From the CDC website:

http://blogs.cdc.gov/safehealthcare/?p=2070

Keeping Medicines Up and Away and Out of Sight of Toddlers
December 13th, 2011 2:53 pm ET
Up And Away Campaign
There’s an important campaign being launched by the CDC to protect children from unintentional medication overdoses. The campaign is called, Up and Away and Out of Sight.

From the CDC website:

http://blogs.cdc.gov/safehealthcare/?p=2070

Keeping Medicines Up and Away and Out of Sight of Toddlers
December 13th, 2011 2:53 pm ET
Up And Away Campaign
Author – Dan Budnitz, MD, MPH, CAPT, USPHS
Director, Medication Safety Program
CDC Division of Healthcare Quality Promotion

Today, CDC announced the launch of an exciting new education program for protecting children from unintentional medication overdoses – Up and Away and Out of Sight. We’ve blogged about the large number of children who end up in emergency rooms each year from unintentional ingestions and overdoses after taking medicine without adult supervision. Our data suggest that many children get into medicine because adults forget to follow simple steps: close the child-resistant packaging and put medicine up and away—out of children’s sight and reach.

In the 1970s, the introduction of child-resistant packaging and memorable awareness campaigns, substantially decreased the number of accidental poisonings. Medicines now outnumber household products as the leading cause of children’s poison-related emergency room visits. It is time for a “refreshed” campaign designed for busy parents of the 21st Century.

The new Up and Away and Out of Sight awareness program directs parents to follow simple steps:

•Store medicines in a safe location that is too high for young children to reach or see.
•Never leave medicine or vitamins out on a counter or at a sick child’s bedside, even if you have to give the medicine again in a few hours.
•Always relock the safety cap on a medicine bottle. If it has a locking cap that turns, twist it until you hear the click.
•Tell children what medicine is and why you must be the one to give it to them.
•Never tell children medicine is candy so they’ll take it, even if your child does not like to take his or her medicine.
•Remind babysitters, houseguests, and visitors to keep purses, bags, or coats that have medicines in them up and away and out of sight when they are in your home.
•Program the poison control center number 1-800-222-1222 into your home and cell phones so you will have it when you need it.
This week, our medication safety partners will be blogging, including the U.S. Consumer Products Safety Commission (who regulates child-resistant packaging), American Association of Poison Control Centers, organizations that represent the manufacturers of over-the-counter medicines, and family practitioners.

From U.S. News and World Report, September 16, 2011:

http://health.usnews.com/health-news/managing-your-healthcare/treatment/articles/2011/09/16/accidental-medication-poisonings-in-kids-on-the-rise
Despite ongoing prevention efforts, a growing number of young children are being accidentally poisoned with [...]]]> There have been several news articles this past week regarding a new study to be published in the Journal of Pediatrics: The Growing Impact of Pediatric Pharmaceutical Poisoning.

From U.S. News and World Report, September 16, 2011:

http://health.usnews.com/health-news/managing-your-healthcare/treatment/articles/2011/09/16/accidental-medication-poisonings-in-kids-on-the-rise
Despite ongoing prevention efforts, a growing number of young children are being accidentally poisoned with medications, according to new research.

The study, which was based on data reported to the American Association of Poison Control Centers between 2001 and 2008, found that medication poisoning among children aged 5 and under increased by 22 percent, although the number of children in the United States in this age group rose by only 8 percent during the study period.

“The problem of pediatric poisoning in the U.S. is getting worse, not better,” Dr. Randall Bond, of Cincinnati Children’s Hospital Medical Center, said in a hospital news release.

In conducting the study, which is scheduled for publication in the Journal of Pediatrics, the researchers reviewed information on over 544,000 children who landed in the emergency department due to medication poisoning over the course of the seven-year study period.

The vast majority (95 percent) of emergency department visits were the result of self-ingestion (the kids took the medicine themselves by accident), the investigators found. Prescription drugs were involved in 55 percent of the emergency visits, 76 percent of the hospitalizations and 71 percent of significant injuries.

