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TREATMENT FOR POISONINGS REQUIRES MEDICAL EXPERTISE

A 3-year-old swallows about 30 aspirin tablets. How would you care for her? What about a 9-year-old who drank a bottle of isopropyl alcohol? Would you know how to treat him in the crucial moments after the poisoning was discovered? Do you know when to give fluids, syrup of ipecac or activated charcoal - and when not to?

Between 1958 and 1989, poison control centers in the United States received reports of 3.8 million childhood poisonings; more than 100 children died. Most of the victims were toddlers.Their increasing mobility and natural inclination to explore with their mouths put kids at special risk. Common household products, improperly stored, pose the greatest danger to curious children.

When a child has swallowed a poison, continually monitor the breathing and pulse should he or she become unconscious. Call the poison control center. Sometimes the center will tell you to dilute the swallowed poison. If so, water is preferred. For children who refuse water, milk is the next best choice. You can also try juice. Do not dilute unless advised to by a reliable medical source (poison control center or physician). Sometimes diluting can force the stomach contents into the small intestine faster, where absorption happens faster. Diluting can also dissolve tablets and capsules faster.

At other times, you may be advised to induce vomiting with syrup of ipecac. A sealed bottle of ipecac will retain its effectiveness for several years. Do not give it for caustic toxins or hydrocarbons such as gasoline, and when the child's level of consciousness is - or may become - altered.

Ipecac requires a glass or two of water for it to work. Having the victim move around can stimulate vomiting. Ipecac usually works within 20 minutes. Ipecac is becoming less popular among toxicologists because vomit can be inhaled and produce a form of pneumonia. Also, the child may continue vomiting for up to four hours, delaying other types of medical treatment. Another treatment involves activated charcoal, which absorbs or binds toxins, thus limiting their ill effects. It does not bind alcohols, glycols and hydrocarbons or rapidly activating poisons such as cyanide and strychnine. It also will not work on caustic agents, iron and other metals. Charcoal is gritty, tasteless and black, and even when mixed with sorbitol, young children may refuse it. Do not try to make the charcoal more palatable by mixing it with tastier substances because doing so may lessen its effectiveness. Afterward, whether the victim stays at home or in a hospital, he or she must be monitored. If the child's level of consciousness is decreased, he/she can't be awakened, has difficulty breathing or begins vomiting, medical attention is needed.

If the poisoning resulted from inadequate precautions in the child's home, the parents should perform a thorough home assessment and any hazards should be reduced to prevent future accidents.