TPCN Spotlight: North Texas SPI Arpan Patel

1. Tell me your history with poison control and how you became a Specialist in Poison Information (SPI).
   
   My journey into the realms of poison control began in March 2019. I believe I found the opportunity to work at a poison center by chance, as I had no idea it was something I could do with my educational background. Working at NTPC has solidified my understanding of the important role poison control centers play in serving the community.  
    
2. I’m sure you hear a lot of interesting stories when answering calls, but what is one story that sticks out in your head that might have been scary, but turned out funny and/or everything worked out after the call. 
   
   Insulin calls during the evenings are always memorable as they involve frequent callbacks throughout the night. Callers are always appreciative of the concern we show them by checking in on them and the education we provide to prevent similar episodes in the future. 
    
3. What do you think people need to know about the people who answer the phones for poison control? 
   
   We are medical professionals who provide medical assistance and care to a variety of individuals including healthcare workers and the general public.  As a result, it’s second nature for us to ask a lot of questions to get a better idea of what’s happening so we can give accurate recommendations. 
   
   
4. What do you enjoy most about your job and why? 
   
   It’s humbling to be able to help callers daily and make a difference.  
5. Why do you think it is important for people to have poison control as a resource for emergency help? 
   
   Apart from playing a key role in formulating treatment plans for sick patients, poison control centers reduce overall healthcare costs by preventing unnecessary ER visits and hospitalizations. This conserves healthcare resources for those requiring it the most and has proven beneficial especially during the current pandemic.  
   
   
   
   

Baby Safety Month: Tips on Keeping Babies Safe at Home

September is Baby Safety Month. With children at home more than ever, it is even more important that medications and cleaners, just to name a few of the dangers lurking at home, are locked and stored up and away and out of sight of young children. Having babies in the home can be an exciting time. To keep your home safe and fun for the little ones, make sure to follow these important tips from the Texas Poison Center Network.

Poison Safety Tips

·       First and foremost, pull out your cell phone and save this number, you never know when you might need it! Poison Center Help: 1-800-222-1222.

·       When it comes to measuring medications for babies, always use measuring syringes or dropper provided with the medication from the pharmacist or doctor. Also, always make sure you give them the correct amount.

·       Cleaning products, usually stored under cabinets, should be moved to another location that is out of sight and out of reach of young children.

·       Remember, once your baby is crawling, he or she can get to anything on the floor. That means you want to ensure there are no dangers within reach (roach bait, rat poison, medications dropped by mistake, etc.)

·       Medicine needs to be out of reach and locked up and away too. Is a purse or a nightstand a good place for your medications? Not with a baby or children around. Lock them up somewhere out of reach. 

·       Children’s medicines, like vitamins and cough syrup, can taste great to kids! If your child can get to these medicines, he or she may take the entire bottle.  Keep all medicines locked up and out of reach.

·       Check your yard for any poisonous plants or flowers too. You never know what babies will put in their mouth.

These are just a few important tips to help ensure your baby stays poison-free. For more information on poison control and tips for babysitters and more, please visit the Texas Poison Center Network website at www.poisoncontrol.org. And if you EVER find yourself or a loved one in a poison emergency, please do not hesitate to call us for help at 1-800-222-1222.

FDA Puts Limits on Arsenic in Baby Rice Cereal

Recently, the Food and Drug Administration (FDA) issued a final limit on the amounts of arsenic in baby rice cereal. This is the first time the FDA has put any limits on any food that could contain arsenic.

It is widely known that white cereals with certain grains can sometimes contain arsenic, but rice cereals can be much higher. Rice cereals, due to their absorption rate, may contain up to ten times more of the heavy metal. 

What is Arsenic?

According to the CDC, arsenic is a naturally occurring element that can combine with either inorganic or organic substances to form many different compounds. Simply stated, inorganic arsenic compounds can be found in soils, sediments, and groundwater. These compounds can happen either naturally or because of mining, smelting, or when using arsenic for industrial purposes. Organic arsenic compounds, on the other hand, are found primarily in fish and shellfish.

