Among things to keep out of the reach of children include most if not all household chemicals, medications, and many plants. Most people are cognisant of this so it is not that often that I see unintentional toxic ingestions. However, sometimes people get careless and they leave things out or don’t realise that their child has the ability to open things and drink or eat them. There have been times when parents have said to me “He never was able to open a bottle before!” Or, “He could never pick up something that big before!” Well, I say, eventually children develop and attain new abilities! Sooner or later, they will learn how to uncrew a cap! (at least we hope so). My advise is to anticipate these things and take precautions BEFORE they learn to do things.
Anyway, I had a baby who was about 7 months old who was brought in because the parents found he had crawled into the dining room and had somehow opened a bottle of lamp oil (which is conveniently coloured red like Hawaiian Punch!). The child did not appear to have obviously consumed any of the stuff but since the bottle was opened next to him, they called poison control who advised he be brought in for evaluation. It was a good thing too. Lamp oil is a aromatic hydrocarbon – like gasoline and is thus very toxic. Although as it turns out, he probably only consumed a tiny amount so in his case the toxicity was not via the gastrointestinal tract. It was pulmonary. Since these substances are aromatic, they are highly volatile – anyone who has pumped their own gas knows what it is like. One can see the vapours escaping from around the pump handle as the petroleum goes into the car’s tank. This is the main danger in the consumption of even small amounts of these substances although nervous system and cardiovascular toxicity can occur as well. The fumes go down the airway and cause serious problems in the lungs. Even a small amount can be deadly to a child or small person. Unfortunately, the damage is often delayed. Technically what happens is “The end result of hydrocarbon aspiration is interstitial inflammation, intra-alveolar hemorrhage and edema, hyperemia, bronchial necrosis, and vascular necrosis”. The child really did look fine when he came in – oxygenation good, alert and somewhat playful. However he did start to have more coughing after about an hour and a repeat chest x-ray showed developing pneumonitis (as did the child in this case who also ingested lamp oil). Unfortunately, he progressed and after another hour required intubation to support his breathing. The poor kid was transferred to a regional pediatric ICU where I later found he was intubated for about a week before he improved enough to breathe on his own. It remains to be seen if he developed long lasting neurological or cardiac side effects. Sad case – but one to learn by. Lock all liquids away in cabinets and make sure they have child-proof caps!
I wonder if we should go back to whale oil……?
I knew a kid, about age 4, that drank 1/2 bottle of lemon dishwashing liquid. He went to the ER but was fine, no other symptoms except burping bubbles occasionally.