During the Christmas holiday, stockings are hung. Homes are decorated with ornaments and lights. Family and friends visit from near and far. What could possibly go wrong? There are several holiday hazards that you should keep in mind during the holiday season. A few of those hazards include visiting families’ medications, methylene chloride “bubble” ornaments, hidden alcohols, and the ever-present poinsettia.
Medications: Any ingestion of medication can be dangerous if it is not prescribed to you. During the holidays, the poison center observes an uptick in exposures involving children and pharmaceuticals. Some of the most dangerous ingestions, considered one pill / sip can kill in children under 2 years old, include calcium channel blockers, beta blockers, colchicine, opioids, sulfonylureas, and liquid nicotine. Be aware of what is new and available coming into your home. Remind guests to keep medications stored safely and out of reach of your children and pets.
Methylene chloride: Bubble light ornaments are brightly colored and very pretty on the tree. Unfortunately, the liquid in them is a chemical called methylene chloride. This chemical, when ingested, gets metabolized by the body into carbon monoxide, resulting in severe and possibly life-threatening symptoms. If any exposure occurs, a carboxyhemoglobin level should be obtained, and oxygen administered. Keep bubble light ornaments up and high on the tree, out of the reach of children.
Hidden alcohols: Holiday baking is a popular activity around Christmas. Many people are unaware that the flavor extracts available in the baking aisle contain high percentages of ethyl alcohol or ethanol. Extracts like vanilla, mint, and almond extract can contain up to 35% ethanol. This is the same amount of ethanol you can find in many common liquors. Accidental ingestions, as well as intentional ingestions, have occurred. Keep extracts up and out of reach of children. Do not add extracts directly to children’s beverages.
Poinsettia: Poinsettia exposures are very common during the Christmas holiday. A common wives tale warns mothers about the dangers of poinsettia. While the milky, white sap that comes from tearing the leaves can be a dermal and mucosal membrane irritant, toxicity from poinsettias is self-limited and typically mild in nature. A Christmas cookie and a cold glass of milk are the recommended therapies in poinsettia exposure.
If there are any concerns or questions about an exposure or a patient, the Tennessee Poison Center staff’s nurses, pharmacists, and physicians to answer the phones 24/7 – even on Christmas. Please do not hesitate to call, 1-800-222-1222! Have a happy and safe holiday from your friends at the Tennessee Poison Center.
This question was prepared by Nena Bowman, PharmD, DABAT
I am interested in any questions you would like answered in the Question of the Week. Please email me with any suggestion at donna.seger@vumc.org.
Donna Seger, MD
Executive Director
Tennessee Poison Center
Poison Help Hotline: 1-800-222-1222