With respiratory illnesses on the rise for both adults and children, many families are turning to cough medications for much-needed seasonal relief. Cook Children’s Health Care System is providing essential safety guidance regarding Tessalon Perles (benzonatate) after seeing cases of accidental ingestion. While effective for older children and adults, health experts are highlighting the importance of strict storage and dosing to prevent accidental ingestion in younger children.

 “Tessalon Perles are used to treat cough for kids over 10 but no safe dosing for younger children has been established,” said Mariana Wilson, M.D., medical director, Cook Children’s Medical Center- Prosper hospitalist. 

Because these liquid-filled capsules can resemble candy, they pose a significant risk to toddlers. Clinical data shows that even a small amount of benzonatate can be toxic to a young child; a recent tragedy in Denton County has prompted local experts to remind families of the need for secure storage.

“Unintentional poisoning can happen to anyone, at any age,” said Klaressa Broughton, poison prevention program coordinator at the Center for Community Health. Broughton explains that these incidents, affecting children from birth through age 18, primarily involved medications and unspecified non-drug poisonings.

In 2025, Cook Children’s Medical Center - Fort Worth saw an increase of poisoning encounters: 1,031 cases compared to 818 in 2024. Broughton explains that the top poisoning for 2025 involved children of all ages from birth to 18 and were related to medication and unspecified non-drug poisonings.  

“If the capsules are chewed, then release of benzonatate from the capsule in the mouth can produce a temporary numbing of the mouth and choking could occur,” explained Wilson. “If parents find a chewed capsule, even if it’s not completely consumed, they should call poison control or come to the ED,” said Wilson.

Cook Children’s experts share what care givers should know to keep their children safe.

Symptoms of Overdose

Symptoms of a benzonatate overdose can appear rapidly, often within 15 to 20 minutes of ingestion:

• Restlessness
• Tremors
• Convulsions
• Coma
• Cardiac arrest

“With technology at our fingertips, it is easy to turn to the internet browser for answers, but this can lead to unclear next steps,” said Broughton. “Calling the poison center at 1-800-222-1222 is free, confidential and all calls are answered by specially trained nurses, doctors and pharmacists.”

If a child becomes unresponsive, call 911 immediately.

Tips for Poison Prevention: 

Safe Medication Dosing 

• Follow the dosing directions listed on the medication by using the appropriate measuring items, such as a medicine cup or oral syringe.
• Double dosing is NOT twice as effective, and in many instances can cause internal damage.
• Adult medications may be too strong for children and should not be given in half doses. Only give medicine to your child that is intended for children.
• Print the medication schedule to keep the right dosage for your family. 

Safe Storage 

• Many people leave medications on bathroom and kitchen counters as well as bedroom nightstands as a visual reminder to take them. Avoid unintentional injury and store medication up high, locked, and out of reach.
• Hang purses and personal bags up high so children cannot reach prescriptions, vitamins, or other regularly used medications.
• Remember, when visiting friends and family, it is ok to have an open discussion about safe storage. 

Safe Disposal 

• DEA Drug Take Back Day is on April 25th from 10 a.m.-2 p.m.
• Visit a medication drop box at a local pharmacy. For more information on poison prevention, visit www.meddropbox.org.
• The best disposal option is to find a drug take-back location, which may be found in retail, hospital, pharmacies, and/or law enforcement facilities.
• Removing any unused or expired medication in the home can reduce the risk of access. 

 Related Stories:

• Expert Tips for a Safe Spring Break: Poison Prevention
• Know When to Use Telemedicine, Urgent Care, or the ER for Kids
• The Ultimate Holiday Safety Checklist

Cases of accidental marijuana ingestion increased again in 2023, a trend reflected in data from the Cook Children’s Emergency Department (ED).

Statistics from the ED at Cook Children’s Medical Center – Fort Worth show 50 patients between ages 0-3 whose urine tested positive for the main psychoactive ingredient in the cannabis plant. Another eight patients in the same age group at the Cook Children’s Medical Center – Prosper ED also had positive screenings last year.

