Transcription:

Conan Gasque: Welcome to Inside Pediatrics, the podcast brought to you by Children's Hospital of Alabama in Birmingham. I'm Conan Gasque. March 20th to 26th is Poison Prevention Week. And with that in mind, we're talking about medication safety. Today, we're speaking with RN educator for the Alabama Poison Information Center, Becky DeVore. Becky, thanks so much for your time today.

Becky DeVore: Thank you for having me.

Conan Gasque: So National Poison Prevention Week, obviously a big deal for the APIC, as we call it, every year. We'll talk a little bit more about what that's about in a second. But first, what is the APIC? For people who aren't familiar with it, tell me a little bit about what you do.

Becky DeVore: Certainly. The Alabama Poison Information Center opened in 1958 as the 14th poison center in the United States, and we serve all ages and all Alabamians.

Conan Gasque: And it's essentially, I guess, a call center for lack of a better way to describe it.

Becky DeVore: It is. We do have a national number. That's 1-800-222-1222 that will route you to your state's poison center. And we have many poisons, but one number. And with that number, you never outgrow the number. We're here for all ages and all Alabamians.

Conan Gasque: So if people call the APIC, what should they expect? Who should they expect to speak with?

Becky DeVore: They will speak to registered nurses and pharmacists that are trained in toxicology, and many are nationally certified. And we are available 24/7, 365. We do offer a free confidential service with expert advice, and we always would like you to call us for any questions at all.

Conan Gasque: And I guess it's essentially a service that's available for people who, you know, may have questions about something they've been exposed to and the effects that it may have on them, or potentially drug interactions, various things like that. Correct?

Becky DeVore: Correct. Snakebites, insect bites, any exposure that you may have, plant contact, poison ivy, any of those types of situations.

Conan Gasque: And I'm sure you stay pretty busy with lots of calls coming in.

Becky DeVore: We do.

Conan Gasque: So again, National Poison Prevention Week, March 20th to 26th, and it's a time to really spread awareness about poison prevention. And here at Children's of Alabama, we want to talk about ways to keep children safe. Tell me a little bit about what National Poison Prevention week is all about and the kind of message that you want to spread.

Becky DeVore: Absolutely. So this year, the theme will be Poison Centers, Here for the Ages, One Number, Local Experts. So again, many poisons, the one number, the 1-800-222-1222 will route you to your local center.

Conan Gasque: So very important to remember that number just in case you have a situation where you believe you or your child has been exposed to a type of poison. We want to play out some common medication errors here, and the kinds of things that you might get calls about in the APIC. So let's play out some scenarios, things that you may have heard from callers. So here's the first scenario. A mother and a father both give a dose of medicine to their child within minutes of each other causing a double dose. So it's very easy for something like that to happen as busy as parents stay. What would be your advice to them?

Becky DeVore: Well, to call the poison center, first of all. We can always, you know, gather information. We will need to know about your child's past medical history, the name of the medication that you've given, the strength of the medication. Since most pediatric medications are liquids, usually there's a strength, milligram per milliliter. And then, we will need to know your child's weight. So many times, we need to do a little bit of math to figure out if your child is above a dose that we can watch at home or if we can safely watch your child at home.

So with parents being very busy, especially in the mornings, getting ready for work and school, we do see this scenario pretty frequently, where both parents give the child the medication. And then, you know, we'd always recommend you to call us for that.

Conan Gasque: Another scenario that we want to play out here, of course, you may have kids and you may have pets as well. So let's say you have a dog and that dog has given medicine and then spits it out on the floor where a toddler then picks it up and ingests it. What do people need to know about a situation like that?

Becky DeVore: Always, again, to call us. We do not recommend calling your vet about, you know, the dog's medication, but call us. That is definitely in our wheelhouse and we can help you. Again, you know, we need to know the name of the medication that the dog is on and the information about your child so that we can make an assessment based on your specific child's situation.

