Safe Medicine Storage – PediaCast 591

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Show Notes

Description

Dr Natalie Rine, director of the Central Ohio Poison Center, and two members of Trainees for Child Injury Prevention (T4CIP), Dr Nicole Clayton and Dr Anne Elizabeth Mason, visit the studio as we explore safe medicine storage. Learn how to protect your children from accidental drug ingestions at home… and away. We hope you can join us!

Topic

Safe Medicine Storage

Guest

Dr Nicole Clayton
Pediatric Resident
Nationwide Children’s Hospital

Dr Anne Elizabeth Mason
Pediatric Resident
Nationwide Children’s Hospital

Dr Natalie Rine
Director, Central Ohio Poison Center
Nationwide Children’s Hospital

Links

America’s Poison Centers
T4CIP – Trainees for Child Injury Prevention
Central Ohio Poison Center
Poisoning Primer for Parents and Educators (CHOP)
Medicine Safety – Prevent Child Injury
Don't Keep Rex Around: Medication Safety Program (PBS)
Kids Medicine Safety – National Coalition Against Prescription Drug Abuse
For Kids 8-12 Years Old: Using and Keeping Medicine Safe (YouTube)
Medication Safety for Children (JAMA Pediatrics)
Candy or Medicine? Game (California Poison Control System)

CDC
Put Your Medicine Up and Away
Up and Away Resources
Brochures and Posters from Up and Away
Candy Confusion Rally Toolkit
Unsupervised Pediatric Melatonin Ingestions
Put Medicines and Supplements, Including Gummies, Up and Away
The PROTECT Initiative

FDA
Disposal of Unused Medicines: What You Should Know
Defining 'Candy-Like' Nonprescription Drug Products

AAP
Medication Safety Tips for Families
Poison Prevention & Treatment Tips for Parents
Medication Safety
Using Over-the-Counter Medicines With Your Child
Poison Prevention: One Pill Can Kill
Preventing Home Medication Administration Errors (Pediatrics)
Medicine Safety for Children and Teens: We All Play a Role
Injury Prevention Image Gallery: Medication Safety

Safe Kids
Medication Safety
Where Do You Store Your Medicine?
Poison Safety

Episode Transcript

[Dr Mike Patrick]
This episode of PediaCast is brought to you by Trainees for Child Injury Prevention, the Central Ohio Poison Center, and Nationwide Children's Hospital. 

[Music]

[Dr Mike Patrick]
Hello everyone, and welcome once again to PediaCast. We are a pediatric podcast for moms and dads.

This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio. This episode 591, we're calling this one Safe Medicine Storage.

I want to welcome all of you to the program. We are so happy to have you with us. As you know, medications are in nearly every home, and while they do help us feel better, they can also pose a serious threat to kids when they are not stored safely.

Today, we are joined by two pediatric residents from the Trainees for Injury Prevention program, along with a poison control expert to explore practical steps every family can take to prevent accidental ingestions. We'll cover safe storage strategies, common myths, what poison control can do for you, and the actions you can take right now to keep your children safe. Of course, in our usual PediaCast fashion, we do have a terrific panel of guests joining us in the studio.

Dr. Nicole Clayton and Dr. Ann Elizabeth Mason are both pediatric residents, and Dr. Natalie Rine is director of the Central Ohio Poison Center at Nationwide Children's. Before we get to them, I do want to remind you the information presented in every episode of our program is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals.

If you're concerned about your child's health, be sure to call your health care provider. Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at pediacast.org. So, let's take a quick break.

We'll get our expert panel settled into the studio, and then we will be back to talk about safe medicine storage. It's coming up right after this.

[Music]

[Dr Mike Patrick]
Dr. Nicole Clayton and Dr. Ann Elizabeth Mason are pediatric residents at Nationwide Children's Hospital, and both are members of T4CIP, which stands for Trainees for Child Injury Prevention. We'll explain who this group is and what they do in just a few minutes. Dr. Natalie Rine is also with us today. She is director of the Central Ohio Poison Center at Nationwide Children's. She is board certified in pharmacotherapy, critical care, and emergency medicine pharmacy. And her interests include management of acetaminophen toxicity, mushroom poisoning, drug screening, and trends in illicit drug exposures.

All three have a passion for protecting kids with safe medicine storage. That's what they're here to talk about. But before we dive in, let's offer a warm PediaCast welcome to our guests, Dr. Nicole Clayton, Dr. Ann Elizabeth Mason, and Dr. Natalie Rine. Thank you all for stopping by the studio this morning.