That’s 58 babies and toddlers whose urine contained a molecule called tetrahydrocannabinol (THC), a marker of marijuana intoxication. For comparison, here are the yearly totals for THC-positive urine screenings in patients ages 3 and younger at the Fort Worth ED in recent years:

• 2019: 8
• 2020: 13
• 2021: 29
• 2022: 33

In all those years, the vast majority of patients with THC-positive urine screenings were teens. But there’s a special concern for babies and toddlers because of the drug’s stronger impact on their small bodies.

“Cannabis has the potential to cause significant harm to children in this age range over any other age range. These are the kids who are going to have the most serious side effects,” said Anelle Menendez, M.D., CSPI, clinical educator for the North Texas Poison Center. “It has the potential to cause very significant toxicity in children.”

No amount of marijuana is safe for children. A child who swallows a marijuana product – edibles like gummies or baked goods, or oil from a vaping cartridge – can become extremely sleepy or unresponsive. Their heartbeat could soar. They might struggle to breathe or have trouble crawling or walking.

Calls to the North Texas Poison Center regarding children exposed to cannabis rose more than 1,000% from 2019 to 2023, Dr. Menendez said.

That’s why parents, caregivers, siblings and guests are urged to take precautions with any marijuana in the home. Young children are curious; they put everything in their mouths. They could quickly eat a marijuana-infused candy or cookie they find on a nightstand or in a purse, for instance, leading to an accidental cannabis poisoning.

Klaressa Broughton works to raise awareness in her role as coordinator for the Poison Prevention program at the Center for Community Health, led by Cook Children’s. Broughton said the best safeguard is keeping marijuana out of the home altogether. But if it’s present, keep it locked up, out of reach and out of sight.

“I tell parents to be aware of who’s in their household,” she said. “Do you have toddlers? Do you have teenagers? Keep in mind who’s in your home, and then create a plan to have safe storage instead of leaving those gummies out on the counter.”

March 17-23 is National Poison Prevention Week, which promotes safe use of all drugs, chemicals and products that could be harmful in the wrong amounts. To amplify that message, here’s a closer look at what happens to young children’s brains and bodies from the “high” of ingesting THC.

Get Help Right Away

If a parent or caregiver suspects a child has swallowed an item containing THC, they should immediately seek medical help or call the poison control hotline. The experts who take calls at the hotline will ask how the child is acting and how much time has passed.

“We’re going to go through a thorough evaluation over the phone,” Dr. Menendez said. “What exactly did they get into? How much are you missing?”  Depending on the severity of symptoms, such as seizures, the caller might be instructed to call 911.

“It's going to have a very negative effect on your baby, and it will be one of the scariest moments you ever go through in your life,” she said. “There’s no judgement here; we’re here to help you the best we can.”

She advises adults not bringing marijuana into the home -- or if it’s there, to keep products locked up so that they’re not accessible. Don’t vape, smoke or consume edibles in front of children.

Emergency Care

When children come to the ED with suspected marijuana ingestion, the medical team will do a urine screening for the diagnosis. They’ll monitor the child’s vital signs and fluids, protect the airway, and watch for worsening symptoms. Extra oxygen or a breathing tube could be needed if the patient’s breathing rate becomes short and shallow.

The intoxicating effects wear off usually within about 12 hours. Children treated for marijuana ingestion can typically be discharged to go home from the ED after they become alert, act playful, and resume eating and drinking. High concentrations of THC tend to cause more severe cases, which may require being admitted to the hospital for additional monitoring.

Jamye Coffman, M.D, MPH serves as medical director of the Cook Children’s C.A.R.E. Team, which works to prevent child abuse and neglect. One of the team’s roles is providing medical evaluations for children injured by drug exposure. She’s seen a preschooler wind up on ventilation in the intensive care unit (ICU) from eating just one gummy with a potent THC level.

“A single gummy in the carpet or in the crevice of a couch can be found by a child and be toxic,” Dr. Coffman said.

Even more alarming is the danger of fentanyl ingestion for people of all ages. Dr. Coffman strongly cautioned parents and caregivers to understand that even a small amount of fentanyl can be lethal.

“One pill dropped on the floor or forgotten on a bedside stand could mean the death of your child,” she said. “There are no do-overs. To see a normal healthy child die so needlessly is heartbreaking.  I don’t know how to stress enough the dangerousness of this drug.”