Conan Gasque: And a perfect example of all the different kinds of calls that you get at the Alabama Poison Information Center. Another scenario that you might potentially encounter, let's say a medication is drawn up in a syringe, set on the counter for a sibling, but then another child ingests it. Of course, you start by calling the APIC, but what kind of information might you need from a parent in that situation?

Becky DeVore: Well, we definitely need to know the child's age and weight, the child's medical history, and then the name of the medication, the strength, so then we can do our calculation to figure out if this is a safe amount for that child or not. And it's important to say that at APIC, for every one child that we do refer to the emergency room, we are watching nine children at home. So, you know, we know the symptoms to look for and we do review that with parents. And then, we know an amount that is -- you know, if they exceeded that amount, it is unsafe to stay at home, so then we would refer to the emergency room. But for the majority of pediatric calls in children less than six, we can watch at home.

Conan Gasque: So that's essentially why the APIC exists, is to help parents decide what to do. Can they handle this situation at home, or should they go to the emergency room?

Becky DeVore: Correct.

Conan Gasque: So another scenario we want to play out here, a mother goes to the restroom and comes back to find her children sharing a bottle of vitamins after climbing onto the counter to obtain the bottle from the cabinet. What do people need to know about that?

Becky DeVore: Well, they need to know that any time medications are left out, children are opportunists, they will find the correct opportunity when mom goes to the restroom. Mom would need to bring that bottle with her to the telephone so that when we are asking about active ingredients in the vitamins, that she will have that information with her.

Conan Gasque: And that's, you know, another example of a case where you want to make sure that you're safely storing your vitamins and medications to make sure that your children aren't able to easily access them.

Becky DeVore: Correct. So we do not think that there's anything that's specifically childproof. It can only be child-resistant. So we do recommend locking up your medications. They do make a lock box that can even go in the refrigerator if you have refrigerated medications. And we do recommend locking up your medications as children many times will think that they're candy or a treat and ingest large amounts. Especially if you put your pills in a pill planner, that pill planner should be locked in that lock box to prevent children from getting into that.

Adolescents may also obtain medications from unlocked medication bottles. And then we also do not recommend that you store your medications in the bathroom due to the humidity. It can degrade medications faster. We do recommend that you store them in a high kitchen cabinet in that locked box. And then again, they can be placed in the refrigerator if necessary.

Conan Gasque: A lot of good advice there. And let's play out one final scenario here. Let's say a grandmother is visiting and a child accesses her purse and ingests medicine from the purse. Call the APIC first, but what other information might you need?

Becky DeVore: So we, you know, definitely get concerned when it's an older person's medication. Many times they're on a lot of heart medications. Those can be more dangerous for children. So we definitely need the name and the strength of that medication. Many times we need to know how many were available to the child and how many are left. And then, we can decide whether, you know, if the child will need to be seen in the emergency department or not.

Conan Gasque: And that essentially gets into another important topic, is what are your recommendations when you have guests in your home? The grandmother was a guest in that case, and it would be very easy for a visitor to come in and bring something in that is unintentionally dangerous to a child. How should you handle things with guests like that?

Becky DeVore: So with guests, we do recommend that they put their purses and suitcases up and then lock up medications that may be available in the purse or the suitcase. Many times, we call the purse, the poison purse, because it does contain many things that can be poisonous, such as medications, hand sanitizer, makeup. Some people carry their pepper spray in the purse. So purses can be a big problem that we do, you know, want to make sure all the poisonous substances are locked up.

Conan Gasque: A lot of good information for parents to have. And if you have any other questions, you can always call the Alabama Poison Information Center. Once again, the national number 1-800-222-1222. That's 1-800-222-1222. Once again, APIC RN educator, Becky DeVore. Becky, thanks so much for your time.

Becky DeVore: Thanks for having me.

Conan Gasque: Thanks for listening to Inside Pediatrics. You can find more podcasts like this one at childrensal.org/insidepediatrics.