Here’s an interesting fact! Back in the day people used inorganic forms of arsenic in pesticides and paint pigment. People also used them thinking they were good for preserving woods as well a way to treat a variety of ailments. Luckily, we know better now and there are laws that restrict using arsenic-containing pesticides, wood preservatives, and medicines.

The Effects of Arsenic on Your Health

According to the CDC, large doses of inorganic arsenic can cause symptoms ranging from nausea, vomiting, and diarrhea to dehydration and shock. Long-term exposure can cause certain medical conditions such as skin disorders, high blood pressure, and even several types of cancer.

The FDA has now established a limit for inorganic arsenic of 100 parts per billion (ppb) in baby food. This is a voluntary limit and unenforceable currently. With the cooperation of makers of these products, we can hope to see arsenic completely out of baby foods. For more information on arsenic in food products, please visit the FDA link here.

If you or a loved one is experience symptoms like these, please reach out to the Texas Poison Center Network for guidance and help. We are available 24 hours a day, 7 days a week at 1-800-222-1222.

Be Safe and Don’t Mix Cleaning Supplies

During a pandemic, fears can sometimes get the best of us. Many Americans are cleaning and disinfecting more than ever to ensure they, and their loved ones, stay healthy. Keeping items clean in the home is a good idea but try not to get too creative in how you clean. If you mix certain cleaning supplies, it can be a bad combination. 

While most cleaning products are safe when used as indicated, if they are mixed with other products, it can cause a chemical reaction that can result in potentially toxic fumes and even explosions. Remember to ALWAYS read the label and warnings thoroughly. Here is a list of some household items you should never mix:

1.       Bleach and Ammonia: When these are mixed together, they can produce a toxic gas called chloramine. This toxic gas can cause irritation to your eyes, nose, throat, and lungs and can even be deadly. If you do accidentally mix these two chemicals together, get out of the room immediately and into fresh air and call the poison center right away.

2.       Bleach and Vinegar: Both products are powerful on their own. Mixing bleach and an acid like vinegar can create a chlorine gas that can be very toxic and potentially deadly at high levels. It can cause breathing issues, coughing, and burning/watery eyes.

3.       Baking Soda and Vinegar: While these two chemicals mixed together turn into mostly water, if they were contained in a tight container, they could explode.

4.       Hydrogen Peroxide and Vinegar: Many people use these two separately to clean fruits and countertops.  What you do not want to do is mix these two chemicals together. By combining them in the same container, it creates a peracetic acid. This toxicity can cause irritation to the lungs, eyes, and nose.

5.       Bleach and Rubbing Alcohol: These two chemicals together cause a nasty chemical called chloroform. It can cause irritation to your nose and eyes and can be a toxic mix. You are probably seeing a theme here: do not mix anything with bleach!

6.       Drain Cleaner and another Drain Cleaner: Never mix two different types of drain cleaners. These are packed with powerful chemicals and if mixed can cause explosive reactions.

7.       Pesticides and Water: Some pesticides, when mixed with water, can create a deadly phosphine gas. Make sure to read the labels when using pesticides and follow the directions carefully. 

There are many other combinations of chemicals that can be harmful.   If you find yourself in a situation where you have mixed chemical agents, either on purpose or by mistake, please do not hesitate to call the Texas Poison Center Network at 1-800-222-1222. They can answer your questions or concerns 24 hours a day, 7 days a week. You can also visit their website at www.poisoncontrol.org.

Be Cautious with Gummy Vitamins

Vitamin gummies are very popular. If you can find a vitamin, you can most likely find it in gummy 

form these days as well. Their similarity in taste and texture to candy gummies can make them very enticing to children. While this encourages children (and adults!) to take their vitamins, it also raises concerns that children might take more than recommended thinking that it is candy. Since the COVID-19 pandemic reached the U.S., the Texas Poison Center Network has seen a 55% increase in calls involving children and vitamins compared to the same time last year. That’s why it is incredibly important to keep any vitamin, especially gummy vitamins locked, up and away like you would do with any other medications in your home.