Education and Resources

Poison prevention at Cook Children’s falls under the scope of injury prevention along with gun safety, drowning prevention, safe baby sleep and car seat safety through the Center for Community Health.

“The three things we focus on in my program are Safe Dosing, Safe Storage and Safe Disposal,” Broughton said.

She provides training and teams up with partners such as the North Texas Poison Center and Challenge of Tarrant County. They supply educational materials for events at schools, churches, community centers and other locations. Broughton also distributes resources such as medication lock boxes, cabinet locks and kits for disposing unused medications.  

She said marijuana should always be kept in locked storage because young children are attracted to colorful packaging and the sweet smell of edibles. And if they see a parent consume a marijuana product, they’ll want to try it too. Toddlers can climb onto counters, and it only takes a minute for them to get into something they shouldn’t have, Broughton pointed out. 

What should parents know? “If you choose to use marijuana, keep in mind who's in your home and how to keep your children safe,” Broughton said. “If you do expose them, know what happens and what to look out for.”

If you think your child has ingested marijuana, get medical help or call the Texas Poison Center at 1-800-222-1222. For more information: Marijuana Edibles - Texas Poison Center Network (poisoncontrol.org)

RELATED STORY:

• Statistics from Cook Children’s Emergency Department Show Increase in Marijuana Ingestion Among Children Ages 0-3 (checkupnewsroom.com)

Fears regarding COVID-19 have increased the amount of hand sanitizer and other disinfectants in homes, giving children more access to ingest these products. While hand sanitizer is beneficial for killing germs on our hands, it can be toxic if swallowed or misused.

“The biggest concern with hand sanitizer ingestion in kids is alcohol intoxication that can lead to low blood sugar, which can cause coma and seizures,” said Justin Smith, M.D., pediatrician at Cook Children’s Pediatrics Trophy Club. “Less serious symptoms can include nausea and vomiting.” 

Earlier this month, the U.S. Food & Drug Administration (FDA) issued a warning for a voluntary recall from Ashtel Studios due to hand sanitizer that is packaged “in containers resembling a food and drink pouch.” The appearance of the product is similar to applesauce and fruit packets and marketed with popular children’s characters, like PAW Patrol and Barbie. 

“It’s important that we remember that hand sanitizers should be kept out of the reach of small children, especially those under 5 years old. While keeping our children safe from COVID-19 is very important, we don’t want to let our guard down against other risks,” said Dr. Smith. “And please don’t buy sanitizer in containers that could look like food or could otherwise be more attractive to kids.”

As the coronavirus pandemic continues and flu season arrives, parents need to be more careful than ever to store hand sanitizer out of the reach of children. For more information on poison prevention, visit our website.

"What happens if my child eats all of my adult vitamins?"

We received this question recently. Let's discuss.

Just like any adult medication, vitamins should be locked away so that kids can't get to them. Vitamins are particularly risky because, while they may seem harmless, ingestion of multiple vitamins can be dangerous. In addition, vitamins are colorful and often made in forms that kids love to eat (chewables and gummies).

Vitamin toxicity can occur if a child is taking a few extra vitamins per day or if a child ingests a large amount of vitamins in one sitting.

The most dangerous vitamins ingested by kids are the fat soluble vitamins (A, D, E and K) and iron. Other vitamins and minerals can cause problems as well, but many are passed in the child’s urine without concern.

If you suspect your child has ingested a large amount of any vitamin, call Poison Control at 1-800-222-1222.

They can help you asses the amount that the child ingested and what the risk is.

Most commonly your child will have some stomach upset with or without vomiting. Severe toxicity can occur with Vitamin A and iron, which can lead to multiple problems and ultimately lead to death.

Hope this helps. Just remember to keep all medications locked away and out of reach of your kids. 

Doc Smitty

After all, they’d already seen one rough and tumble boy try to wreck the house and put everything in his mouth, so they were ready for the other two. Or so they thought, until one brief, fluke of a moment.

Heidi World Slaydon gave her son Blaze, who was 18 months old at the time, a bath. Heidi placed Blaze down briefly to grab something and when she picked him up, she realized he’d bitten into a laundry detergent pod. The pod box was said to be child-proofed and Heidi placed it so high up that she used a stool to reach it. But somehow, one got on the floor.

