28/11/2008 (Graphic Online) - Early last month, three accidental poisoning cases occurred in various homes but all ended up at the Paediatric Emergency Unit of the Komfo Anokye Teaching Hospital (KATH).

In the first instance, an eight-year old girl whose father is a herbalist accidentally ingested one of the chemicals for the preparation of the herbal tonic. The “factory” for production of this herbal concoction is in a wooden structure located opposite the child's house.

One afternoon, this child, after eating, was looking out for water to drink. Not finding any, she entered the father's factory and found some colourless chemical in a container.

She was at home with her play mates alone. Thinking it was water, she drunk some (not too much). About five minutes later, she started complaining of abdominal pain. Some few minutes later she fell, became unconscious and started foaming at the mouth.

The shout of the play mates attracted neighbours who rushed her to KATH for management. When this child arrived, she was deeply unconscious, breathing very fast, extremities were all cold, heart rate was high and the pupils were dilated.

This was a challenge to the doctors on duty because the specific agent she drank was unknown to them. Moreover, the exact quantity she took was also questionable.

Finally, the container with the liquid was brought to the hospital. This even confused the doctors the more because the container was only not original but also it had no label.

Various chemicals or drugs have specific antidotes. But in her case, the chemical component was unknown. The choice of intervention was a tussle because it could worsen her already bad state. The good news was that she eventually pulled through and has been discharged after counselling.

In the second instance, another eight-year old epileptic boy on regular carbamazepine ingested many tablets at the same time. He had been on medication for over six months and was aware of the number of tablets per day to take. The drugs were in a rubber sachet and he could have easy access to them.

As young and curious as he was, he possibly thought he could cure himself of the disease with a single large dose. He could also have thought the daily medication was boring and that if he finished them early, he could be free of the daily routine.

He became unconscious after taking the drug (it has sleeping properties). Because the drug was known, specific interventions were instituted and he was saved.

In the last instance, gas oil, which had been kept in a Voltic mineral bottle, was accidentally given to a four- month old baby by her older sibling, who was five years old, because he thought it was water. They were living in a single room. The mother had gone out briefly and left the baby in the care of his elder brother.

When the baby started crying, her brother had compassion and sensing that the baby was thirsty, he decided to give the liquid in the Voltic bottle to the baby. The baby, however, survived.

These are but a few occurrences in our homes. Some die at home and the cases may not have been recorded. Even though all those in the examples I have given were saved, some die because they arrive at the hospital too late or the chemicals taken were extremely dangerous.

In all the above cases, the age-old tradition of giving palm oil to induce vomiting was applied.
The way forward for avoiding accidental poisoning among children at home begins with education of children, parents, grandparents and other family relations.

The child should be made aware that every chemical or substance in the household is potentially toxic, whether through ingestion, inhalation or contact with the skin and that before they come in contact with any of these, they should inform an elder person. This may not work, generally because children are curious and would always want to experiment.

Parents, grandparents and guardians should therefore be absolutely responsible for the safety of the child at home.
We need to ask ourselves if all potentially harmful products are out of the reach of children or stored in a locked cabinet.

In almost every kitchen, toilet or store room are disinfectants, soaps, bleaches, and detergents and toilet bowl cleaners. All these products contain chemicals that, if ingested, could harm a child.

The only true way to prevent accidental poisoning is to be certain that the items are totally inaccessible to small children. Child-proof locks can be placed on cabinet doors, or these items can be stored on shelves that are out of reach of children or in locked containers. Remember that children still require constant adult supervision.

Never underestimate the ability of children to get into areas and containers that appear "childproof". Are all potentially harmful products stored in their original container? This point is worthy of note because kerosene is typically stored in Coca-Cola, Fanta or beer bottles.

Detergents are mostly stored in mineral bottles. Children mostly see these as coloured drinks and would therefore go for them. Bigger still is the problem with herbal medicine bottles. They are so unspecified and without label.

Moreso, the manufacturers cannot give the chemical components of their products. As much as possible, these chemicals or reagents in disguised bottles should be consciously kept away from children. The Ministry of Health should strictly monitor the production of herbal medicines.

Are all of the medications and other potentially harmful substances in your home equipped with child resistant caps? Are your medicine cabinets accessible to children? Most of our homes are alien to child-resistant caps. I recommend that this be adopted by pharmaceutical firms to protect our children from preventable accidental poisoning.

For child-resistant packaging to be effective, remember to resecure the lids to all medications and potentially harmful substances after using them. It may take a few extra minutes to tightly secure the lids on medications, but the time is well spent, if it eliminates the potential for accidental poisoning in the home. Even if there are no children living in your home, use products with child-resistant packaging.

Have you helped your own parents “child-proof” their house? A significant number of accidental poisoning cases occur when children are visiting grandparents and they come across medications stored on tables and in nightstand drawers.

Likewise, older adults often take their medications into homes where small children live, and these medications may become easily accessible, if a child finds them in a purse or suitcase.

Have you considered vitamins and minerals when child-proofing your home? Vitamins and minerals can be dangerous to children, although we often think of vitamins as non-toxic substances. Overdose of iron could be harmful to children. Iron is available without a prescription, and it is often found in children, pre-natal and adult vitamins.

The amount of iron contained in children and adult vitamins can be enough to kill a child when taken in excessive amounts.

Are you aware of the number of things stored in the garage or storage area of the home that can be poisonous when ingested? Children have died after swallowing such everyday substances as charcoal, lighter fluid, paint thinner and remover, anti-freeze, turpentine and pesticides.

All of these products must be stored out of the reach of small children. Special shelves and cabinets can be installed to make these items inaccessible.

Be careful never to place rodent or insect baits where small children can get to them. Teach children that pesticides are poisons, something they should not touch.

It is better to rush the child immediately to the closest health facility than to give him palm oil. From experience, children given palm oil to induce vomiting have more complications because they end up aspirating the vomitus into their lungs. It should be avoided as much as possible.

Every child counts. We should do everything to prevent death through accidental poisoning.