Summer Poison – PediaCast 497
- Dr Ally Funk visits the studio as we consider summer poison. Washing the car, gardening, pool maintenance, backyard barbeques and a hike in the woods all pose danger for young kids. We explore the possibilities and share tips for keeping your family safe!
- Summer Poison
- Dr Alexandra Funk
Central Ohio Poison Center
Clinical Pharmacy and Toxicology
Nationwide Children’s Hospital
- Central Ohio Poison Center
- Holiday Hazards – PediaCast 479
- Fire Safety – PediaCast 336
- Poison Safety – PediaCast 344
- Water Safety – PediaCast 348
- Tip-Overs and Falls – PediaCast 361
- Sun Safety – PediaCast 433
Announcer 1: This is PediaCast.
Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.
Dr. Mike Patrick: Hello, everyone and welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike, coming to you from Nationwide Children's Hospital. We're in Columbus, Ohio.
It's Episode 497 for August 4th, 2021. We're calling this one "Summer Poison". I want to welcome all of you to the program.
So summer is in full swing. And our goal today is helping you, the PediaCast listener, helping you keep your kids during the summer months and in particular safe from poisons and other chemical exposures.
There are many toxic substances that threaten kids this time of the year. Here's an example, your kids may be playing in the driveway. The garage door is open. And perhaps like many families, you have bottles of chemicals in the garage, things you don't think about very often.
You may even forget that they're there, things like antifreeze, cleaning solutions like carwash concentrate, concrete cleaner, power wash. There could be fertilizers and weed killers in the garage or even out by the garden. And you might even have pool chemicals around the house, pH balancers which are acids and bases, chlorine, bromine, pool shock.
The backyard barbecue is not immune from danger with lighter fluid and tiki torches, alcoholic beverages and perhaps medication in grandma's purse.
And while you're enjoying the great outdoors, we must also consider sunscreen and insect repellant, poison ivy, poison berries, poison mushrooms, and in some areas of the country, snake bites.
So, lots of poisonous danger lurks about in the summer, but here is the good news. Most poisonings and chemical exposure are preventable. And that's really our aim today, to raise awareness of summer dangers and share strategies for preventing harm to your kids during the warm weather months.
To help us with the topic, Dr. Ally Funk from the Central Ohio Poison Center joins us again. You'll recall that Ally visited last December as we considered holiday hazards. She returns today as we explore summer poison.
Before we get to Dr. Funk, let's run through our usual quick reminders. Don't forget, you can find PediaCast wherever podcasts are found. We are in the Apple and Google Podcast apps, also iHeartRadio, Spotify, SoundCloud, Amazon Music and most other podcast apps for iOS and Android. If you like what you hear, please remember to subscribe to our show so you don't miss an episode.
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So, let's take a quick break. We'll get Dr. Ally Funk connected to the studio. And then we will be back to talk about summer poison. It's coming up right after this.
[Start US Poison Control Center Jingle]
1-800-222-1222, 1-800-222-1222, if you think it might be poison, then the first thing you should do is call 1-800-222-1222.
Announcer: For poison emergencies or just questions, the Poison Control Center Hotline is here 24/7, with the expert help you need.
If you think it might be poison and you don't know what to do, call 1-8000-222-1222.
[End US Poison Control Center Jingle]
Dr. Mike Patrick: Dr. Ally Funk is a clinical pharmacist and toxicologist at Nationwide Children's Hospital and director of the Centra Ohio Poison Center. She's here to talk about keeping kids safe in the summer and in particular, common sources of poisoning and chemical exposures in the garage around the pool and during those backyard barbecues.
So, let's give a warm PediaCast welcome to Dr. Ally Funk. Thanks for stopping by today.
Dr. Alexandra Funk: Thanks, Dr. Mike, for having us. It's a very timely topic as we come into the last month of summer here, August. And I'll be happy to talk about some of these most common and frequently encountered poisons that maybe some don't realize that they actually are poison or could cause harm and damage to young children.
Dr. Mike Patrick: Yeah, absolutely. We really appreciated you stopping by during the holiday season last year when we covered holiday hazards back on PediaCast Episode 479. It was really helpful for parents.
So, this time, we're going to concentrate on more of the warm weather poison stuff. And I'll be honest, I kind of walked around my house. Because we talked about that last time, like that's one way of poison proofing your house. You just kind of pretend you're a kid and see what you might get into.
And I started with the garage because in the summer, a lot of times, kids are out playing in the driveway. And the garage door's up and mom and dad are distracted doing something else. And there always seems chemicals in the garage that kids could possibly get into.
What are some of those things that we have to worry about?
Dr. Alexandra Funk: Absolutely. The garage or shed or other areas where you frequently access in the summertime, some of those can be things related to the car, so like antifreeze, washing detergents. So, with antifreeze, the biggest thing that we're concerned about is that's considered a toxic alcohol.
And so, alcohol, everyone thinks okay, ethanol, beer, wine. Well, antifreeze is something called ethylene glycol or can be methanol or other components and, even in small amounts, can be very toxic, very dangerous to small children or even bigger children with adults.
And the thing with these components, these products is that they're usually pretty colorful. You think about your car antifreeze, that's blue. Maybe it's orange. Maybe you have an RV or a boat that has other antifreeze. It could be pink.
So, these products are very colorful, and they grab the children's attention, especially if you're maybe working on your car and you leave it out not realizing how dangerous it can be.
Dr. Mike Patrick: Now, I've not tasted antifreeze. And I don't recommend that anyone do that. But I have heard that it has sort of a sweet taste to it, which can also be a problem. Because not only is it colorful, but you take one little sip and you might want to drink a little more if you're a young kid and you don't know what you're getting into, right?
Dr. Alexandra Funk: Yes, I also personally have not tasted it, but I have heard that does have a sweet taste. And several years ago, the government actually issued a bittering act to put bittering agents into antifreeze. And this is more so for people who are trying to intentionally ingest it. But kids, it can be sweet. Or they say it can be sweet to pets too if it's dripping on the driveway.
