Teenage self-harm and tot paracetamol poisoning

child with paracetamol

Figures from Perth’s Princess Margaret Hospital for Children and compiled by KidSafe have shown that a significant proportion of poisonings are due to self-harm by children aged 14 and over.

During the period July 2010 to June 2015, females accounted for 66.7% of poison-related injury presentations to the hospital’s emergency department; 87% of children aged 13 and over reported that the poisoning was an act of self-harm.

“We normally deal with under-15s, but we do the emergency department reporting for all injury for Princess Margaret Hospital, so we do go up to age 19,” explained KidSafe WA chief executive Scott Phillips.

“And teenagers, particularly female teenagers, are showing a spike over these last few years when it comes to self-harm. So obviously we’ve got people either trying to self-medicate, or overdosing.”

While the “paracetamol challenge” of a year or so ago seems to have been an urban myth, Phillips says that social media challenges such as the Cinnamon Challenge can be dangerous.

During the last financial year 89 intentional poisonings among teenagers were recorded, plus another four unintentional injuries. This was a drop from 171 in the 2012-3 financial year.

During the five year period from July 2010 to June 2015, 2,527 children aged between zero and 15 years presented to the Princess Margaret Hospital Emergency Department as a result of a poisoning related injury.

Of these presentations 1,419 were due to poisonings from pharmaceutical substances, accounting for approximately 56% of the total poisoning injury presentations to PMH ED. Pharmaceutical substances include prescription medications, over the counter medications and herbal or traditional products.

Phillips told the AJP that while teenagers self-harming was a worrying issue, unintentional poisoning incidents involving younger children remains a significant issue, with paracetamol remaining the biggest problem.

Children under five years of age are at greater risk of sustaining an injury due to poisoning from a pharmaceutical substance, accounting for 47.9% of presentations to PMH ED.

He said it was of significant concern that consumers generally don’t understand that paracetamol is dangerous if misused, perhaps because it is so freely available in supermarkets and other non-pharmacy channels.

“Part of the pharmacy role is to explain usage and about some of these dangers, and that’s not going to happen in the supermarket.

“Often they get it from Mum’s handbag – you go out and have a coffee with your girlfriends, your child gets under the table and looks through your handbag for your keys to play with, and they find the paracetamol,” he says.

“We all seem to have gotten rid of our medical cabinets in our houses. We seem to have all our cupboards down low, now, so little children are able to access them – they also access medicines from the fridge.

“We have a lot of incidents where grandparents are looking after the children, and they’re used to just having their medicine out, and they have a lot of it – then it’s a lot more accessible to children when they visit.”

Phillips encouraged pharmacists to talk about medicines storage safety with parents and grandparents.

“Try and talk about products available for parents to safely lock medicines away from little ones,” he suggests.

“From KidSafe’s point of view we’d like good education of parents, and as a health care professional any point of contact with young families, where you can give useful information, is important.

“The pharmacist is in a perfect position for that – simple things, like saying, ‘Did you know paracetamol is the number-one cause of poisoning in little children – so be careful how you store it!’”

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