Chris Slaydon, Blaze’s father, said his little boy couldn’t have been on the floor more than 15 seconds. But that was enough time to put it in his mouth and bite into it. After calling poison control, the Slaydons were told to monitor their little child. Within a matter of minutes, Blaze was stumbling around like he was drunk. His parents scooped up Blaze and rushed him to the emergency room in Vernon, Texas.

Teddy Bear Transport took Blaze to Cook Children’s. He spent 10 days in the Pediatric Intensive Care Unit (PICU) after ingesting the laundry detergent pod. He suffered throat burn, infiltrated lungs and a blockage of airway passage, causing him to spend 10 days on a breathing tube.

Doctors treated Blaze with a strong dosage of steroids and a year later Blaze is doing well physically. Although his dad says his son still has the occasional nightmare about the traumatic event. He’s not alone.

“I can’t describe the utter fear we had then,” Chris Slaydon said. “It was terrifying. One, you are so helpless. Two, it’s a child full of innocence. We aren’t talking about an 18 year old. This is an 18 month old. We can’t even talk with him about what’s going on. He’s still in diapers. What happened to Blaze could happen to anyone.”

Single-load laundry detergent pods hit the market in early 2012. In the May 2016 edition, Pediatrics released a comprehensive report on the dangers of "Pediatric Exposures to Laundry and Dishwasher Detergents in the United States."

The study found that of the 117 children who required intubation, 104 were exposed to laundry degergent packets. During the study, 2013-2014, there were two deaths and both were linked to laundry detergent packets.

Because the number of children making contact with these pods, ConsumerReports^® announced that it would not include pods on its list of recommended laundry detergents and strongly urged households with children 6 and under not to keep them in the house.

Laundry pod exposures reported to Texas Poison Center Network (Oct. 1, 2014 – July 16, 2015):

Corwin Warmink, M.D., medical director of the Emergency Department at Cook Children’s, says children under school age are particularly at risk due to the packaging of the pods looking like candy, so ingestion is more likely. Smaller children also are more at risk for severe complications.

The most common effects are vomiting, coughing, choking, fatigue or drowsiness and eye irritation/pain. But it can be much more serious.

“Deaths have occurred and these exposures can be quite severe, causing respiratory depression and failure,” Dr. Warmink said. “The easiest solution is to not keep any such detergent in the house, if you have children … especially under age 6. If you choose to use them, even after all the warnings, keep them in an absolutely child-proof, high cabinet. Although, I’m not sure if there is such a thing”

Just ask the Slaydon family.

“I’m not angry with the company or anything like that,” Chris Slaydon said. “This is a chemical and it’s manufactured to be extremely potent and concentrated. But because of that, it’s a lot more dangerous to kids. You can try to watch your kids 24/7, but it only took seconds for us to take our eyes off of Blaze. People need to be aware this can happen to them. Kids get into stuff. I don’t really blame anyone. I just want parents to be aware that it can happen to them and if you have a little child, don’t keep these products in your house.”

Learn more about poison prevention, by clicking here. 

Every year Cook Children’s treats more than 600 children due to poisonings. Seventy-five percent are medication related. Children can be accidentally poisoned by finding medication belonging to a friend or family member at their house or in their purse or bag; or by getting into a cabinet that contains household cleansers like bleach or window spray.

Nationally, nearly 60,000 young children end up in the ER every year because they got into medicine.

“Telling your child that medicine is candy or disguising it as candy in anyway is never a good idea,” said Corwin Warmink, M.D., medical director of Emergency Services at Cook Children’s. “Young children who can’t read labels may not know the difference between candy and pills or between juice and a cleaner. If you stack them side-by-side, you would have a hard time distinguishing between Sudafed tablets and candies like Red Hots, Tic Tacs or red M&Ms.”

So what do you do if you suspect your child has been poisoned?

Call the North Texas Poison Center help number at 1-800-222-1222 if someone in your family eats, drinks, breathes, touches poison or gets it in the eyes.