Opioid-containing pain medications (such as morphine, codeine and oxycodone), as well as muscle relaxants, sleeping pills and heart medications had the biggest impact, the study authors noted in the news release.

The researchers suggested that the reason for the trend is likely due to greater availability and easier access to medications in children’s homes. They also noted that “poison-proofing” efforts, such as safe guards on packaging and child-proofing in the home, may have declined in recent years.

“Prevention efforts of parents and caregivers to store medicines in locked cabinets or up and away from children continue to be crucial. However, the largest potential benefit would come from packaging design changes that reduce the quantity a child could quickly and easily access in a self-ingestion episode, like flow restrictors on liquids and one-at-a-time tablet dispensing containers,” said Bond.

He added that these types of changes should apply to both pediatric and adult prescription and over-the-counter medications.

I’m adding a link to the news release from the Cincinnati Children’s Hospital Medical Center. Institution of the study’s lead author Dr. G.Randall Bond.
Title of the study: The Growing Impact of Pediatric Pharmaceutical Poisoning.

September 16, 2011
Number of Children Poisoned by Medication Rising Dramatically, Study Says
http://www.cincinnatichildrens.org/about/news/release/2011/poisoned-by-medication-09-16-2011.htm

These recommendations follow from work done by a CDC led task force which resulted in the PROTECT initiative: http://www.cdc.gov/medicationsafety/protect/protect_Initiative.html.

From the Stanford School [...]]]> This past week there has been much news about an FDA released guidance document for manufacturers of liquid OTC drugs, calling for all such products to be packaged with calibrated dosing devices.

These recommendations follow from work done by a CDC led task force which resulted in the PROTECT initiative: http://www.cdc.gov/medicationsafety/protect/protect_Initiative.html.

From the Stanford School of Medicine’s, Scope – medical blog, http://scopeblog.stanford.edu/archives/2011/05/new-ways-to-prevent-drug-overdoses.html.

The task force has several recommendations to attack the problem:

1. Make child-resistant packages safer for kids. The task force suggests introducing passive flow-resistor devices on pediatric liquid meds and “unit-dose” packages that replace large bottles of pills.

2. Educate parents. The task force is starting an “Up and Away” campaign to remind parents to put medications in a secure spot immediately after use so little ones can’t get into them.

3. Improve labels and dosing devices on kids’ medicines. Several recent studies have indicated that children often receive improper doses of liquid OTC medicines because parents give them in household spoons, or because the included dosing devices are poorly marked. One study found that cups included with liquid medications were particularly prone to errors, with some 70 percent of parents putting more than 6 mL of liquid into a cup intended for dispensing 5 mL.

One of the first results to come from the FDA guidance is that over-the-counter drug makers have announced that they will no longer produce acetaminophen in concentrated infant drops; liquid acetaminophen products for children under 12 will be sold only in a 160 mg/5 mL concentration.

From abc NEWS/health: http://abcnews.go.com/Health/w_ParentingResource/infant-dose-counter-acetaminophen/story?id=13535850.

The Consumer Healthcare Products Association (CHPA), the chief trade group for OTC drug manufacturers, indicated the move is intended to reduce dosing errors.

“CHPA member companies are voluntarily making this conversion to one concentration to help make it easier for parents and caregivers to appropriately use single-ingredient liquid acetaminophen,” said CHPA president and CEO Scott Melville in a statement.

Manufacturers will also be adopting syringes with dose restrictors for products intended for infants, the CHPA indicated, but cups will continue to be provided for older children.

The shift will begin in the middle of the year, the group said, but it warned that there will be a “transition period” during which multiple concentrations of the infant products may be on store shelves simultaneously.

“During the transition, the makers of these medicines also will work with retailers to ensure that, as the new medicines are introduced, the more concentrated infant drops will be removed from store shelves,” the CHPA statement indicated.

“Consumers should always read and follow the label and pay particular attention to the concentration, especially when a healthcare provider gives dosing instructions,” it added.