So yes, it supposedly has a sweet taste. I can't say for sure. But the scary thing is it's blue, usually it's blue, if you hold up a container of say Gatorade or Powerade or smaller sports drink with the bottle of antifreeze, it's very very hard, almost impossible to tell the difference between the two.
So, I imagine that, yeah, if it does have a sweet taste and it looks like it could be a sports drink, we could run into some severe concerns and problems there.
Dr. Mike Patrick: Yeah, as I look in my garage, I also found carwash solution. We have some concrete cleaner. There was some power wash. Those cleansing agents, are those dangerous for kids?
Dr. Alexandra Funk: Yes, they can be. Usually, they'll contain detergents and soaps. But some of them, especially like your concrete cleaners or maybe even your rust wheel cleaners, will contain a corrosive that could be sodium carbonates, hydrofluoric acids. So those are very dangerous, especially if they get on your skin. If it's splashed in the eye, splashed in the mouth, those can cause burns. They cause irritation to the skin, to the eyes, to the hand.
So, you want to make sure that you are utilizing protective equipment, especially if the bottle state so, utilizing gloves. Your typical car wash detergents, of course, they're going to be like a detergent, something similar to a soap. That shouldn't usually cause too much of a problem.
It could be irritating, especially if you've been using it for a long time or if you have it on your skin for a long time. Maybe you soaked your clothes and you now have the wet clothes on your skin. But making sure that you just wash your hands, wash it off right away.
If it doesn't say use gloves, want to make sure that you use gloves with those products. But definitely, the danger is associated with any product that has more of acidic or corrosive agent in it.
Dr. Mike Patrick: Absolutely. And the ones that say 'concentrate' are going to be a little more worrisome because they're going to have a harsher chemical. There's nothing deluding it like the regular carwash that's quite a bit different than like a concrete cleaner, which may be concentrated and also have something to sort to etch the concrete a little bit. Which, obviously, if it can etch concrete, it can probably etch you.
Dr. Alexandra Funk: Yes, exactly.
Dr. Mike Patrick: Stay away from those things.
Dr. Alexandra Funk: Exactly.
Dr. Mike Patrick: And you mentioned sodium carbonate. And we're going to talk about pool stuff, but I know that's pH increaser which is a base. So obviously, that can be quite a problem, especially if it gets in the eyes or those can be quite caustic, so we got to be so careful.
So, with all of this kind of bottles of things in the garage, what's the best way to keep our kids safe? It makes sense for a lot of people to store these in their garage. I mean, your kids are a little less likely to be in the garage most of the year. And so, it's probably better there than inside the house, but we still want to keep kids safe. How do we do that?
Dr. Alexandra Funk: Absolutely, yes. The garage is a good place, as long as the products are up away, out of reach, out of sight. The biggest thing is also keeping them in their original containers. As I mentioned, some of these products can be colorful. They can look like other juices.
Making sure that they are labeled. If you do have to transfer them into a smaller container, making sure that you have that labeled. Have the tops closed on them completely tight. But the biggest thing will be just be keeping them out of reach and out of sight for children.
And so, it's fine to have these products. It's fine to use them. But when you're done, put them back. Don't leave them out in the driveway. Don't leave them out in the ground where they could access them.
Dr. Mike Patrick: Yeah, so child proof cap and keep it out of reach, especially with those young kids, too. Now, let's say someone does get into one of these things and you're not really sure whether this is problem or not a problem, how do folks get in contact with their local poison center?
Dr. Alexandra Funk: So, we're really easy to get in contact with. You can call us from anywhere in the local United States. You dial 1-800-222-1222 on a cellphone or a landline. It should route you to your nearest poison center. And then, when you get in contact with the poison center, you'll be talking to either likely a nurse or pharmacist, maybe even a physician.
And we'll ask you a lot of questions. We'll probably ask you the specific name of the product. If you have it readily available, can you read the label to us? Making sure that we know exactly what we're working with. And then, we'll kind of provide next steps or instructions on what to do next.
The biggest thing first and foremost would be to remove the exposure, remove the substance. So, if you do get it on your hands, if you do get it in your eye, wash your hands, flush your eyes out. And we typically recommend you do that while on the phone with you as we're gathering some information, because we want to make sure we're getting it off, the contact with you right away.
Dr. Mike Patrick: Yeah, that makes sense. And I just want to put a plug in. The Poison Center folks are always really friendly and helpful. And so, don't always think like "On, I'm bothering this people. This is not really something that…" You have this nugget of worry, but you're not a 100% that you need to be really worried, if you have a nugget of worry, then you probably ought to just call the Poison Center and make sure that everything's okay. You're not bothering them.
And I will say, it's not just parents. I work in an emergency department when we have kids come in who have ingested something or there's been an exposure. You're like the first people we call even as a doctor in the ER because there's so many different substances out there, and you can't remember everything about everything. And so, we want to use resources that are really good. And we call the Poison Center even from emergency departments, right?
Dr. Alexandra Funk: Yes, absolutely. And thank you, Dr. Mike, with that nice plug. I appreciate it. Yes, we're here 24/7, 365 days, all hours. So, it's our job to answer the phone. I always say no exposure or no situation ever too small or too silly to call the Poison Center. It's always better to be safe than sorry.
If we can, we will keep you at home and we will kind of treat at home. If it is a more severe situation, we would recommend that you go and be evaluated. And again, I would hate for it to be a situation where with the goal is to do something safe at home, finding that out it's not, something bad happening. But yeah, no exposure, no products, no question is ever too silly or too small to call the Poison Center. We'd rather have that reassurance.
As Dr. Mike said, we also help parents as well as doctors, nurses, pharmacists from hospital settings, if they have questions as well.
Dr. Mike Patrick: Yeah, 1-800-222-1222. And we'll play the jingle a little bit later on because once you hear that, you can never forget this phone number, 1-800-222-1222. Wherever you are in the United States, you call that, you'll get routed to your local poison center.