1. Program the Poison Center number into your cell phone today.

2. Don’t be afraid to call. Only the people who help you will know your name.

3. The phone line is available 24/7 and your call is free. More than 150 languages are spoken.

4. The Poison Center is staffed by nurses, pharmacists and doctors.

“Parents should call 9-11 immediately if a child, or anyone else in the family, won’t wake up or is having trouble breathing or is having seizures,” Dr. Warmink said.

Here are 5 other things you should know if you expect your child has been poisoned:

1. If your child has swallowed poison, have him or her spit out as much as possible.

2. Don’t make the child vomit, unless the label on the poison or local poison control center ask you to do so. “Vomiting can often times cause even more problems,” Dr. Warmink said. “First of all, it’s usually not very effective at removing the poison and the vomit can also go down the wrong way and find its way into the lungs. Another concern is that products such as cleaners and dishwasher powders can actually cause more burning.”

3. Don’t be alarmed if the child does vomit on his or own, but call for advice. “Sometimes it’s a natural reaction for a child to throw up,” Dr. Warmink said. “If that’s the case, it’s a good idea to give the child a few sips of water and then call the North Texas Poison Center.

4. Don’t use syrup or ipecac to induce vomiting. “This is not something that we recommend any longer as a routine treatment for poisoning,” Dr. Warmink said.

5. Don’t give your child milk without consulting a medical professional first. “First, consult with the professionals at the North Texas Poison Center,” Dr. Warmink said. “Milk can be helpful at times, but depending on what the child absorbed, the milk can increase the possibility of poisoning.” The same holds true for other fluids, such as juice or soda, consult with the Poison Center first.

Here are 5 other things you should know if you expect your child has been poisoned:

1. If your child has swallowed poison, have him or her spit out as much as possible.

2. Don’t make the child vomit, unless the label on the poison or local poison control center ask you to do so. “Vomiting can often times cause even more problems,” Dr. Warmink said. “First of all, it’s usually not very effective at removing the poison and the vomit can also go down the wrong way and find its way into the lungs. Another concern is that products such as cleaners and dishwasher powders can actually cause more burning.”

3. Don’t be alarmed if the child does vomit on his or own, but call for advice. “Sometimes it’s a natural reaction for a child to throw up,” Dr. Warmink said. “If that’s the case, it’s a good idea to give the child a few sips of water and then call the North Texas Poison Center.

4. Don’t use syrup or ipecac to induce vomiting. “This is not something that we recommend any longer as a routine treatment for poisoning,” Dr. Warmink said.

5. Don’t give your child milk without consulting a medical professional first. “First, consult with the professionals at the North Texas Poison Center,” Dr. Warmink said. “Milk can be helpful at times, but depending on what the child absorbed, the milk can increase the possibility of poisoning.” The same holds true for other fluids, such as juice or soda, consult with the Poison Center first.

About the Source

Corwin Warmink, M.D., is medical director of Cook Children's Emergency Services are available 24 hours a day, seven days a week. Cook Children's Emergency Department (ED) treats more than 105,000 patients every year. Our ED is the only EMS-designated pediatric trauma center in Tarrant County. Now, thanks to years of dedication and hard work, Cook Children'sMedical Center has reached Level II Trauma Designation from the American College of Surgeons and the Department of State Health Services. Cook Children's Medical Center is one of nine such facilities in the state of Texas. Click to learn more.

Four species of venomous snakes found in Texas: rattlesnakes, cottonmouths, copperheads, and coral snakes.

Rattlesnakes are most populous in dry areas with prevalent rocks and canyons. When threatened, rattlesnakes will curl into a defensive position and rapidly shake their rattles. Rattlesnakes can be recognized by the “rattle” apparatus at the end of the tail. This species of snake has scales in a distinct diamond pattern, as well as a large head and fangs. Depending on the location, rattlesnakes can vary in color from brick red, buff pink, straw-yellow, beige, brownish and light gray:

Cottonmouth snakes (seen on the right), also known as water moccasins, are found where prey is plentiful. These snakes require large basking sites and will travel far from water to hibernate. Cottonmouths spend the majority of their time coiled at the edge of bodies of water or draped over nearby vegetation:

Copperhead snakes are common in wooded areas from the hardwood bottomlands in east Texas, to woody patches in the Trans Pecos of west Texas. Additionally, copperheads can be found in open areas within short proximity of woods. During the summer, copperheads are most active at night:

Coral snakes are extremely common across the state, from the pine forests in the East to the oak juniper canyons on the Pecos River. These snakes thrive in urban, suburban, and other habitats with plentiful rock crevices or plant cover:

Mark Shelton, M.D., an Infectious Disease doctor at Cook Children’s and an Eagle Scout with the Boy Scouts of America, says it’s important to teach respect for snakes.