The study reviewed more than 50,000 prescriptions for narcotic-containing drugs given to kids up to [...]]]> A study presented at the Pediatric Academic Societies annual meeting in Denver and reported by Bloomberg Businessweek: http://www.businessweek.com/lifestyle/content/healthday/652405.html found that for children younger than 2 months, the prescribed dosage for narcotics was too high 40 percent of the time.

The study reviewed more than 50,000 prescriptions for narcotic-containing drugs given to kids up to age 3 and found about 4 percent were given an overdose.

The rate was much higher among the youngest babies, according to the study.

“Almost one in 10 of the youngest infants, ages 0 to 2 months, received more than twice the dose that they should have received based on their age, gender and a conservative estimate of their weight,” the study’s lead researcher, Dr. William T. Basco Jr., director of the division of general pediatrics at the Medical University of South Carolina, said in a news release from the American Academy of Pediatrics.

“Since we know that parents have difficulty measuring doses of liquid medication accurately,” Basco said, “it is critical to strive for accurate narcotic prescribing by providers and dispensing by pharmacies.”

The researchers analyzed the prescriptions of 19 drugs given to children enrolled in Medicaid from 2000 to 2006. They calculated the proper daily dose of each drug — based on a child’s weight, age and sex — and examined whether they got the correct dose.

The youngest kids were most likely to get an overdose of a drug, Basco said. Among children who were younger than 2 months, about four in 10 received an overdose. The percentage of overdoses was 3 percent in kids older than a year, the study found.

The overdoses were significantly higher than the proper doses — for an average child, for instance, about 42 percent larger than they should have been, the study reported.

Narcotic drugs such as codeine and hydrocodone can be dangerous for infants and children because of their sedative effects, the researchers noted.

For Immediate Release April 13, 2011

American Association of Poison Control Centers: Poison Centers Federal Appropriations Cut by Nearly 25 percent in Proposed FY 2011 Continuing Resolution; Damaging Impact to States’ Ability to Help Citizens

Alexandria, Va. –U.S. poison centers suffered a nearly 25 percent cut in [...]]]> From the American Association of Poison Control Centers:

For Immediate Release April 13, 2011

American Association of Poison Control Centers: Poison Centers Federal Appropriations Cut by Nearly 25 percent in Proposed FY 2011 Continuing Resolution; Damaging Impact to States’ Ability to Help Citizens

Alexandria, Va. –U.S. poison centers suffered a nearly 25 percent cut in federal dollars in the proposed 2011 fiscal year continuing resolution agreed upon by House and Senate negotiators and released publicly on Tuesday – a damaging cut, but one far less brutal than originally proposed by the House of Representatives in H.R. 1.

The House of Representatives, in H.R. 1, had originally called for a 93 percent reduction in federal funding for America’s poison control system, a move that would have produced disastrous effects on public health.

“We’re grateful that Congress has recommended that a majority of our 2011 federal dollars be restored in the final compromise,” said Richard Dart, M.D., Ph.D., president of the American Association of Poison Control Centers. “But we must be clear: These cuts are still extremely harmful for poison centers. The cuts come on top of budget cuts at the state level. Many centers are experiencing total cuts from all sources of 40 percent or more. It’s short-sighted to believe that centers can sustain these cuts and continue to provide the same level of service that they did before.”

Federal dollars account for roughly 20 percent of total funding for poison centers, with states and other non-federal sources funding most of the balance. Poison centers provide free and confidential medical advice 24 hours a day, seven days a week, and have been cited as a model for cost-effective health care delivery.

“These cuts come during a time when poison centers are already facing enormous financial strain,” Dart said. “It’s too soon to know what these cuts mean. At best, callers to poison centers may have to wait longer before talking to a medical expert. At worst, we may see more of our poison centers close.”

In 2010, the state of New York closed three of its five poison centers, citing budgetary issues. In 2009, Michigan closed one of its two centers. New Mexico has seen a 29 percent reduction in state support over the past three years. Poison centers in California, Illinois, New Jersey and Washington have also fought tough battles in recent years to preserve funding.