[Dr Nicole Clayton]
Thanks so much for having us. 

[Dr Anne Elizabeth Mason]
We're super excited to be here. Looking forward to a great conversation.

[Dr Natalie Rine]
Thanks so much. Thanks for having us and looking forward to this convo.

[Dr Mike Patrick]
Yeah, I am really looking forward to it as well. Since I mentioned a term that some of our audience members may not be familiar with, T4CIP. Nicole, can you explain what that group is and why it was created?

[Dr Nicole Clayton]
Absolutely. So, like you said, T4CIP stands for Trainees for Child Injury Prevention. And it's a year-long training program for trainees at every level.

So, it's medical students, residents, and fellows. And we have monthly virtual sessions where national experts come in to deliver lessons about various child injury and advocacy topics. And so, we learn about public health approaches, how to engage communities.

The goal of the group is to promote interest and engagement in child injury prevention. And then also to facilitate and promote trainee-initiated outreach and engagement activities. And so, each year we have two days of action.

And our upcoming day of action coming up in October is on safe medication storage.

[Dr Mike Patrick]
Great. And, Elizabeth, can you talk a little bit about the day of action? Like what's its purpose?

And why did you guys decide to focus on medication safety?

[Dr Anne Elizabeth Mason]
Definitely. So, our fall day of action, like Nicole mentioned, is on medicine safe storage. This year's date is October 22, 2025.

And it's a day where pediatricians, families, and community partners can all come together to kind of raise awareness of this topic. We know that everyday prevention steps like locking up medicines and safely disposing of unused ones can protect our children and our loved ones. Our message is powerful and simple, and it's store meds safe.

On this day of action, we'll be sharing educational materials on our social media platforms. You can follow us on Instagram and X at T4CIP, as well as TikTok. And we will be showing tips for families and reminders about safe disposal options, including the National Prescription Drug Take-Back Day, which occurs this year on October 25th.

So, whether you're a parent, a caregiver, or a health care provider, October 22nd, it's a great opportunity to join the conversation around safe medicine storage, spread the word, and take real steps to make homes safer for children.

[Dr Mike Patrick]
Yeah. So, so important. Also, as background, I want to talk a little bit about the Poison Control Center.

Natalie, can you tell us a little bit about the Central Ohio Poison Center? And really, it's going to echo what poison centers all across the United States do. So, tell us about that and how you guys serve families.

[Dr Natalie Rine]
Thank you for asking that question. I think sometimes people don't really know what poison control is or that we're here. The Central Ohio Poison Center, we're here at Nationwide Children's Hospital, and we're one of 53 regional poison centers throughout the country.

Our staff is made up of nurses, pharmacists, and physicians who all have special training within toxicology. And we serve families. We're a resource that's available 24-7, 365.

And it's one of the few medical services that you can call to get immediate expert medical advice if a child or anyone else in the family is exposed to a medication, a chemical, a plant, or any other number of items. And so, when people are aware of poison control, they tend to think it's just for a child that got into something. But really, we're here to serve anyone of any age.

And what our team does best is we can help determine if your family member can be safely observed at home or if it's something that's a little bit more concerning that you might want to get medical attention for in a hospital.

[Dr Mike Patrick]
Yeah, yeah, absolutely. You guys are a really great resource. And the phone number, regardless of where you are in the country, is 1-800-222-1222, which after our listeners heard the jingle and we're going to play it again toward the end of the program, I guarantee you will not forget this number.

But it's still a great idea to stick it in your smartphone, just stick it under Poison Center, 1-800-222-1222. And that way, phone number is always at your fingertips. And because in an emergency, you know, you're really concerned, perhaps your child got into something and you're worried, you may not remember the jingle, you know, because you're stressed.

And so, it's always important to have that number where you can access it very quickly. And gosh, 2 million calls annually across the country. That's a call every 15 seconds.

So, folks, definitely use the Poison Centers. And it's a great thing for families, a great resource that can save a life, actually. So definitely call when you're worried.

And even if you're not really worried, but you're just questioning, you know, it's still okay to call. No one's going to judge you for calling when, you know, for a silly reason. There are no silly reasons when it comes to our kids.

So, Nicole, why then is safe medicine storage such a critical issue for parents?