And since we all have smartphones, that should be a contact in our smartphone, right? So, we can get to it immediately when we need it. Use to be the magnets or sticker by the phone, but no one has land phones anymore. Well, I mean, someone has a land phone, but not very many people do anymore. So just keep that in your contacts and your smartphone for sure.
Dr. Alexandra Funk: Yeah, and you can actually even text the word POISON to 797979 and it will reply back to you with a contact that you can save directly into your phone.
Dr. Mike Patrick: Oh, I did not know that. So, 797979 and you text the word POISON. As soon as we're done, I'm going to have to try that. That's really cool.
All right, so let's move from the garage to the garden, although a lot of gardening things are stored in the garage or in shed. So, we're kind of cross-doing it here. So, what about plant fertilizers and weed killers? Are these dangerous products?
Dr. Alexandra Funk: Yes, they can be. Plant fertilizers, they usually contain a variety of minerals. A lot of times, it's often nitrogen, potassium, phosphorus. These are typically intended to be like diluted in buckets of water and poured on your plants like a Miracle Grow or something of that nature.
In general, especially like the granular and the liquid ones do tend to have a low degree of toxicity for small accidental ingestions. That being said, if it's an unintentional or large, I'm going to say drink, a large gulp of it, we could run into more severe problems.
A lot of times, it can be hot, some stomach upset, maybe an irritation on your skin. The biggest problem is if we have too much of these because these are elements that are also found in our body. We can sort of lose our natural body's homeostasis with a large ingestion.
But typically, not too much of a problem. A lot of times, we can't keep these exposures at home. Of course, wash your hands. Rinse your mouth out. Rinse your eyes out.
Again, they can be irritating. So, if we are having issues after our basic decon we call it, decontamination, washing, then we would probably have to say we need further evaluation.
Dr. Mike Patrick: Then what about the weed killers?
Dr. Alexandra Funk: Yep, the weed killers, and this is a very broad topic. There are several different products out there. A lot of times, they're usually chlorophenoxy compound, which are actually could be cytotoxic. So actually, killing the cells of the leaves, especially like the broad leaf plant like your dandelions, clovers.
Again, inadvertent ingestions, small ingestions, accidental ingestions, typically aren't something that we would have to rush you to the ER for. Again, probably cause mild irritation to your skin, maybe your mouth, you accidentally drink it. To your eyes, it's splashed in.
But larger ingestions or more concentrated products, you would have more severe symptoms. Maybe nausea, vomiting could potentially be there, irritating as well. And again, biggest thing is making sure that these are out of sight, out of reach. If you do get them in your hands, splash on your hands, wash it off right away, flushing out your mouth or your eyes with that as well.
Dr. Mike Patrick: It's a little more difficult with these because you can't have a child-proof cap so much. A lot of these are in bags and they just zip close or a container that's a little easier to open. And I think we all tend to store these things lower. I don't know why. But I bet if you went to most garages, you're going to find these things on the floor, where the chemical bottles may be up high. So, you really got to think about these things too, that kids could get into them.
And as you say, small exposures, maybe not a big deal. But still call the Poison Center, just to be sure that you can read what's on the label in case maybe yours is something different. And you guys have a huge complete database that you can dig into. Because even you guys don't know everything about everything, correct?
Dr. Alexandra Funk: Yeah, we have a very robust database that has a lot of manufacturing information on specific products, specific ingredients. Again, if we don't have that specific product, we'll ask you to read the label and then we can kind of dig a little deeper based on the active ingredients.
Dr. Mike Patrick: All right, let's move on to pools and hot tubs because everyone's trying to keep their pH balance and you're adding sanitizers and shock and algaecides and whatnots, clarifiers and all these things. What are the particular hazards around the pool and hot tubs with the chemicals?
Dr. Alexandra Funk: In pool cleaners, we have a lot of our acids. We have our chlorine-based products. We have our bromine-based products. Again, kind of similar to detergents we talked about earlier. A lot of these are acids that can be corrosive. They're intended to kill bacteria in the pool, right, because you're using these products to make sure that your pH is at a certain range, so you don't have unwanted bacteria.
So, a lot of these, if used inappropriately or accidentally get exposed to them, can be irritating. Again, the biggest problem with these, we often see is more of the respiratory effects. So especially if you're opening a product that's granular based, it has dust with it.
Or you're pouring chlorine into your pool and it's creating a gas because it's mixing with the organic material that's in the pool. It can be very irritating to the respiratory tract. Especially maybe if it's a windy day and you have some wind blowing up at you. Can cause coughing, choking, difficulty breathing, especially if there's underlying respiratory illness such as asthma or other respiratory effects that a kiddo may have.
Some of the products are also very aesthetic. So, like your muriatic acid, that's a very strong hydrochloric acid. And so that getting on the skin would be very concerning, can cause severe burns, irritation. We want to make sure that that is removed right away.
Similar to like the MPS, that oxidizer again interacts with some chlorine and oxygen atoms and again, it's very irritating. Typically, I'd recommend using this in a well-ventilated area, avoid using it on a windy day because you don't want some of that mist to come back at you.
And same thing with the weed killers and insecticides. You don't want to be spraying it into the wind and having it come back at you.
The big thing with these two that many people don't realize is that some of these can actually be flammable. So, making sure that you're not storing them maybe near the pool heater or other equipment, other machinery that could be potentially be a fire hazard here as well.
Dr. Mike Patrick: Yeah, this is a situation where you may be using multiple chemicals at the same time. And so, you really don't want to mix those, right? Because you can create chemical reactions.
And I have found that out sort of the hard way. Not of course, intentionally, but we have a hot tub. And I put in some pH up, so I think it was the sodium carbonate. And you have a little plastic thing, you measure it out and you pour it in. And I rinsed it out really well.
And then, and I don't know if it was that or maybe it was bromine. But again, I rinsed it really well. But then, even the next day, I put in a tablespoon of oxidizer shock and it started bubbling. And there was a little mist coming up and I got it in the hot tub really fast before I breathe anything in. I did not call the Poison Center. But it really was pretty mild.