A 2008 study conducted in Arizona and published in the Journal of Medical Toxicology found that poison centers saved $33 million in state-funded health care costs in one year, and that for every dollar the state of Arizona spent on the poison center, it saved about $36 in unnecessary health care charges.

According to some estimates, for a total yearly operating cost of less than $150 million, U.S. poison centers save more than $1 billion dollars in avoided health care costs. This doesn’t include other benefits, such as higher quality and more efficient care of poisoned patients, local, state and federal public health collaboration, professional and public education, regionally-related research and governmental consultation, to name a few.

According to the Centers for Disease Control and Prevention, accidental poisoning is the second-leading cause of unintentional injury death in the United States, trailing only automobile accidents. U.S. poison centers received more than four million calls in 2009, offering free, confidential information and professional medical advice to those exposed to poisons ranging from carbon monoxide to snake bites to food poisoning.

“Poisoning remains a very real public health threat,” said Jim Hirt, executive director of the American Association of Poison Control Centers. “But poison centers help reduce the cost of poison exposures. Nearly 91 percent of human exposure cases handled by a poison center are kept from having to go to a health care facility. Doctors, nurses and other medical professionals rely on poison centers every day for professional advice.”

In recent years, poison centers have emerged as a leader in public health surveillance, thanks to the National Poison Data System, a system that tracks all toxic exposures and certain public health emergency data reported to U.S. poison centers.

That system in 2010 helped collect invaluable data for public health agencies on the impact of the Gulf Oil spill. More recently, it has tracked radiation exposures and provided public health information, as requested by the U.S. Centers for Disease Control, linked to the earthquake in Japan. Poison centers were also the first to raise the alarm about the toxic effects of synthetic marijuana and psychoactive products marketed as bath salts.

Currently, 57 poison centers cover all 50 states as well as the District of Columbia, Puerto Rico, American Samoa, the Federated States of Micronesia, Guam and the U.S. Virgin Islands.

About the American Association of Poison Control Centers: The American Association of Poison Control Centers supports the nation’s 57 poison centers in their efforts to treat and prevent poisoning. Poison centers offer free, confidential medical advice 24 hours a day, seven days a week. If you have questions about poisons, or you believe you’ve been exposed to something that could be bad for you, call your poison center at 1-800-222-1222.

Contact: Jessica Wehrman

wehrman@aapcc.org

(703) 894-1863

www.aapcc.org

Cutting Poison Control

PRESIDENT’S F.Y. 2010-11 REQUEST: $29 MILLION

HOUSE VOTED: $2 MILLION

Eliminating nearly all the money for poison control centers would save $27 million — not even a rounding error when it [...]]]> The following comes from an editorial in the New York Times published online March 3, 2011, http://www.nytimes.com/2011/03/04/opinion/04fri4.html?_r=2&scp=1&sq=poison%20control&st=cse.

Cutting Poison Control

PRESIDENT’S F.Y. 2010-11 REQUEST: $29 MILLION

HOUSE VOTED: $2 MILLION

Eliminating nearly all the money for poison control centers would save $27 million — not even a rounding error when it comes to the deficit. Yet it is so foolish that it perfectly illustrates the thoughtlessness of the House Republican bill to cut $61 billion from the budget over the next seven months.

The nation’s network of 57 poison control centers takes four million calls a year about people who may have been exposed to a toxic substance. In three-quarters of all cases, the centers are able to provide treatment advice that does not require a visit to a hospital or a doctor, saving tens of millions of dollars in medical costs.

While a single visit to an emergency room can cost hundreds or thousands of dollars (often paid for by the government), a call to a poison center costs the government only $30 or $40. A study in the Journal of Medical Toxicology estimated that the poison centers saved the State of Arizona alone $33 million a year. Louisiana eliminated its centers in the 1980s but restored them when it realized how much money they saved.