[Dr Nicole Clayton]
Yeah, this is so important because medications are in every household. And when we say medications, we mean everything. This includes prescriptions, vitamins, supplements, and even over-the-counter medicines.

And unfortunately, safe storage is not always practiced. And so, kids can get into these medications by accident, and then they can get sick or have to go to the hospital, like Natalie was saying. So, we know about 35,000 children are seen in emergency departments across the country annually.

So that means every 9 minutes, a kid is going to the ED due to taking a medicine. Beyond that, every hour, a kid is being hospitalized. And unfortunately, every 12 days, a young child dies from medication exposure.

And so, learning how to safely store these medications is crucial because these emergency department visits, hospitalizations are preventable by taking proper action.

[Dr Mike Patrick]
Yeah, yeah, absolutely. Can you guys share a few stories that illustrate these dangers? Some of the, of course, you know, we're not naming kids or families, and we want to keep privacy as, you know, is very important.

But what are some trends that you guys have seen in your own careers so far? Sure.

[Dr Anne Elizabeth Mason]
I think, you know, when we first started brainstorming about doing this podcast and about our messaging for our platform this Day of Action on the Safe Medicine Storage, all of us had seen different stories and had known very, like, easily kind of could come up with different events that had happened to each of us. And so, the one that I'll be mentioning today is when certain medicines and substances weren't stored safely and led to a negative outcome. So, one of my night shifts when I was working in the hospital, we had a group of young children, and they were brought into the hospital after what they thought were sharing some candies.

But it turned out that those candies were actually THC gummies. And several of these children became very ill, and a couple needed to be admitted to the intensive care unit for close monitoring and treatment. And ultimately, they all recovered, but it was a very scary situation for the families and the patients themselves.

And so, I think that's why all of us really focus on child injury prevention, because simple steps like locking up medications and talking openly about safety can prevent emergencies like this from happening.

[Dr Mike Patrick]
And when we were talking about medicines of all kinds, and you said prescription medicines, over-the-counter medicines, the THC is also a medicine. It's a chemical that acts on the body. And so those are also going to be really important to keep out of the reach of kids and to store those safely because they can be life-threatening in large amounts for sure.

Vape cartridges and vape pens, even with just nicotine, we know that the concentrate in those is really, really high. And so, it doesn't take much to get a really big dose and cause symptoms and even potentially be life-threatening for kids. So, it's a great reminder that even those gummies that are legal now in many, many states, they can be dangerous for kids.

And then, Nicole, do you have some additional stories to share?

[Dr Nicole Clayton]
Yeah, absolutely. Unfortunately, situations like Ann Elizabeth experienced are not infrequent. And so, I was working in the emergency department one night, and I had a couple kids come in who had accidentally found their parents' antidepressant medication on the counter and, again, thought it was candy.

And I think that's the common theme is that kids can't recognize the difference between what's medicine, what can be dangerous, and what's candy. And so, kids love to share, and I think that's ultimately what ends up happening is one kid finds it, and then the whole group gets involved because they're trying to share and be nice. And so, in that situation, they ended up having to be admitted just for observation.

Everybody ended up, again, OK. But it's important that we recognize that limiting children's access to these medications is really what's most important. If they can't get them, then they can't think they're candy, and they can't accidentally take them.

[Dr Mike Patrick]
Yeah, yeah. I'd like to share a story as well. When I was a resident, so this is a few decades ago, but when I was a resident working at the emergency room, we had a toddler come in who wouldn't walk and just seemed out of it but was breathing OK.

It wasn't emergency, but there was something going on. And we were getting ready to do a big workup and a CAT scan and the kid might have even gotten a spinal tap when the kid crawls over to grandma's purse and reaches in and grabs this little package of cough drops and pops one in the mouth really quick and starts chewing it. And so, I take it and look, and it has dextromethorphan or DM, which is an anti-cough.

And that's the reason he just needs some IV fluids and let his body metabolize it overnight and then he was good to go. But again, even in grandma's purse, that's not a safe place to keep medicine, especially when you have a little toddler around. And something as seemingly harmless as cough drops, well, one, it's a choking risk for little kids, but it can have medicine in it like dextromethorphan or DM, which is over the counter for coughs, but in large amounts in a toddler, it can cause real big problems.

Natalie, I'm sure that you have all sorts of stories that you could share as well. Can you give us an idea of the current statistics? I know Nicole mentioned some of these.

35,000 emergency department visits. That's a lot from ingestions. What kind of numbers are you guys seeing?