When it comes to gummy vitamins, they can sometime contain more sugar in them than vitamin benefits. In other cases, vitamins can be downright harmful to children. It is not beneficial to children to get more than the necessary number of vitamins their bodies need, and most children get the nutrients they need from the food they eat every

day. While vitamins can act as a positive supplement where needed, too much of a vitamin can cause harm.

Here are some examples of what can happen if a child gets too much of a certain type of vitamin:

•       Large quantities of Vitamin A can cause brain swelling, vomiting and distorted vision.
•           Large quantities of Vitamin D can cause nausea and vomiting as well as liver damage.
•           Large quantities of Calcium can cause heart problems.

These are just a few examples of how too much of any vitamin can be harmful. Keeping this

information in mind, if children find or have access to gummy vitamins, they might eat them like candy and end up sick. The Texas Poison Center Network has these tips to help keep vitamins and medicines stored safely:

• Put all medicine up and away and out of sight. Most children easily get into medicines of their parents and grandparents.
• Consider where you keep your medicines and vitamins stored. Children get into nightstands and purses very easily
• Save the Poison Help line in your phone: 1-800-222-1222. Put the toll-free number for the Poison Center into your cell phone so you always have it when you need it.

For more information on gummy vitamins or any other type of vitamin or medicine, you can always reach out to the Texas Poison Center Network with your concerns.

TPCN Spotlight Blog: North Texas Poison Educators Cristina Holloway and Lizbeth Petty

This week we spotlight some of our incredible Texas poison educators. Read below to learn more about our North Texas educators, Cristina Holloway and Lizbeth Petty.

Cristina Holloway

1. Tell me your history with poison control and how you became a SPI. (Length of time worked there/background/passion for this, etc.)

I have worked for the North Texas Poison Center for almost 5 years. With a background in public health and health education, the opportunity to educate ALL people on a subject that they probably know little about and can impact them in a big way was a huge draw to the poison center world for me. It has always been important to me to serve others, especially the under-served. My position as a health educator at the poison center allows me to immerse myself in the varying cultures, cities and neighborhoods of our large region. I love to learn and at the poison center I learn something new every day.

2. I’m sure you hear a lot of interesting stories when answering calls, but what is one story that sticks out in your head that might have been scary, but turned out funny and/or everything worked out after the call.

Although as a poison educator I do not answer calls, we do get to hear the types of calls that come in. While some are frightening or even sad, others can offer some serious comic relief. No matter what the caller is calling for, our specialists are there to help.

3. What do you think people need to know about the people who answer the phones for poison control?

When we are out educating in the community, we always want the people to know that each time they call they will speak to a trained medical professional. We remind them that the PC is open 24/7, assistance is offered in English & Spanish, and it’s free & confidential. It’s also important that they know that people who answer the phones for poison control are just people, just like them, members of our community that are there to help them.

4. What do you enjoy most about your job and why?

There are many parts of my job that I enjoy, but the best part is presenting to a group where maybe they don’t want to be there, or they don’t want to hear about a certain topic, but then afterwards being so grateful for the information. I think there is something really refreshing about receiving information in a clear, unbiased, factual way. Our education team prides itself on presenting data driven information to the public.

5. Why do you think it is important for people to have poison control as a resource for emergency help?

I think it is important for people to have poison control as a resource for emergency help because oftentimes when an emergency happens, people aren’t sure what to do. Knowing the Poison Help # prepares a family or individual for any poison emergency, and I believe that is empowering.

Now more than ever, having poisoning assistance at your fingertips without even having to leave your home is priceless. No literally, it’s FREE!

Lizbeth Petty

1. Tell me your history with poison control and how you became a SPI. (Length of time worked there/background/passion for this, etc.)

I have a background in Public Health and I knew when I graduated that I was looking for a position in which I could truly be a part of the concerted action to restore and maintain the capacity of the field of Public Health. I get the best of both worlds working within our host institution, Parkland Hospital, which is vital to our community in attending to those who are under-served.

2. I’m sure you hear a lot of interesting stories when answering calls, but what is one story that sticks out in your head that might have been scary, but turned out funny and/or everything worked out after the call.

While I do not take calls, I enjoy hearing cases from our SPIs and I take those cases and use them as examples in the community when providing education. I'm also told a lot of stories in the community from my audience.