But I just thought, "Gosh, if you accidentally put whatever two chemicals, and again I'm not sure which ones, I know it was the oxidizer shock, the MPS. But you can really get a reaction on your hands, right? And it heated up. It warmed up the container. You got to be careful.
Dr. Alexandra Funk: Absolutely. You have to be careful. Especially with these products because usually they're going to be more concentrated because they're intended to be going into a large body of water. Yet, you can create chlorine gas. You could chloramine gas. You could create bromide gas. And that could be very dangerous if inhaled.
And the thing with a lot of this is the warmer the water, the more gas is it's producing. So, your kind of having a Catch 22 there. If it's heating up, it could be producing more gas and could be more damaging and more irritating to the respiratory tract.
So, I strongly encourage to use one container or one measuring cup for one product and one container, one measuring cup for the other product, then not to mix. Because even if you think it's dry, there could be some remnants left there and we don't want to have a situation where you're creating toxic gases.
And interestingly enough, the gas is pretty heavy. So, it will sit right on the water, too. So, if you happen to mix these, say, in your container and you mix them in the pool at the wrong rate or wrong dilution and you're creating this toxic gas, it could be running in the water. And then if you have swimmers or if you are at the pool for extended period of time, you could be potentially exposing yourself to that as well.
Dr. Mike Patrick: Really great advice. So be careful with these things. Don't mix them together and wait a little while after you put them in to actually take a dip in the pool or the bathtub.
Dr. Alexandra Funk: Yes.
Dr. Mike Patrick: All right, see, even I need this advice.
Dr. Alexandra Funk: We all learn a little bit of something, right?
Dr. Mike Patrick: Absolutely. I did that and I was actually kind of appalled because I always try to be so careful. And of course, my wife and my son are kind of laughing at me, but okay.
Anyway, let's move on to the backyard barbecue. And there are some hazards here as well.
First, I want to say, when you're lighting anything, you don't want to squirt it out from the can, right? Because aside from the poison issue, these things can be flammable and we've had explosions even, and especially folks who maybe try to gasoline to light something. This is not a good idea at all, correct?
Dr. Alexandra Funk: Correct, yes. That's very dangerous. Making sure that if you do want to put like a Firestarter or gasoline on a fire doing it before it's lit and not trying to pour it under the fire because the stream of fluid can get caught on fire. And now, you're holding a container that's on fire. And you could potentially get burned or have an explosion and that's very dangerous.
Dr. Mike Patrick: Yeah, the can may have gasoline vapor in it, which actually that's what explodes. So, the liquid, just the fire but when it hits that aerosolized gas, then that's when you can really get into trouble. And the sad thing is we see this, unfortunately, in the emergency department.
So, this is not something that you never hear of. I mean, people do put these products directly on open flames and can have some really bad results. So always teach your kids never to pour things directly unto a fire.
So, let's think about lighter fluid. Because I may just be sitting around in a can. That can be really dangerous for kids too, if they get into it, correct?
Dr. Alexandra Funk: Yeah, it can. It's what we would call like a hydrocarbon. It's a slick liquid that it's very easily get into lungs. Even a couple of drops, that could again affect the breathing, someone's ability to breathe. It could cough, choke. It could potentially even cause what we call a chemical pneumonia, a chemical pneumonitis.
And because it's so slippery, it has low viscosity, so it moves really quickly. Like if you think about pouring a drop on the table, it doesn't stay in a pile like honey. It goes very quickly. It disperses very quickly. That's also what would happen in your mouth or in your lungs if you ingested it.
If you get it on your hands or your skin, that's probably just a little bit of an irritant. You can wash it off. Again, the biggest concern here would be ingesting or accidentally ingesting it.
Again, similar to what we talked about with like the antifreezes, a lot of times, this can be yellow in color, maybe even clear. Look like apple juice or some other fruit juices or maybe even water, especially if they're not in their original containers. It could be very dangerous if swallowed.
Dr. Mike Patrick: And again, even if your child swallows a tiny amount, you really do want to contact the Poison Center. So at least you know exactly what you're going to be watching out for and what to do. And a lot of these ingestions, you don't make kids vomit anymore.
I remember way back when at the I think it was the 18-month visit. Because there weren't any immunizations and we have a poison pack that we would give folks and had poison safety stuff. Because at 18 months, this is the time that kids are starting to get around.
And it always came with a little bottle of syrup of Ipecac. And we would say, "If they get into something, call the Poison Center. And if they tell you to give it," so even back then, we knew you don't just give it. Call the Poison Center first. But you would sometimes actually have them drink a little of that to get them to vomit, but you don't do that much anymore, right?
Dr. Alexandra Funk: No, we actually don't recommend inducing vomiting ever, anymore. It often will cause more harm than good. Or you could have secondary injuries. The syrup of Ipecac too would often have like a prolonged nausea vomiting. It's not just a one-time episode. It will be multiple persistent nausea and vomiting.
But, exactly, we would not recommend vomiting up in this case. And this is one situation where if you do vomit, you can actually cause more harm than good. Again, because the liquid can come back up. Your bile, your stomach acid contain some of this and again, it can go back into your lungs and cause even more of a problem.
And even if you don't think that your kid or your child got exposed to it, but you found the bottle around, you found the cap off, definitely give us a call because we can ask some more questions. We can tell you what to watch out for. Mostly, we'll be telling you to look out for coughing, choking, maybe try a little bit of water. Can they tolerate that?
And then, we'll continue to follow up with you about every 30 to 60 minutes for the first couple of hours or so just to make sure that everything is going well. Because initially, someone could be asymptomatic and then, as it get into their lungs, they can develop a cough or a choke or have difficulty breathing.
And then, if it's severe, we can send you to the emergency room and there are tests and images and medications that we could recommend helping with difficulty breathing or to really see okay, is this into your lungs? Is this going to be a problem here?
Dr. Mike Patrick: The other products that we sometimes see, the backyard barbecue especially as it turns into evening time, are those tiki torches and the oil that's in the tiki torches. Very similar right, in terms of the dangers, similar kind of chemical to the lighter fluids, correct?