[Dr Natalie Rine]
So, when you look at all exposures reported to poison control across the country, nearly half of all of those exposures occur in children under the age of six. And those are primarily what we consider unintentional and exploratory behaviors. So, like they said, you know, kids get some sort of product.

They think it's candy, something that's a snack that they don't recognize as being different. But again, these are just, they occur because they like to explore their environment and tasting things sometimes is one of the things kids like to do. And then the most common poisonings we see are typically things children have access to.

So, think about what's in their environment. So, household cleaning items, cosmetics, personal care items, things you find in grandma's purse. And then you see analgesics and over-the-counter medications just because primarily those are not usually stored the same way as prescription medications are.

They're generally thought to be safe. So those just, they're easily accessible. And while it sounds kind of alarming to hear that almost half of all of the exposures we hear about occur in that age group, the nice thing is the majority of these cases we can manage safely at home with close monitoring.

[Dr Mike Patrick]
Yeah, yeah. And so, call to the poison center may be able to save you a trip to the emergency department, which, you know, no one likes to spend hours in an emergency department if you don't have to. But on the other hand, if that's really what needs to happen, then you're going to let parents know, hey, you really do need to go to the ER.

So, it's definitely a great place to call and to utilize. And then I think it's really important to say that the majority of unintentional poisonings are kids less than six years of age. And like 90% of them are kids less than 12.

So, it's really the young kids that we worry about. And they're not doing it intentionally. They're just, as you said, exploring and, you know, come across something.

It looks like candy. They want to taste it, see what it is. And then things can go negative from there really fast.

Nicole, what are some myths that parents often believe about medicine safety?

[Dr Nicole Clayton]
Yeah, this is a great question. I think one that we hear often is that the childproof caps mean that the medications are safe. And so, unfortunately, that's not the case.

The caps aren't childproof. They're just child resistant. And the testing that actually goes into deeming a cap child resistant is that 85% of children under the age of five who were tested should be unable to open it within five minutes.

And so, breaking that down, what that means is that 15% of kids under the age of five would have been able to open it within those five minutes. And then what about if the kids have it for longer than five minutes? They found it.

You were in the other room. You didn't know that they were playing with the medicine. You give them enough time, they'll figure out how to open it.

And so, unfortunately, these caps do make it more challenging, but it doesn't make it impossible for kids to get into them. And so, I think the second point of that is that if we keep our medications up high, then they're also safe from children. And this too, we know kids are climbers.

They love to get on whatever they can. They'll pull out drawers. They'll pull out chairs, climb up on the counter and reach up high.

And so that's why we're emphasizing kind of the two aspects of medication safety is that they need to be locked up and kept up high. So locked in a thing that kids can't get into. So not just the child resistant caps, but an actual lock box and kept up high so that they can't reach them.

[Dr Mike Patrick]
So, Ann Elizabeth, what does safe medicine storage actually look like? So, Nicole talked about having two things in place to protect our kids from medicine. What does that look like?

[Dr Anne Elizabeth Mason]
Nicole did such a great job setting me up for my good answer. So hopefully that gives us a good starting point. When we talk about safe medicine storage, we're really talking about building small daily habits that kind of make a big difference.

So, the good rule of thumb is to put every medication away every time. So, this includes prescriptions, over-the-counter medicines, vitamins, supplements and even pet medications, because that's one that people oftentimes forget about and they're stored pretty low. So, after you use the medicines, make sure you take the container and the pills, put them out of sight, out of reach of children and in a locked container.

Never put the medicines on a kitchen counter, the bathroom sink, bedside tables, where any sort of children's hands can kind of find them. It is always important to use a locked box or a locked cabinet if possible and make sure that that area is stored up high so the kids can't reach them. The other part of safe medicine storage is safe disposal of the medicines.

So, on October 25th is our National Prescription Drug Take-Back Day, and it's a great opportunity for families to get rid of expired or unused medicines safely. Hospitals, pharmacies and even police departments will have these drop-off boxes or take-back programs, and some of them occur year-round. FDA website lists all of the year-round disposal locations near you, so you're welcome to check that out for more information on that.

But basically, in a nutshell, safe storage means locking it up, keeping the medicines out of sight and making sure our old meds are disposed of in a quick and timely manner.

