- Providing Safe Environment:
According to level of children's
development, age, and capabilities, children are attracted toward certain
hazardous environment, which may lead to accidental injuries. The steps should
be taken to prevent such injuries by providing safe environment at home,
school, and in the community.
As a responsibility of nurses, it is
important to help the parents and community to be aware of accidental injuries
in children and their relation to the growth and development of their children.
It should be stressed that children need the positive and clear instruction to
protect themselves from the accidents. Provision of a safe environment is also
Poisoning is a condition which occurs due to ingestion,
inhalation or injection of injurious substance. Here the poisoning by ingestion
in children is discussed. Poisoning is common in from 1 year of 4 years. It is
an accident due to lack of supervision and carelessness of leaving poisonous
material within the children's reach.
Common poisons may be cleansing
agents, detergents, insecticides, sleeping pills, tranquilizers, paint solvent,
kerosene, corrosives, cosmetics, and adulterated food.
Signs and symptoms:
1. Gastrointestinal disturbances, such as anorexia, vomiting,
diarrhoea, and abdominal pain are commonly seen.
breathlessness, cyanosis, sternal retraction, and grunting.
Circulatory problems should be
checked for shock and collapse.
Children may have convulsions or
Children's mouth may have the smell
or colour of ingested poisons such as, kerosene or organophosphurous compounds.
Identification of poison is
necessary to start appropriate treatment.
Removal of poison: Vomiting is
induced immediately, to prevent further absorption of poison. Ipecac syrup with
water may be given for emetic effects.
Gastric Lavage (stomach
wash - refer practicals): Gastric lavage is given to empty the stomach off
Vomiting and gastric lavage are contraindicated, if a child
is comatose, in severe shock, had corrosive poisoning, or has lost gag reflex
to prevent aspiration. If a poisoning agent is mineral oil, the vomiting can
cause aspiration, resulting into chemical pneumonitis. If a poison is a strong
corrosive (acid or alkali), vomiting may further damage the injured tissues of
the pharynx and oesophagus.
1. Decontaminating stomach with activated charcoal helps to
absorb many compounds. It is used within one hour of poisoning but after the
patient is vomited.
Dilution of a poison: Dilution of a
poisoning agent is necessary when toxic substance cannot be removed such as
Place the patient in a semi prone
position to facilitate drainage of secretions and prevent an aspiration.
Maintain the patent airway.
Administer oxygen if necessary.
Check the vital signs and observe
the patient for the signs of any changes in the symptoms. Maintain the normal
Give emotional support to the
patient and parents. Nothing should be given by mouth.
Monitor parental fluid intake and
Provide comfort measures to the patient.
Parents should be explained about the measures to prevent
poisoning in children as follows:
Instruct about proper storage of poisonous substances.
Explain to keep the poisonous material beyond the children's
Instruct to put label on the container.
Poisonous substances should never be placed in a container
used for the food, because the child may mistakenly ingest it.
Instruct to seek the medical advice when poisoning is