Dr. Alexandra Funk: Yep, very similar. Again, we've fallen to like a hydrocarbon situation here, the very slick oil base product that can get into the lungs and cause difficulty breathing.
Yeah, bad lamp oils, and I know those lamps can be very pretty, especially if the nighttime barbecue or a picnic or maybe trying to keep the bugs away. But again, making sure that we're keeping those bottles or those products out of the way. Again, not to mention the fire hazards too when you lit a wick flame, you want to make sure that they're kept out of reach for children, so they don't burn themselves, too.
Dr. Mike Patrick: Absolutely. Another source of poisoning that also can happen at the backyard barbecue is alcoholic beverages. And you can sort of see how this would happen fairly easily because you set your can down or the bottle down, glass, and you walk away and you're engaged, talking to someone, you're really distracted. And your kid comes along and says, "Oh, I'll take a drink of this." That can be a problem, right?
Dr. Alexandra Funk: Yes, and this, we see a lot in summer as well as every other season. Yes, alcohol, while it can be safe or you can take it safe in moderation for adults, it can be very dangerous to children, even in small amounts. Their bodies may not metabolize it as well.
As well as it can cause a severe drop in their blood glucose, something that we don't see in adults. And so, it can make kids very hypoglycemic. It can cause them to be drowsy. And if it's severe enough, could even lead to coma or seizures or even death in very severe situations.
And the big thing with this too is children love to mimic their parents. So, if they see mom or dad with a drink, grandma, or grandpa, they want to think that they'll be cool or act like their parents, so they may try to drink it. Especially if these products are mixed, mixed with fruit juice or if you have a punch out, a kid may not realize that there's alcohol in that punch. So, making sure that you do specifically keep alcoholic beverages away from non-alcoholic beverages.
And a lot of those Seltzers and the new products nowadays, they look very similar to a non-alcoholic beverage. So, accidents can happen at that situation where the wrong product can be grabbed. And one thing that we do always encourage and share as a prevention measure here, and sometimes you don't even think about this, is making sure to clean up after your party that night.
Not waiting until the morning in case the kids wake up early or wake up in the middle of the night and kind of go out into the area where the party was and find extra cups laying around or remnants and bottles and cans.
As well as not storing these in unlabeled containers, never store alcohol in a water bottle in the fridge or in an unmarked cup. There can be situations where it's accidentally grabbed as a drink, thinking that it's a juice or water and even in worse situation could be used to mix baby food or baby formula, which has happened.
In those situations, we usually have pretty concerning alcohol levels in pretty sick kids because of the amount that they were exposed to.
Dr. Mike Patrick: Wow, that's really scary. And so great advice, keep them in their marked bottles. And I love to keep the alcoholic beverages away from the non-alcoholic beverages. Because you're right, a lot of them, these newer products, to taste them, you wouldn't even know there's any alcohol in them, so some of them. So, got to be really careful with that with kids.
Dr. Alexandra Funk: And alcohol's so prevalent. I mean, it's probably at most functions you go to and most people don't realize how dangerous it really could be to a small child.
Dr. Mike Patrick: Yeah, absolutely. Another danger is in grandma's purse. I'm singling out grandma, but it could be medication that anybody brings along to the party that they have with them. And so, the big thing there, right, is just really keeping an eye on your kids. I mean, supervision is going to be most important thing.
Dr. Alexandra Funk: Yep, supervision. Especially if you're going to someone else's house, you don't really know how well their house is poison-proofed or child-proofed. And making sure that your children are going into rooms unsupervised or getting into bags, purses, containers without supervision.
There are several medications, we kind of call this, the one-pill-can-kill list. Like examples, opioids, suboxone is a big one. Some heart medications, beta blockers, calcium channel blockers, even a very small, potentially a leak or even one pill is very dangerous to children.
And so, if we have a situation like that, we're going to be very concerned. And so, making sure that you keep good eye on your kids, making sure there is adult supervision, that they're not getting into something that they shouldn't be. And making sure that if there is a situation, you're able to find out what that medication was.
And maybe the strength that could help, that would be determinant, "Okay, can this kiddo be kept at home? Can we monitor at monitor at home? Or would he need to go in?" If we don't know or if we know what it was, and it was one of our concerning medications that can cause dangers at a very small amount.
Dr. Mike Patrick: The vaping liquids are also dangerous. And as we see folks vaping, they may be doing that at the party. But those containers with the fluid is really concentrated nicotine in there, and that can be deadly for kids.
Dr. Alexandra Funk: Yes, very very concentrated. It's much more concentrated than a cigarette or even a handful of cigarettes would be. And nicotine often, and especially those high amounts, would cause pretty early on nausea and vomiting. But yeah, those high concentrated products, or even now, marijuana, there is vapes that have marijuana in them, especially as more states become more legalized in their marijuana in their edibles, too.
Cookies, candies, all of that stuff, we were seeing a lot more cases of this because it's just in more houses. It's in more homes. It has more potential to be accidentally taken because it's just a around more, something that we didn't really have many years ago.
And the one other thing with the medications is again, children mimic adult behavior and I will say never to refer to medication as candy. Because then we're mixing what is edible, what is safe to something that can be very dangerous if the kid thinks, "Oh well, this is mommy's candy. I want some of mommy's candy."
Always referring to medications as to what they are, as medications. And checking your kids never to take unsupervised or take more than what is given to them.
Dr. Mike Patrick: Yeah, really really good points all around. As we move away from the barbecue and we're just kind of hanging out in the yard, maybe taking a hike in the woods. There's still lots of chemicals that kids can come into contact with.
One of those is sunscreen. Is sunscreen a particular hazard? It's supposed to be on the skin. What if you ingest it?
Dr. Alexandra Funk: Sunscreen, they contain a combination of chemicals to help block the UV rays, typically in an accidental ingestion or if you get it on our hands, you lick your hands, that's typically not going to be a problem. If a larger amount, maybe it's accidentally squirted in the mouth, again it probably could cause some upset stomach, maybe some irritation, yucky taste on the mouth.