3. What do you think people need to know about the people who answer the phones for poison control?

I like my audience to connect with me so when I provide education, I am transparent about times I've had to call the Poison Helpline even as an employee. I believe that demonstrates the trust I have for our specialist.

4. What do you enjoy most about your job and why?

I enjoy meeting new people which is why this position is so well suited for me. With just only 4 years underthis role, I am  well known in the community and have made friends basically everywhere I've been.

5. Why do you think it is important for people to have poison control as a resource for emergency help?

This is a service that is not well known but important because it is not exclusive. We are able to provide help to people regardless of their race, gender or age. Accidents or unintentional poisonings can happen to anyone and people need to know that we are there to serve them. It is not an extra service with a fee you can purchase. It is a service willing and ready to help our community.

One Thing to Look Out for this Summer: Harmful Algal Blooms

The summer heat is on in Texas and that is driving many people to lakes, rivers, and beaches. There have been recent reports throughout Texas of harmful algal blooms (HABs) also known as “red tide”, that in recent years have become an increased health concern.

What are HABs?

For starters, algae are known as a nonflowering plant that lives in water. Most types of algae are harmless. HABs are formed by microscopic algae. Algae can sometimes have an overgrowth in areas, which is usually due in part to increased amounts of nitrogen and phosphorus.

Unfortunately, it seems humans are contributing to this issue. An example of how humans might have contributed to this is by fertilizer running off into nearby water coming from farm fields close by. It might not seem like it has the potential to cause a big problem, but when algae take in these rich nutrients, they can start to grow at alarming rates. When they grow, they turn the water various colors of red (hence, the term “red tide”), brown, yellow, and/or green. It can also create an icky film on the top of the water. If you are out and about at a lake, river, or beach this summer and fall, you might notice the algae in the water. These blooms are most often found in the summer or fall seasons.

Why are they dangerous?

Algal blooms consume oxygen and block sunlight that other marine life and organisms live off. They also produce a toxin that is harmful and can kill fish, other marine animals, and in worst-case scenarios, even people. These toxins are known to accumulate in muscles, clams, scallops, and even oysters. People can become ill when they eat these toxic shellfish.

Symptoms of Algal Bloom Ingestion

·       Numbness and tingling of the face, hands, and feet

·       Nausea

·       Vomiting

·       Diarrhea

If you think you have consumed toxic shellfish, please do not hesitate to contact the Texas Poison Center Network.  We are available 24/7 at 1-800-222-1222.

Additionally, HAB’s can also lead to ciguatera fish poisoning which occurs after the fish are exposed to these same toxins. Luckily, these are usually only found around the Caribbean and Pacific Islands. There is still a risk that you might eat contaminated fish from those regions without knowing it. Symptoms are similar to ones from eating the contaminated shellfish. However, one of the defining symptoms of ciguatera poisoning is sensory reversal, in which cold things feel hot and hot things feel cold. While most individuals will recover without any treatment, the symptoms could last weeks. The most common fish to be poisoned with HABs include hogfish, barracuda, and king mackerel. This is due largely in part because these fish are larger in size and tend to eat smaller fish that have consumed HABs.

Can You Swim in Water with HABs?

Water contaminated with HABs can cause a rash, itching, skin irritation, and nose, eye, and throat irritation. If you have asthma, it can cause you even further discomfort, especially if you accidentally inhale the contaminated water. Even swallowing the water can cause diarrhea, nausea, vomiting, and abdominal pain.

How do I prevent HABs Poisoning?

Follow these steps to help eliminate your potential for encountering HABs.

·       Always avoid any contact with water that might be discolored or have a scum or film floating on the top of the water.

·       Try to avoid any activities, like playing, swimming, or boating, in water that looks contaminated by HABs.

·       If you see discolored water or view algal scum, please do not fish in these waters.

·       Try not to swallow or drink water that is not treated. These include lakes, streams, and/or rivers.

·       Same steps apply to your pets!

If you do find yourself in contact with HABs, wash your hands with soap and water, then call the poison center at 1-800-222-1222 to speak with a poison specialist that can provide additional information.