[Dr Mike Patrick]
Yeah, yeah. Natalie, I wanted to ask you really quick, can folks take medicine back to pharmacies? So, we have the National Take-Back Day, we have places designated to take them, but let's say you're listening to this podcast and that day has passed and you're not sure when the next one is.

Perhaps you have some narcotic pain medicine, maybe from a dental procedure. It seems like everybody's got one of those laying around the house that you didn't actually use, but it's still there, and you want to get rid of it. What can you do when it's not Take-Back Day?

[Dr Natalie Rine]
I would check with your local pharmacy. There are some pharmacies that do have the ability to take those medications back and dispose of them. It just kind of depends on the location of that, but your local pharmacy can probably direct you best, depending on where you're at.

[Dr Mike Patrick]
Okay, and especially for controlled substances and opioids, we don't want to put those in the trash or flush them down the toilet. We really want to have them safely disposed of, and your local pharmacy friend may be able to help you figure out what to do to get those out of your house. Ann Elizabeth, you talk about keeping it in a locked box or a locked cabinet, the medicines, and out of sight, out of reach.

How then do you remember to take your medicines? For a lot of people, it's sitting on the counter by their toothbrush, or maybe it's in a medicine cabinet, but they're going in and out of that, so they see it regularly. If it's out of sight and out of mind for kids, it might be out of sight and out of mind for the person who's supposed to be taking the medicine.

How can we remember but also be safe?

[Dr Anne Elizabeth Mason]
That's a great question. The way I recommend doing it is setting a little bit of an alarm on your phone. For me, I think it's really easy to just set an alarm, 9 a.m. or 9 p.m., whenever your medicine time is, and that way you kind of get that daily reminder. I also do recommend for kids, if they're struggling to start taking a medicine, to kind of pair it with another activity. Like you mentioned, brushing your teeth in the morning or in the evening. Hopefully, that just daily reminder or twice-daily reminder kind of will trigger yourself to kind of take your medicines as well.

[Dr Mike Patrick]
Yeah, absolutely. And then what about when we're traveling? We may be going on vacation, we're in a hotel room, we take our medicines with us, and now we may not have that locked cabinet and not be able to put it out of sight of kids.

Or we may just be visiting relatives over the holidays, or grandma may be coming over, and she's got her medicine in her purse. How can we keep our kids safe when traveling?

[Dr Anne Elizabeth Mason]
I think that's such a great question. One, I love traveling, so it's something near and dear to my heart. But especially when we travel, we kind of let our guard down.

You know, we're on vacation, we're having a good time. And so, I think we have to keep in mind that habits really matter in those times as well. And so, one of the things that we can talk about when you're traveling yourself is to make sure you keep your medicines in the original child-resistant containers.

Nicole mentioned, she said that just because it's child-resistant doesn't mean that it's child-proof. But it does help and kind of gives you hopefully a little bit of a barrier of time to kind of reach that time to get to the medicine. If the pills are kept in a pill organizer or a plastic bag, the children are much easier to get into those medicines much quicker.

The second thing to do is when you arrive to your hotel or your destination or house, make sure you kind of look for a place that you can store them. So, a locked suitcase option, a hotel room safe if it has a passcode, or even like a high cabinet as well. So, these kind of small steps can kind of help keep your children safe when you're traveling.

When you have visitors, especially grandparents that have lots of medications or even babysitters or relatives, make sure you kind of mention to them when they come in the home, hey, do you have any medications on you? If so, is it okay if I store them in a specific spot so that our children are less likely to get into those medicines as well? And so, I think those are some good tips to have even on the go.

Make sure the medicines are up, away, out of sight, and locked every time.

[Dr Mike Patrick]
Very, very important. Nicole, we talked about some myths surrounding prescription medications. What are some myths surrounding vitamins and over-the-counter products?

Because those may be dangerous, especially in large quantities, as well as prescription medicine.

[Dr Nicole Clayton]
Yeah, this is another great question. And it's really important that we keep all types of medications, including vitamins and over-the-counter products, locked up like Anne Elizabeth was sharing with us. And so, I think sometimes parents and families think it's just vitamins or it's just an herbal supplement, so they're less harmful and it's not as serious or as important to keep them locked up.

But vitamins are medications, and they can have really serious adverse effects as well. One of the most common things, or one of the common things that we can see is iron overdose from vitamins. And this is a very dangerous ingestion and one that definitely would need to go to the hospital depending on the quantity that was taken.

