T H E  M E D I C I N E  C H E S T

Poison Prevention
in the Child Care Setting

The age-old adage "an ounce of prevention is worth a pound of cure" is especially pertinent in poisonings. Every ingestion of a non-food item is a potential poisoning. Poisonings include ingestion, absorption through skin (dermal), substance in the eyes (ocular), inhalation exposures, and stings and bites (envenomation). Approximately 60 percent of poisonings reported to poison centers in the United States are pediatric cases. Fortunately, only a small percentage of these poisoning incidents occur in childcare centers.

There are several steps that can be taken to prevent poisonings:

• All medicines brought into the center must be placed in a locked cabinet or a locked box in the refrigerator. Never leave medicines in a diaper bag or child's cubby. Never accept unlabeled bottles from parents. Request written and signed instructions for all medicines that are to be given while the child is in your care. Keep all purses and bags of staff, parents and visitors up and out of reach.
• The number one ingestion problem for children less than one year of age involves plants. Know what is in your area. Identify all plants both inside and in outdoor play areas. After rainy days, be especially alert for mushrooms, which may have sprouted overnight.
• Do not store cleaning products under the sink which is eye level for toddlers. Store all cleaning products in locked cabinets. Never mix cleaning products, because some products produce toxic gases when mixed and inhaling these gases can cause serious problems. Keep all cleaning products in their original containers and be carefully to avoid storing non-food items in food containers.
• Use art supplies that are non-toxic. Even though a product might not be toxic, it may be still be a choking hazard. Children often put crayons, modeling clay, and other objects in their mouths that pose choking hazards.
• Call the area poison center about every exposure. Some products are so toxic that less than a quarter of a teaspoon may be poisonous. Have the poison center number posted near the telephone. Many poison centers have stickers for your phone and magnets for your refrigerator. Do not follow instructions on the label of the product, because up to 40 percent of all labels have incorrect treatment recommendations!

A national 800 (toll free) number for public access to poison control services has been proposed. Several states now can call 800-POISON-1 for information. Poison centers are available throughout United States and Canada and most are available 24 hours a day to answer questions. For further information, check with your local poison center. The telephone number for the centers can usually be found on the first page of a telephone directory.

 Ann Slattery, R.N., R.P.h., is the Supervisor of the Regional Poison Center of Alabama.

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SAFETY CHECK

When performing safety checks of the classroom or playground, watch for poison "possibilities." Check for plants, art supplies, cleaning supplies, diaper bags, purses or backpacks of visitors (that might contain medicines, etc.).

In outside playground areas, check for carelessly placed garden or maintenance supplies. Plants can be poisonous so if the play area is near a garden, fencing might be appropriate.

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