Typically, these are going to be what we'd say like minimally toxic products that something's that's not going to cause significant injury or significant toxicity. But again, we want to make sure that we're utilizing these as instructed, utilizing them per your doctor's recommendations or pediatrician's recommendations.
Again, there's a certain age limits and restrictions where you should or shouldn't use sunscreen for. So, if you don't know, definitely ask your pediatrician or if there's a concern, to give us a call. But again, typically, these are going to be not to cause too much of a problem in small amounts.
Dr. Mike Patrick: Every summer, you see some things pop up in social media and on the Internet about sunscreen and its relationship to cancers. But what we can say is that not using sunscreen and having some exposure all the time is also really high risk for getting skin cancer. And so, using sunscreen appropriately and according to the product label, the benefits of the sunscreen are definitely going to outweigh any risks that may be associated with it. So, we would highly recommend using those products.
What about insect repellants? So, you hear some things about products that have DEET in them? Should parents be concerned about those things?
Dr. Alexandra Funk: Typically, if they're used as instructed, as directed, it's not going to be too much of a problem. The DEET is used to repel mosquitoes.
And again, similar to the benefit and the risk of skin cancer versus using sunscreen, the same thing here, the benefit of using inappropriate manner of bug spray to ward off mosquitoes that may be carrying disease would be more beneficial than getting bit by mosquitoes. Especially with those pesky mosquito bites, I know my eyes swell up pretty big when I get mosquito bites.
Making sure that you're not spraying them in a repetitive pattern to the point where you're soaking your clothing or you're soaking your skin because obviously then you're going to have more absorption, more spraying into an open wound or an open cut. That would be problems of concern.
And if you do have a reaction, these are going to be typically local reaction, maybe irritating, maybe cause a rash of the skin. Very rare, could have some more systemic reaction or whole body based on the ingredients of the pyrethroids or the DEET that's in it. But typically, wouldn't have a lot of skin absorption as long as you're using it as intended.
You're not soaking your skin. You're not spraying it to an open wound. And I imagine it would be very painful too spraying it to an open wound as well.
Dr. Mike Patrick: Maybe a good idea to take a shower when you go inside for the night, if you've been using a lot of these stuff.
Dr. Alexandra Funk: Yep, shower, remove your clothing. Wash it off your skin, especially if you're in an area where you kind of have to apply a couple of times that day just to ward off the bugs. You have to stick it off your skin if you still have any remnants of it.
If you can still smell it on your skin, it's still there. And definitely, a shower, soap and water would be good. Even with our kids, before they go to bed, try to wipe off their skin, wash it off, absolutely.
Dr. Mike Patrick: And if you're in a place where you've needed to use insect sprays or creams, you're going to want to also just check your skin to make sure there's no ticks in there.
Dr. Alexandra Funk: Yes.
Dr. Mike Patrick: Lyme disease, the black-legged ticks, also known as the deer ticks, those are really expanding their territory. In the United States, it was very rare to see them in Ohio and that's not the case anymore. And they're really small, like sesame-seed size. And so, it's going to be important to just really look at your skin and make sure you don't have any ticks
Dr. Alexandra Funk: Skin and your hair.
Dr. Mike Patrick: Yeah, yeah, up in the scalp, absolutely. And really check that out. And if you're doing a shower after you come in for the night, that's a good chance to inspect and make sure that those things aren't there.
Dr. Alexandra Funk: Absolutely.
Dr. Mike Patrick: What about the citronella candles? I'm not sure how well that those really repel insects. Maybe they work a bit. And then we also have the ones that have the padded, the cartridge and you light a little flame and a lantern. And it goes through like the Thermacells as an example.
Any risk or dangers with those kinds of chemicals?
Dr. Alexandra Funk: Similar dangers that we've kind of already discussed with the citronella. Again, the citronella's made from a couple of plants. Oftentimes, there's more essential oils added into it for the smell as well. They're supposed to ward off the mosquitoes based on the smell or the heat.
The citronella, the pure oils is again going to be a hydrocarbon so we're going to have concern if it gets ingested accidentally. If it gets into your skin, it could be a little irritating. It shouldn't be a huge problem. Maybe some people can have a reaction to it like a contact dermatitis or an itchy rash.
The ones that are in more of a solid form, maybe like a citronella stick, that's probably going to be less concerning versus like a pure oil. And then, same things with the Thermacells, the biggest thing would be the chemicals that's inside of it. A lot of times, those are pyrethroids.
And so, they can be problematic if ingested or if used like a fogger. When you're entering the room or the area too soon and there's still a lot of it in the air, can cause again respiratory symptoms.
The biggest thing with these products is really just reading the label, using them as intended. Making sure that you're not spraying anything in the wind or in your face and getting exposed that way. But a lot of times, especially in these situations and these products in small amount, accidental liquor taste are typically going to be okay.
Again, it could be very irritating. If you get it in your hands, it could be irritating. But more concerning with the larger amounts or if it was intentionally trying to be consumed.
Dr. Mike Patrick: And again, if you have any questions of whether this was a hazardous exposure or not, call that 1-800-222-1222 and talk to your friendly local Poison Control experts.
Dr. Alexandra Funk: It's very hard to give a blanket statement because every situation is so different. And it really depends on what happened and the amount and how your kiddos doing now and if they have underlying medical disease, asthma, et cetera. So yeah, always give us a call, we can always just go through all the questions and get a really good understanding of the situation, provide you the next best steps.
Dr. Mike Patrick: Absolutely. All of the poisons and chemicals that we've talked about so far have been manmade products that are out there to buy for consumers. There are also naturally occurring poisons that we have to be concerned about. And as we think about being outside and hiking, one thing that comes to my mind are poison berries and poison mushrooms. This can be a concern, right? You don't want to eat anything that you don't know what exactly it is.
Dr. Alexandra Funk: Yes, absolutely. It's very hard to identify a berry or a mushroom. Even experts, and I am no mycologist, I am not a botanist, so it's very hard for myself or even people who are mycologists or who are trained to identify some of these berries and help with these situations.
