At Cook Children's, we're here for it all.

That statistic comes from Up and Away and Out of Sight, a platform that raises awareness of the danger of overdoses that happen accidently. Prescription medications, over-the-counter medications, vitamins and supplements can all be harmful if they aren’t used as intended.

March 16-22 is National Poison Prevention Week, a chance to educate parents and caregivers about the importance of keeping children and teens safe from ingesting substances that can be dangerous. Poison prevention at Cook Children’s falls under the scope of injury prevention along with gun safety, drowning prevention, safe baby sleep and vehicle safety through the Center for Community Health.

Schools, clubs, libraries and organizations such as North Texas Poison Center work in partnership with the Center for Community Health. The center’s poison prevention program distributes medication lock boxes, cabinet locks and kits for disposing of unused medications.  

“Education and resources are shared at each level to help influence safer practices while the messaging stays consistent,” said Klaressa Broughton, program coordinator. “We use social media ads, trainings, parent group presentations, local community events and health fairs for the greatest reach and overall impact.”

Three Key Points

You can help prevent accidental overdoses with these layers of protection:

1. Safe dosing – Follow a medication schedule checklist to make sure your child gets the right amount at the right time. Set an alert on your phone to remind you when it’s time for another dose. Measure accurately using an oral syringe, dosing cup or dropper. Follow the instructions on the bottle.

2. Safe storage – Keep medications in a locked cabinet that children can’t access. According to the Cook Children’s 2024 parent/caregiver survey covering an eight-county service area of North Texas, about 570,400 children live in homes where medications aren’t always locked up.

3. Safe disposal – Remove any unused or expired medication from the home by taking it to a designated drop box. Don’t flush them down the toilet or pour them in the sink.

Medication safety can be an extra challenge, Broughton said, when families are traveling or when houseguests bring medications into your home. Good communication is needed if a child stays with multiple caregivers.

“A common mistake is double-dosing,” she said. “Similarly, it’s important to not take a medication that is not prescribed to you or for your age range. It may be very harmful.”

Ask Your Pediatrician

Karen Evans, M.D. points out that medications for children are usually calculated based on weight. When writing a new prescription, she explains the dosing instructions with the parents of her patients at Cook Children's Pediatrics Parkwood in Frisco while in the office.  

“That opens the door for the parent to ask questions,” she said, adding that pediatricians and pharmacists are happy to answer those questions.

From her experience as a mom with three kids, Dr. Evans offered a tip: If your child is sick, have a syringe or dosing spoon washed and handy in case your child wakes up with fever in the middle of the night. Review the dosing instructions ahead of time. Making a plan for dispensing medication can help prevent mistakes when you’re exhausted.

Never try to trick a child by saying medicine is candy, Dr. Evans advised.

She also emphasized the risk of teens sharing medication with other teens. Parents should talk with their teens about taking medications only from trusted adults. Even if a friend at school offers what appears to be a familiar brand of pain reliever, you can’t be sure what the substance is, Dr. Evans said.

Warning signs of potential overdose include change in the child’s behavior or awareness, vomiting, choking, trouble breathing, seizures or not responding. Call 911 and get medical help right away.

Contact the Texas Poison Center at 1-800-222-1222.  

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A recent study done in the adult oncology world and published in JAMA, found that doctors had a perception that patients were demanding extra treatment and testing. Review of the patient encounters showed that doctors perceived demands that did not actually occur. Many of the requests that did occur were medically appropriate.

In pediatrics, the most common issue where this comes to a head is the desire to give children antibiotics. It can also play out in other areas as well. Another common one that comes to mind is request for further testing for diagnosis.

Fortunately, in my experience, parents are becoming more informed about what situations require antibiotics and which illnesses will pass with a little time and TLC.

The problem is that many doctors have gotten into the unfortunate habit of wanting to provide what the parents are requesting without actually asking the parent what they expect. Doctors may perceive that parents want antibiotics or further testing when, in fact, they simply want reassurance that waiting is OK. This becomes a particular problem in urgent care or retail clinics where patient satisfaction plays a bigger role in getting patients to come back and see you.

So, how can you prevent this from happening to you?

Here are five casual statements that you might use the next time you visit the doctor to help them understand your expectations:

1. I’m pretty sure I’m just over concerned. I just wanted you to check things out so I can be sure.

2. I don’t really like to give my kids medicine but I wanted your opinion about what we should do next.

3. I’m totally OK with waiting, if that’s what you think is best.

4. What would you do if it were your child?

5. Are there other things we can try first or other options?

Your doctor should not feel threatened by these statements. If antibiotics are the only right choice, they should be able to explain the reasons why that is.

“Hey bud, how did you get that BAND-AID^®?”

“I just climbed up on this and got it (from the medicine cabinet).”

Those are 2 conversations that happen frequently and just yesterday, respectively, in my house.

A study released this month in Pediatrics (the journal of the American Academy of Pediatrics) looked at out-of-hospital medication errors in patients less than 6 years of age.

There were many questions that the study looked to answer:

How common are medication errors?

Almost 700,000 errors in these children over the 10 year period, that is equal to 1 error every 8 minutes.

Many of these were minor and required no medical care, but there were almost 2,000 children who required intensive care and 25 death due to medication errors.

What type of medications were associated with more errors?

Liquid medications were the most common, accounting for 81.9% of the errors. These kids are more likely to be taking liquid medications so this might be expected but it’s still a good reminder we need to be cautious.

Where do the ingestions occur?

The child’s own home was the location of the ingestions 96.9% of the time.

What errors were the most common?

The 5 most common errors were:

1. Medication accidentally given twice.
2. Confused the units of measure (1  milliliters (mL) vs 1 teaspoon (tsp).
3. Wrong medication taken/given.
4. Medication given too soon.
5. Accidentally was given or took someone else’s medicine.

So what can you do to protect your child?

1. Be aware. These errors are common and we need to be aware.
2. Be cautious with liquid medications. Kids can find and ingest them more easily and dosing errors are more common.
3. Protect your own home. Make sure that medications are locked away in a safe place.
4. Double, triple and quadruple check your dosing. You know the saying measure twice and cut once? For meds it should be measure 5x and give once.
5. Assign a primary medication giver for the house. If anyone else is giving meds, run it through them first.