POISONS AND OUR KIDS: A case study on kerosene and other toxic substances

WHEN SHE DRANK KEROSENE

 …could you please bring palm oil, mummy Jide, we want to give it to Blessing

Some minutes before, Grace’s mom had seen Blessing with a laCasara bottle containing kerosene

But, she only drank a little, said Bola, and moreover, you already gave her palm oil she would be okay

The scenario painted above is just one of those events that happen in our environment especially when there are no supervisions and in order to take care of such situations, people would proffer different solutions. As an African (A Nigerian) in particular, we have our science, our ways of “treating” conditions. Thus, in this write up we would learn if those remedies truly work and if they do, how do they work? Apart from kerosene, what other substances are injurious to the body either by ingestion (taking in through the mouth), injection, touch and so on. All these substances we term “poisons”.

What is a Poison?

A poison is a substance which causes illness or harm if someone eats, drinks, touches it or breathes it in and poisoning would mean exposure to chemical or other agents that adversely affects the functioning of an organism. It could be accidental, intentional or even for medicinal purpose.

The Swiss Alchemist and physician Paracelsus once said, ‘all substances are poisons,…the right dose differentiates a poison

For children majorly less than 6 years of age ingestion of harmful substance is the main cause of injury. This is because for the very young according to Sigmond Freud, they are in the oral and anal phase of development. But, for the adult, it is more of intentional -either by another to inflict pain or by an individual to gain attention.

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Examples of ‘poisonous’ Substances

As earlier stated any substance can be a poison depending on the dosage and poisoning may be a medical emergency depending on the substance involved.  Some of the substances are:

Those taken by children:  Cosmetics and personal care products; hydrocarbons like kerosene, lamp oil; a cough and other cold preparations; Perfume; Mouthwash;  Analgesics like paracetamol; Foreign bodies like button hole batteries; Pesticides; Topical agents for example nail polish and so on.

Other substances are Alcohol; Narcotics and Drugs of abuse; Organophosphates; Acetaminophen; Iron supplements; Benzodiazepines; Tricyclic Antidepressants

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These two kids above are taking dry gin probably from having access to parent’s stash

 

How You May Suspect an individual has taken A Poison

  • Eyewitness account and the individual might complain of

-wanting to vomit or even vomit

-difficulty with breathing or swallowing

-drooling of saliva (in children)

-drowsiness or confusion

  • Empty medication bottle
  • Chemical smelling breath or clothing
  • burn stains and odor
  • skin rash or burns around the mouth or lips

Specific poisons:

Kerosene Ingestion.

Kerosene is a chemical used mainly in paints, pesticides, lighter fluid, illuminating fuel and heating. The type and severity of symptoms vary depending on the amount of chemical involved and the nature of the exposure. Since most households store it in containers for ‘drinkable’ substances, most kids tend to go for it. Others are those who use kerosene to cure some ailment either by rubbing on the skin or inhaling.

The individual (mostly child) may present with:

– most times may not present with any symptoms if it is a little quantity.

– A cough, choking, gagging and grunting

– and the child may be breathing fast

– may feel the urge to vomit or even vomit

– there is a risk of taking into the trachea ( i.e risk of aspiration, thereby causing what the doctor might refer to aspiration pneumonitis)

– The child may feel burning sensation, belch a lot and even pass a lot of watery stool (i.e diarrhea) and so on.

Organophosphates (e.g Insecticide)

In addition to what has been said about kerosene above, the individual might be stooling and not being able to control it. Might feel restless, confused or even in a coma. Also might feel abdominal pain and may feel his heart beating faster than normal.

The differents substances that might cause the poisoning would in one way or the other present with the above-mentioned symptoms.

What Should You Do (Home Remedy)

– Call an emergency center (if it exists) to notify them of poisoning, by this, they would tell you the necessary things to do and prepare for the individual before arrival at the Emergency room (if needed).

– Remove the individual from the source of the poison if gaseous, remove clothes and expose to fresh air.

– If your child has been burned or spilled on, remove all clothing that the poison has touched and flush skin with cool or lukewarm water for 15 minutes.

– If the poison has been swallowed and is awake, small sips of water can be given.

-Please under no circumstance should you FORCE vomiting, it is no longer recommended.

– Protect yourself from coming in contact with the substance of poison either by touching, testing the taste, or even breathing it in.

– Note the substance of poison to be shown to the doctor or nurse in the emergency room or hospital.

– If the eye is affected, flush or irrigate well the eye immediately with water.

KEROSENE (AND LIKES) POISONING

Most of the above can be applied, but to reiterate

If vomiting occurs, lean patient forward or places on the left side (head-down position, if possible) to maintain an open airway and prevent aspiration.

Please do not induce VOMITING, and for the use of palm oil or milk, I would only answer with a research done by D.O Fagbule and others in a 6-year retrospective study in the University of Ilorin Teaching Hospital.

They said; “Approximately, three-quarters (74.3%) of patients with radiologic abnormalities had palm oil alone or in combination with milk as home remedies. The severity of poisoning was influenced by the type of home remedy and the interval between accident and admission”.

In essence, very early presentation at the hospital is better. Most of the scholars do not mention the use of palm oil as first aid.

At the HOSPITAL

The doctor would ask you some questions concerning the poisoning, what, how, where it happened. If the victim is awake, the kind of substance that has been ‘taking in’, the quantity and so on, what has been done and so on. He or she would ask for some tests, draw blood for some tests, do a chest x-ray if kerosene poisoning. Then he or she would go ahead with the appropriate measures to save the victim. For some poisons, antidotes are given. The hope here is, most times even for large kerosene ingestion, symptoms resolve within 2-7 days, only that chest infection may have ‘come in’

Prevention is Better Than Cure

Using the host, Agent, Environment model. The host is the victim (the child), the Agent is, for example, the kerosene or bleach and the environment are the containers. You have to take care of the three.

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The reduction in the incidence of childhood poisonings in the past half-century has been dramatic as result of the combination of highly effective active and passive methods of intervention.

Passive interventions eg: the introduction of child-resistant containers for drugs and other dangerous household products.

Active interventions, which require a change in behavior by parents and caretakers, include the safe storage of household products.

– Never transfer medicines or other harmful substances into drinking or food containers

-Store drugs (medicines), cleaning products, paints, and liquid cosmetics in a locked cabinet or out of reach of children.

-Do not put rat or insect poison on the floor or close to the reach of children.

-For kids playing with toys or other electronics which contain button hole batteries, monitor them carefully as swallowing the batteries would be more injurious to them as it could also lodge in their throat thereby causing a great problem. Note that ingestion of alkaline liquid is more dangerous than the acidic ( though both are not good).

In a nutshell, what I really want you to get from this write up is that prevention is better than cure and if it so happens that the accident has occurred, follow the necessary steps in addressing the situation and not a shortcut which may or may not have saved the day.

 

 

Ibrahim Olajide DADA is affable and a graduate of medicine and surgery. His interests are the prevention of diseases with emphasis on child and mental health. His maxim “for every child and the mentally affected there is hope”, ennobles his views to ensuring healthy lifestyles and promoting adequate wellbeing for all. He is also a prolific writer with a couple of publications to his credit. 

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Author: Dr Ahmad Abdullah, MBBS, MSc Clinical Pathology

Ahmad is a father, a husband and a poet. He was born and raised in Lagos, Nigeria. He earned his medical degree from the University of Juba, currently in South Sudan. He is interested in medical research and currently practicing in Lagos, Nigeria.

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