And so, yeah, if you don't know what it is, if you did not plant it, if you're not growing it, I strongly encourage you not to eat it.
There are several different poisonous berries, some of the common ones, like pokeweed, yew berries or holly berries, mayapple berries. A lot of times these berries, even a couple, maybe three to five to more of a handful can cause problems. A lot of times, it's gastrointestinal. So, nausea, vomiting, abdominal pain, cramping, diarrhea.
But again, you don't necessarily know, it could look like an edible berry. It could be very similar to a plant that you think is edible. But if you didn't plant, if it's not in your yard, I hardly recommend not to ingest it.
Same thing with the mushrooms, while there are thousands of different mushroom species and only a few that are poisonous, it's very hard sometimes to tell the difference between the two. And poisonous mushrooms, again, people may go out and forage them or a kiddo might actually ingest one.
Typically, they'll have stomach upset. And there's kind of a rule of thumb, if you have early symptoms, you're kind of in the clear. If you have more delayed, late symptoms, it's going to be more concerning and could you put you at risk for a toxic exposure to a poisonous mushroom.
And there's a wonderful quote that we say in the Poison Center world and our medical director here, Dr. Casavant, will always often quote it, and share with everybody but, "There's old mushroom hunters and there's bold mushroom hunters. But there's no old, bold mushroom hunters."
Dr. Mike Patrick: That is great. I love that. Yes, because some of those really can be deadly.
Dr. Alexandra Funk: Some of the, particularly like the berries and the mushrooms can be very deadly and cause a lot of symptoms. It can cause liver failure. It can cause your kidneys to shut down, especially with the mushrooms and the amanita mushrooms.
Typically, the little brown mushrooms in the yard, the one parents tend to be worried about that, typically those may cause some stomach upset. But again, we don't know for sure what species are these.
So, I definitely encourage to instruct your kids berries or mushrooms that were not bought from the grocery store, were not intentionally grown. If you have a situation and you're not sure what product it was, for plant particularly, you could always take a clipping of it and go to your local nursery and see if they can help you identify what it is.
Especially I know a lot of people are moving around these days, if you move to a new home, you may want to take a survey of your surrounding area and see if you do have any trees or have plants or berries on them or flowers. And maybe identify what they are by using your local nursery to help with that. So that way, you do know what is in your backyard in case there is a situation that would come up.
Dr. Mike Patrick: Absolutely. One plant that you definitely want to be able to identify is poison ivy. So definitely look that up, teach your kids, stay away from poison ivy. Because the oil from that plant, it will actually bond permanently to your skin and you have to make new skin in order for it to slough off, right?
Dr. Alexandra Funk: Yeah, the oil, the resin is very sticky. Not sticky as like glue, but once it's on your skin, it is on there. And the kicker with this is the longer time that it's on there, it's Toxicodendron oil, the longer time that it's on there, the more likely you're going to have a reaction.
So, if you get exposed and you can go really quick, rinse off your hand with soft and water for several minutes, you could potentially prevent a reaction. But if it's been sitting on your hands and under your fingernails for even a couple of minutes, the chance of having that contact dermatitis or rash is more likely.
And we often don't think about cleaning under our fingernails very well. But poison ivy, poison oak, poison sumac, all on this category, the resin can stay under your fingernails. And so, if you're scratching an area or even go to a different area that wasn't exposed, you can be transferring the oil to other areas of your body.
And so, the biggest thing is if you see leaves of three, let it be. It's the little slogan. And as Dr. Mike said, look it up. Be familiar with the way that these plants look. And then, if you do have exposure, try to rinse it off ASAP. The sooner, the better.
Dr. Mike Patrick: Yeah, absolutely. And other things to think about where you can get poison ivy oil from, gardening gloves. And then you come along, could even be the next season and you pick up those gloves and the poison ivy oils on the outside of the gloves.
And pets can get into poison ivy. And then they have the oil on their fur and then you pet them. And so sometimes, we seen poison ivy rashes in kids. It's like, "They were never around poison ivy." But the oil came to them, then them going to the oil.
And you should never say, "Well, I'm not allergic to poison ivy," because that can develop at any point, right? You can get sensitized. And then, the next time, even though you've been around hundreds of times, that next time is going to get you.
Dr. Alexandra Funk: Right, yep. And it can be anywhere from a rash up to more severe blisters. And there's a, I guess it's a myth, but if you have a blister that pops, that shouldn't spread the rash. And that's not going to spread the rash. It's more of the oil that cause the rash. And as you mentioned, it can hang around an inanimate object for a long time, or even pet for a long time.
And so, you want to make sure that you are washing those things, the gloves, your clothes really well. Maybe multiple times, and separately. You don't want to throw in a pair of pants that may have poison ivy with the rest of your laundry because now, you potentially put that oil unto all of your clothes and you got to put it on. And now, you could have a reaction.
So, making sure that you're keeping those separate. Wash them a couple of times, get the oil off there. Time to get your pets a bath if they get in contact with it. And so, they're not spreading it around the house, too.
Dr. Mike Patrick: One of the worst cases of poison ivy I ever got was from an outdoor cat that we had many many many years ago that would forage in our woods. And I picked it up one time and the oil soaked through my shirt, actually. And I just had a horrible rash, right, where the cat had been. Again, I learned things the hard way.
Dr. Alexandra Funk: And they say, I think it's like I guess 70% of people have reaction to poison ivy. So, as you mentioned, yeah, you may think that you're immune but as you continue to get exposed, you can develop that sensitivity over time.
Dr. Mike Patrick: What about snake bites? Do you get calls about snake bites at the Poison Center?
Dr. Alexandra Funk: We do. We probably don't get as many calls as some other poison centers in the country, more of our southern centers or western centers. But we do have some poisonous snakes her in Ohio. We have a couple rattle snakes, some copperhead potentially.
So yeah, we do get calls. It's maybe something that you don't think of a poison center right away. But there is medication and antidote that could be administered, and we can help the hospital with that. Obviously, that's something you can do at home.