And so, it's really important to keep those locked up. Gummy vitamins, I love my gummy vitamins, but I think that it would be impossible for a kid to tell the difference between this one has medicine in it versus just the Halloween candy that we're going to start seeing here soon. Like which one's medicine and which one's just a candy?

Hard to tell. So even those gummy vitamins, they look harmless, but they need to be stored safely too. And then over-the-counter, I think that sometimes we hear in the community that we can just buy it without a prescription, so it must be less harmful, but that's also not true.

Acetaminophen or Tylenol is over-the-counter. And in high doses, this can cause liver failure. And so, these medications are just as serious as the prescription medications can be.

And then I think we've talked a little bit about our poison control centers. And that's another thing that we want to highlight. I think some families think that if something happens, they'll just Google what to do.

And the Internet has its amazing things, but there's also a lot of misinformation out there. And so, we need to be careful about where we're getting our information from. And so that's why we really want to highlight the poison centers.

They are the fastest and safest way to get an expert, like Natalie said, available 24-7, 365 days a year. And I want to highlight the number again, so everybody has it. It's 1-800-222-1222.

They're available for you anytime that you need them.

[Dr Mike Patrick]
And Natalie, as director of the Central Ohio Poison Center, do you see a lot of phone calls related to vitamins and over-the-counter products?

[Dr Natalie Rine]
Oh, we do. Yeah, we get calls like that all the time. Sometimes, again, depending on how much was ingested, if the parent caught the child pretty quickly and they only ate one or two, it's probably not a big deal.

But if they're like, oh, they've had this bottle for a while. I don't remember how much was in it. So, we can kind of help you triage that.

But very common calls, yes.

[Dr Mike Patrick]
And why then is it better for parents to call you rather than Google? Because that may just seem easier. Like, okay, I'm going to Google what happens if my child took five vitamins instead of one.

And we're so used to just Googling everything. But what makes the Poison Control Center really a better option than Googling?

[Dr Natalie Rine]
Well, I think that's a fabulous question and glad we're talking about it more. And even on top of that, you know, Googling is one thing. And now that we're in the age of AI, like, oh, well, I can just go ask this chatbot to give me a quick answer.

And I don't have to talk to anybody on the phone. But, you know, again, Nicole highlighted this really well. Calling Poison Control gives you immediate access to a live human being that's specially trained in toxicology.

So, you have a healthcare professional live on the other end of the phone, which is a very difficult thing to find, I think, this day and age. And Google is just; it's kind of a double-edged sword when you're talking about medical advice. So, you can have, you know, both ends of the spectrum.

You can have something that Google can make you think it's really, really serious. And you're like, oh, my goodness, I need to go to the ER right away. You call us, it's like, actually, it's going to be perfectly fine.

You could just stay home. But then you could also find the other end where Google tells you, eh, this isn't a big deal. And then you call us, we're like, oh, no, no, no, no.

We need to get you in. We need to get you seen. We need to do a couple of tests to make sure you're okay.

So really, when in doubt, call Poison Control. That is what our staff specialty is. We're specially trained to handle those questions, those calls.

And we're going to get a little bit more information about how long ago the ingestion was, that sort of thing, so we can make sure that you or your child is going to be perfectly safe to either stay at home or if you need to go in.

[Dr Mike Patrick]
Yeah, yeah. And what I love about Poison Center is you don't only field calls from parents and the general public, but you also field calls from emergency departments. So, like, when a kid comes in with an ingestion, you know, they've taken something, that's one of the first things we do, actually, as emergency department physicians, is we call the Poison Center because you guys really do have the latest, up-to-date information at your fingertips.

So, how is it that you guys have access to great information and the rest of us, it's a little more difficult to find?

[Dr Natalie Rine]
Yeah, we do have a few resources. And again, so it's not just our frontline nurses and pharmacists that are answering the phones. You know, we also have immediate access to a toxicologist.

So, we always have someone on call 24-7. So, even if there happens to be a situation that seems a little bit more complex or unexpected maybe for the staff, we have a toxicologist that we can pull right into the conversation and provide even a higher level of help if we need that. So, we're very lucky to have that here.

[Dr Mike Patrick]
Yeah, yeah, absolutely. And then what happens after a parent makes a call? What do you guys do in the background?

Is it just a one and done, or do you guys follow up with the family? Sort of what's your process after that initial contact is made?