If you ignore a snake, more than likely, the snake will avoid you,” Dr. Shelton said. “But kids being kids, that’s sometimes easier said than done. Talk to your children about staying away from the snake. Don’t try to pick it up or kill it. Teach your child not to touch it or walk near it. Children should stand still when they spot a snake, then turn around slowly and walk away. Usually, the snake will crawl away into the bushes.”

Don’t be alarmed by the prevalence of these creepy crawlies within our great state, they love the sun and warmth just like us! Here are 10 tips to stay safe from snakes this summer:

1. Be especially careful of snakes after the rain. They will be seeking dry area and may be on a sidewalk or walking path they normally wouldn’t cross.
2. Don’t canoe or boat under limbs on rivers, streams and lakes.
3. Ignore the snake and they will ignore you.
4. Don’t touch or pick up a snake.
5. Don’t try to kill a snake.
6. Wear closed-toe shoes when in wooded areas.
7. Don’t put fingers under rocks and don’t crawl under houses or other structures.
8. Avoid the edges of lakes, streams, and rivers where vegetation is high.
9. Instruct your children to notify you if they see any species of snakes or other threatening animals.
10. If bitten by a snake, seek medical help immediately. Don’t open the wound or suck out the venom. Seek medical help.

Imagine you are 5 years old. It’s a beautiful day and you are stuck in the house with a fever. Your wonderful mother gives you little orange tablets that taste like oranges. You think taking these little tablets that look a lot like M&M’s will make you feel better really soon. What a wonderful Mom! Then she leaves the bottle with the little orange flavored tablets on the table just a few feet away. What would you do?

I was the child that decided if a couple of little orange things would make me feel better than the bottle of little orange things would get me well quicker and I could get back to playing with my friends. What I didn’t know was that there were enough tablets in that bottle to cause a very large overdose. After I took the pills, my mom noticed that I wasn’t responding to my name. I was nearly unconscious. So I was given a trip to the emergency room at our local hospital. I was fortunate that someone noticed and that it wasn’t something worse. 

A recent study in Pediatrics found that 640,000 emergency department visits were made in the U.S. from 2004 to 2013 because children were able to to get medication without adult supervision.

When I became a mother myself, I was very diligent in keeping medications away from little hands by keeping the medications in a high or locked cabinet. We can protect our children from an accidental poisoning at home by looking at things from their eyes. Everything that looks like candy is interesting to them.

Every year Cook Children’s receives more than 600 children due to poisonings. Seventy-five percent are medication related. Children can be accidentally poisoned by finding medication belonging to a friend or family member at their house or in their purse or bag. Or by getting into a cabinet that contains household cleansers like bleach or window spray. Remind your friends or family members to keep medication and household cleaners out of the reach of your children. Often Grandmother’s medication looks like candy, just like my little orange pills, or the cleanser bottle looks like lemon/lime drink.

Sometimes it’s as simple as not measuring a liquid medication correctly. Ask your pharmacist for a medication measuring spoon or oral syringe so you give the correct amount of medicine to your child. The spoons in your kitchen will not always measure the same amount as a medication spoon.

Also, make sure to keep the poison control number (1-800-222-1222) near your phone in case you need it.

Rosanne Thurman is director of Pharmacy at Cook Children's. Cook Children's pediatric pharmacists are available at the medical center to make sure your child's medicines are safe and effective.That includes helping parents understand what their child's medicine is for, the best times to take the medicine, the right dose, side-effects and any possible drug interaction with other medications that their children may be taking, such as other prescriptions, over-the-counter medications like cough syrup or antihistamines and herbals. They can even tell parents what food and drinks might cause an interaction.