And so, if you are bitten by a snake, you usually have a puncture wound, right? You'll feel it or you'll see the snake. We don't encourage you trying to capture the snake to go after it. If you have a cellphone, you can take a picture from a safe distance, that's great.
Interestingly enough, even if you cut the snake's head off, it can still bite and secrete venom if it's a poisonous snake. So, there are a couple of poisonous snakes in the United States, mostly are pit vipers which includes cottonmouth, copperheads, and rattle snakes. And then, in our southern states, we have coral snakes.
The pit vipers will cost more of like a local reaction typically, bruising, swelling, pain, inflammation, which could progress to a more system reaction, could have impact on your heart, on your kidneys, on your hem bodies, blood, could cause you to clot. As well as with the coral snakes, that can be more damaging to your respiratory tract. That can actually cause paralysis of your diaphragm there.
But in general, we do have non-poisonous snakes and poisonous snakes. And we can help you try to identify, are you having symptoms that we would need to refer you to the hospital for? Or do we think this is what we call a dry bite? That may not have secreted venom but would still need appropriate wound care cleaning the area out, making sure it doesn't get infected.
Dr. Mike Patrick: When I lived in Florida for a time, there were coral snakes down there. And there was a saying that, "If red is next to black, it's a friend of Jack. And if red is next to yellow, kill the fellow." So, the coral snakes have red and yellow next to each other. But in any case, if you've get bitten by a snake, call and get some help and make sure that it's not something serious.
Dr. Alexandra Funk: Exactly. And the biggest time that you're going to get bit by a snake is if you're kind of messing with it, if you're trying to play with it, take a picture with it, take a selfie with it. Obviously, there are situations where you may reach into a bush while gardening and you don't realize it's there.
So being aware of your surroundings, being aware of any tall grass or bushy areas, if you leave shoes outside or pots outside, making sure that you're kind of shaking them before you're putting your foot or your hand in there. Just looking for any nice home, because they usually like to stay in kind of dark secluded areas.
They don't intend. They're not trying to be vicious, but they're protective. And so, if they're spooked or they're stepped on, they're going to react. And that reacting is them biting.
And even venomous snakes, or poisonous snakes, could have situations where you have a dry bite, too. So, they don't secrete venom.
Then, if you are been bitten by a snake, we do encourage to remove any tight clothing. Remove any jewelry in the area. That way, after a bite, you will tend to swell, whether there's venom injected or not. So, removing any tight clothing, removing any jewelry, and keeping your extremity at heart level.
We do not encourage trying to suck out the venom, any of those venom bite kits to try to suck out the venom or yourself trying to suck it, or any of that. The venom's going to spread and you doing that probably is going to cause more damage.
And then, we typically don't recommend icing it. More so, just kind of keeping it elevated, keeping it above heart level and removing any restrictive clothing.
So yeah, snakes, spider bites, insect bites, bees, wasp, we get called about everything. And we can definitely help determine is there something that needs to be evaluated in the hospital or could you potentially stay home?
Dr. Mike Patrick: Tell us once again, how do folks get in touch with their local poison center?
Dr. Alexandra Funk: Yeah, absolutely, calling 1-800-222-1222 from any cellphone or landline if you have it. And it will direct you to your local poison center and where you'll talk with nurses, pharmacists, and physicians. And they'll ask you a lot of questions to get the best information about the situation. So, they can make the assessment and help determine if you can stay home. And if you can stay home, what can you do to treat the situation and if you need to go in the hospital.
And if we recommend that you go to the hospital, we will also follow on with the hospital. We provide recommendations and make sure that everything is going as intended there.
Dr. Mike Patrick: Yeah. And you even follow up if they get discharged from the hospital and go home. You still follow up with folks, right?
Dr. Alexandra Funk: Yep, absolutely. And even we talked about, like our medications, too. Here at the Central Ohio Poison Center, we do have some lockboxes available. And so, if a family or a person needs a way to store medications safely, you can contact us at the Central Ohio Poison Center, and we'll be able to share that with you. We can mail it out to you.
They're not big enough to store chemicals or weed killer or anything like that, but they're intended for medications. So, we can help with that.
And poison prevention materials, if there are teachers or other daycare nurses, teachers listening, we also have materials that we can send out as well. And we're happy to do education to schools as well.
Dr. Mike Patrick: Great. And we'll put a link in the show notes to the Central Ohio Poison Center. Of course, if you have a poison question that's happening, ongoing, you want to call that 1-800-222-1222. But if you want to request a lockbox or a visit, an educational visit or something, going to the website, maybe more appropriate. And again, we'll put a link to that in the show notes.
We'll also put a link to our Holiday Hazards podcast that we did which will be in just a few months. It will be something that we'll be thinking about again. And we'll try to share that as the holidays approach. But that link will also be in the show notes.
And then we've done several other PediaCast episodes in the past on safety issues in general. We did one on fire safety, water safety, sun safety. We've talked about tip overs and falls and really, making your house as safe as possible for kids. And we'll put links to all of those episodes in the show notes as well.
So, Dr. Ally Funk, director of the Central Ohio Poison Center and clinical toxicologist and pharmacist at Nationwide Children's Hospital. Thank you so much for stopping by again.
Dr. Alexandra Funk: Thanks, Dr. Mike. It was fun chatting with you.
[Start US Poison Control Center Jingle]
1-800-222-1222, 1-800-222-1222, if you think it might be poison, then the first thing you should do is call 1-800-222-1222.
Announcer: For poison emergencies or just questions, the Poison Control Center Hotline is here 24/7, with the expert help you need.
If you think it might be poison and you don't know what to do, call 1-800-222-1222.
[End US Poison Control Center Jingle]
Dr. Mike Patrick: We are back with 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. Really do appreciate that.
Also, thanks to our guests this week, Dr. Ally Funk, director of the Central Ohio Poison Center and clinical toxicologist at Nationwide Children's Hospital.
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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.
Announcer 2: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.