The centers, which collect poison reports, can also act as an early warning system for pandemics or large toxic exposures, allowing a quick response.

The federal government pays about 20 percent of the cost of the centers, with states, cities and philanthropy picking up the rest. Many strapped state and local governments have cut back their financing, and experts say that the virtual elimination of federal money would force many centers to close and sharply damage the effectiveness of the national network.

Could savings be achieved by consolidating centers? Possibly. House Republicans didn’t bother to examine that or how much the cuts would actually increase spending on emergency care. If they get their way, lines at emergency rooms will be longer.

From their blog:

The study compared [...]]]> We came across a great blog entry from our colleagues at the Illinois Poison Center. They summarize findings from the article: Adverse events from cough and cold medications after a market withdrawal of products labeled for infants, published in Pediatrics, the official journal of the American Academy of Pediatrics.

From their blog:

The study compared emergency department (ED) visits by pediatric patients exposed to CCMs for the 14-month period prior to the 2007 withdrawal, and the 14-month period thereafter.  First, the good news – the results showed that ED visits related to CCMs in children younger than 2 years of age decreased by one-half in the post-withdrawal period when compared to the pre-withdrawal period.  And the not-so-good news – the total number of ED visits in children younger than 12 years of age remained the same.  While this study reflects a step in the right direction, there is still more work to be done by all of us to lower the overall incidence of adverse events associated with CCM poisoning, use, and misuse.

The entire blog entry can be found here: http://ipcblog.org/2011/01/11/a-year-in-review-children%E2%80%99s-otc-cough-cold-products-label-changes/.

The article can be found here: http://pediatrics.aappublications.org/cgi/content/full/126/6/1100.

From the article:

“Whether they’re over the counter medications or prescription medications, they should be kept out of reach,” said Dr. Shane Speights.  In fact, new warnings are being [...]]]> This story comes from KAIT, ABC 8 in Jonesboro, AR, more great information and advice. The whole story can be found here: http://www.kait8.com/Global/story.asp?S=13334377.

From the article:

“Whether they’re over the counter medications or prescription medications, they should be kept out of reach,” said Dr. Shane Speights.  In fact, new warnings are being issued by  federal health officials to keep medicines out of a child’s reach.  Dr. Shane Speights says accidental ingestion of drugs can be a deadly situation.

An accidental overdose is a scary thought for mom Sara Thomas.  She makes sure the meds they do have are out of reach, and under lock and key.

“We make sure everything is locked up,” said Thomas.

“We have one of those safes that you have to enter the combination yourself and only me and my husband know it,”said Thomas.

Remember,  just because a lid may say child proof, it’s doesn’t always mean children won’t be able to open it.

Children under age 5 make up the bulk of the more than 100,000 Americans treated in emergency rooms each year after accidentally swallowing medications.

Most such poisonings occur in 1- and 2-year-olds — an age group whose curiosity and climbing skills often outstrip [...]]]> According to an article in the USA Today: http://www.usatoday.com/yourlife/health/medical/pediatrics/2010-10-14-poisoningsonline_ST_N.htm

Children under age 5 make up the bulk of the more than 100,000 Americans treated in emergency rooms each year after accidentally swallowing medications.

Most such poisonings occur in 1- and 2-year-olds — an age group whose curiosity and climbing skills often outstrip their judgment — according to a new report from the Substance Abuse and Mental Health Services Administration.

While 85% of children were treated and released from the ER, about 10% had more serious injuries and required hospital admission, the study says.

Experts offer these tips to keep children safe:

•Properly dispose of unneeded or expired medications, advises the Substance Abuse and Mental Health Services Administration.

•Don’t take medications in front of children, which may inspire them to try to imitate you, Casavant says. Tell children never to take medication unless you give it to them.

•Never refer to pills as candy.

•Because children can sometimes open child-resistant caps, keep medications out of sight, out of reach and in a locked container, Casavant says.

•Keep the national poison control center number — 800-222-1222 — on or next to all of your phones.