[Dr Natalie Rine]
Another fabulous question. So, once you call Poison Control, you'll get a staff member, and they're going to ask you a few questions to help them better understand the situation. So, first thing we're going to do, we're going to ask for some contact information just because we want to make sure that if the call gets disconnected for whatever reason, we're able to get back in touch with you.

And then we'll ask a number of different questions. What was the medication or the product or the plant? An estimate of how much was taken.

Was it just a bite? Was it a taste? Was it half of the bottle?

How long ago this occurred? And then we'll ask a little bit information just on the child. You know, is the child generally healthy?

Do they have any medical problems or other medications that they regularly take? Anything like that that we should know about. And then once we have that information, our specialist is able to assess if this is an exposure that we can monitor at home or if we should have the child taken into the nearest hospital.

So, one of the things that's really helpful when you're calling in, of course, like this could be a frenzied situation, but if you have that medication bottle handy, it's helpful because we can get a little bit more information from there to know the strength or the concentration of the medication that's in there about how much might be left. And then if it's determined that medical attention is needed for your child, we'll also get a little bit more information and we'll call the hospital ahead of time so that they know that you're coming, they know to expect you, and they can be ready to go with whatever labs or monitoring your child might need so we're well prepared for you. And then if your child is safe to watch at home for a little bit, we'll give you some advice about what sort of symptoms should you look out for.

That way, if something changes, you can call us back and tell us that and we can kind of talk through if that's something that elevates their level of care if they need to go in. But depending on that substance, we might just call you back in an hour or two or a couple of times just to make sure you're still okay to stay home.

[Dr Mike Patrick]
Yeah, so great that you guys provide all of this service and really care about the families that call in. And I just want to point out again; there's no silly reason to call. If it crosses your mind as a parent, should I call the Poison Center?

Just go ahead and do it. And they may give you reassurance, which is fabulous, but we'd much rather you call when maybe you didn't really need to than to not call but there's something in the background that is concerning, and you don't want to find out by having a negative event occur with your child who you love dearly. So that's going to be really important.

[Dr Natalie Rine]
One other thing to add to that, you know, if you're thinking about calling, call us. But also, don't worry that we're going to think you're a bad parent or that this is your fault. This happens all the time.

It's not abnormal and kids, despite your best efforts, sometimes just get into stuff. So please don't feel like anyone is going to be judgmental or shaming you for being bad. Just call us because ultimately, we just want to make sure you and your child are safe.

[Dr Mike Patrick]
Yeah, yeah, yeah. So, you know, I'm a pediatrician and one time when my, so my son is in his late 20s now, but when he was a toddler, you know, I'm doing hot tub chemicals and I had something, you know, measured out in a little cup and I was getting, I sat it down. And of course, like that, you'd like turn away and I look back, and he's got it in his mouth, you know, swallowing it.

And I'm a pediatrician. So, yeah, don't, don't feel bad. It definitely, it definitely happens.

So, Ann Elizabeth, now, there are instances where you may not actually want to take the time to call 1-800-222-1222. You should call 911. What, what are, what's a true emergency where you really want to get medical help as fast as you can?

[Dr Anne Elizabeth Mason]
I think in all those situations, the first rule, which is the hardest one to follow, is to stay calm and act quickly when things are going awry. So, if the child is unresponsive, not breathing, having difficulty breathing, blue around the lips, call 911 right away. Those are true emergencies that are very life-threatening and need to be seen by a medical provider immediately.

Otherwise, you do have a little bit of time and can call the Poison Help number. And that way, you can be connected, you know, to a real live person and they can kind of help triage the situation and kind of let you know we're okay to monitor a little bit at home or we need to go on to the emergency department, either by ambulance or by car. So, they're a really great resource.

But if a patient, again, unresponsive, not breathing, cyanotic or blue around the lips, having trouble breathing, in sort of any type of distress, go ahead and call 911 right away. And like everyone's mentioned, and just to re-echo, if you're unsure or have a question, it's always better to call. Everyone is here to help, and they'd much rather call early than wait and be sorry later.

So, I think that's just something good to keep in mind.

[Dr Mike Patrick]
Yeah, yeah, absolutely. Nicole, then, as we wrap up, what are the really important takeaways for the families who are listening today?

[Dr Nicole Clayton]
Yeah, I think our key messaging today is that storing medication safely can prevent harm and can really save kids' lives. And so, we want to make sure that you feel well-informed and that you can take action today. So, some of the things that can happen, pick up a lockbox, set up a medication station, like Anne Elizabeth had talked about.

