC.pdf [32]Day R, Bradberry SM, Jackson G, et al. A review of 4652 exposures to liquid laundry detergent capsules reported to the United Kingdom National Poisons Information Service 2008-2018. Clin Toxicol (Phila). 2019 Dec;57(12):1146-1153. https://www.doi.org/10.1080/15563650.2019.1590586 http://www.ncbi.nlm.nih.gov/pubmed/30892959?tool=bestpractice.com Although most exposures were asymptomatic or resulted in only minor harm, some resulted in significant or severe clinical consequences.

All families of children presenting to a healthcare provider after a toxic ingestion should receive counselling on 'poison-proofing' the home. This should include data on how to make the home safer by locking up medications, removing potentially dangerous substances from the child's environment, and discussing safe practices in the home, including smoking cessation. Social services may need to evaluate the home situation if there is a pattern of ingestions with either the same child or multiple children. Adolescents who ingested medications or substances for non-therapeutic reasons should receive counselling on the risks and dangers of substance misuse. Children who ingested medications in suicidal attempts will require psychiatric intervention. In cases of accidental lead toxicity, every effort should be made to find and address the source of the exposure.