Keep your medications locked up away and out of reach of your children. Have conversations with people who are coming over to visit, grandparents, babysitters. Ask them if they're bringing medications into your home so that you can make sure that those medications are safely stored as well.

We want you to save the poison control number in your phone, 1-800-222-1222. And finally, share our T4CIP messaging with people in your community, with grandparents, babysitters, schools. Our Day of Action is coming up on October 22nd, and there's going to be tons of messaging on social media.

You can help us spread the word to store meds safe.

[Dr Mike Patrick]
Yeah, very, very important. Well, really appreciate the three of you stopping by and chatting with us today. We are going to have a ton of resources in the show notes.

So, if you want to learn more about poisons and kids, keeping kids safe from medications and medicines, what to do in an emergency, all of these things, head on over to the show notes at pdacast.org. It's episode 591, and you'll find a ton of resources there. Just some examples, we have, of course, links to the Central Ohio Poison Center.

We have Medicine Safety from the American Academy of Pediatrics, from the Centers for Disease Control and Prevention, the FDA. Safe Kids is an organization that has lots of resources surrounding keeping kids safe, and that includes keeping them safe from medicines. So, all of these resources are going to be available to you in the show notes.

Once again, just head over to pdacast.org, episode 591. You'll find them all there in the show notes. But the most important resource, really, is going to be to take that phone number and get it in your smartphone.

Put it under Poison Center at 1-800-222-1222, and that way it will be at your fingertips whenever you need it. So, once again, Dr. Nicole Clayton and Dr. Ann Elizabeth Mason, both pediatric residents at Nationwide Children's Hospital, and Dr. Natalie Rine, Director of the Central Ohio Poison Center at Nationwide Children's. Thank you all so much for stopping by and chatting with us today.

[Dr Nicole Clayton]
Thank you so much for having us. It was a lot of fun. 

[Dr Anne Elizabeth Mason]
Thank you, guys. I had such a good time. 

[Dr Natalie Rine]
Thanks, everyone. Thanks for having us. And, again, just call Poison Control. We're here if you need us.

[Music]

[Dr Mike Patrick]
If you are still with us, I think that phone number is going to be in your brain for quite a while. And that's okay. Once again, just put it in your smartphone.

That's the best place that it should live. We are back. And we have just enough time to say thanks, once again, to all of you for taking time out of your day and making PediaCast a part of it.

We really do appreciate your support. Also, thanks again to our guests this week, Dr. Nicole Clayton and Dr. Ann Elizabeth Mason, both pediatric residents with Nationwide Children's Hospital, and Dr. Natalie Rine, director of the Central Ohio Poison Center, also at Nationwide Children's. Don't forget, you can find us wherever podcasts are found.

We're in the Apple Podcast app, Spotify, iHeartRadio, Amazon Music, Audible, YouTube, and most other podcast apps for iOS and Android. Our landing site is pediacast.org. You'll find our entire archive of past programs there, along with show notes for each of the episodes, our terms of use agreement, and the handy contact page if you would like to suggest a future topic for the program.

Reviews are also helpful wherever you get your podcasts. We always appreciate when you share your thoughts about the show. And we love connecting with you on social media.

You'll find us on Facebook, Instagram threads, LinkedIn, X, and Blue Sky. Simply search for PediaCast. We also have a podcast for healthcare providers.

It's called PediaCast CME. It is similar to this program, but we do turn the science up a couple notches and offer free continuing medical education credit for those who listen. And that includes not only physicians, but also nurse practitioners, physician assistants, nurses, pharmacists, psychologists, social workers, and dentists.

And since Nationwide Children's is jointly accredited by many professional organizations, all the ones I mentioned, in fact, it's likely we offer the credits you need to fulfill your state's continuing medical education requirements. Shows and details are available at the landing site for that program, pediacastcme.org. You can also listen wherever podcasts are found.

Simply search for PediaCast CME. And if you are an academic physician, so if you teach medicine at a university, we also have a podcast for you. It's called FAMEcast.

It is a faculty development podcast from the Center for Faculty Advancement, Mentoring, and Engagement at The Ohio State University College of Medicine. So, if you're a teacher in academic medicine or a faculty member in any of the health sciences, then this is a podcast for you. You can find FAMEcast at famecast.org and wherever podcasts are found by searching for FAMEcast. Thanks again for stopping by. And until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So long, everybody.

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