Vicky, a school nurse called. A special-needs student, a little boy aged 8, had eaten a good portion of a toy. “Well, not the toy itself. It’s this special kind of “Real-Life Reptile” and he chewed a hole in the tail and ate a bunch of these little white beads …. what we want to know is if those beads are toxic or not?”
First I established that the little boy, Ricky, was generally healthy and having no obvious problems at this time. He had been given a glass of water to drink and was doing so without problem. They estimated the amount of beads he had ingested as ¼ cup….
"Do you have the original packaging on the toy, and does it say non-toxic?"
"Oh no, we never keep all that stuff."
"Then do you know the manufacturer’s name or number?"
"Only what it says on the tag..."
Turned out the tag said the product was a "Real-Life Reptile" made by Boinky Ball Toys (all names changed to protect the innocent), but nothing more. The particular reptile he had ingested was a "Fast & Friendly Gecko," blue-green with bulging orange eyes and red toes.
I did a quick search on our Poisindex© system – neither the toy nor the manufacturer was listed.
Then I did a quick Google© search – and voila! Boinky Ball Toys was listed, and so was our little reptile friend... unfortunately there was no information on the contents and their potential risks if ingested.
I advised Vicky that I doubted this was a toxic exposure, as toys are generally made with non-toxic components, because kids do tend to nibble on them. I suggested that I take her number, and that I would call the company and track down the actual ingredients, just to be sure. Meanwhile she would closely monitor little Ricky. She was agreeable with that approach.
I called Boinky Ball Toys and spoke to Tiffany in their Customer Service department. Eventually I got her to understand that I wasn’t interested in placing an order but I needed to speak with someone in charge of product development, to find out what the product was made of. Then I spoke to Shelly, who said I needed to talk to Dave, "but he’s in a meeting right now, may I have him call you?" I explained, yet again, that we had a child that had EATEN their toy and we needed to know sooner, rather than later, what the toy was composed of. Shelly promised to interrupt Dave’s meeting.
A few minutes later, Dave called back. He had obtained the MSDS on the toy and was pleased to report that the white pellets were vulcanized plastic and totally non-toxic. I thanked him for his time and called Vicky back.
"Good news, it’s just plastic, completely non-toxic," I told her. "The only risk would be a concern for obstruction, but that’s unlikely since the format that Ricky swallowed was all tiny pellets." Still I recommended that he be fed a high fiber, high fluid diet for a few days and that he be watched for any signs of an acute abdomen. Of course, if he developed any symptoms, he should be checked by his FMD and that the physician needed to be informed of this exposure.
When Indiana Poison Center opened it’s doors, in 1977, nurses used a microfiche to look up general topics and made a general guess as to their contents. When I joined IPC in 1988, they had recently moved to a computerized database, Poisindex©, which tries to list every possible substance and it’s ingredients, with general directions on managing each. Since the early 2000s, with the advent of the internet, we’ve turned more and more to Google© and other search engines to help us find things that have yet to hit the database. But often technology is still not enough and it comes down to basic research and personal interaction to find the information that we need.
Was all that necessary? Well, I could have slept pretty well that night, knowing that the chance was 99.9% that Ricky’s ingestion was non-toxic... but I’d rather take the extra time, make the extra calls, and make 100% certain there was NO risk – treating that child like my child. So that’s what I did.
Gwenn
To be a registered nurse at Clarian, visit RN Job Opportunities Indiana.
First I established that the little boy, Ricky, was generally healthy and having no obvious problems at this time. He had been given a glass of water to drink and was doing so without problem. They estimated the amount of beads he had ingested as ¼ cup….
"Do you have the original packaging on the toy, and does it say non-toxic?"
"Oh no, we never keep all that stuff."
"Then do you know the manufacturer’s name or number?"
"Only what it says on the tag..."
Turned out the tag said the product was a "Real-Life Reptile" made by Boinky Ball Toys (all names changed to protect the innocent), but nothing more. The particular reptile he had ingested was a "Fast & Friendly Gecko," blue-green with bulging orange eyes and red toes.
I did a quick search on our Poisindex© system – neither the toy nor the manufacturer was listed.
Then I did a quick Google© search – and voila! Boinky Ball Toys was listed, and so was our little reptile friend... unfortunately there was no information on the contents and their potential risks if ingested.
I advised Vicky that I doubted this was a toxic exposure, as toys are generally made with non-toxic components, because kids do tend to nibble on them. I suggested that I take her number, and that I would call the company and track down the actual ingredients, just to be sure. Meanwhile she would closely monitor little Ricky. She was agreeable with that approach.
I called Boinky Ball Toys and spoke to Tiffany in their Customer Service department. Eventually I got her to understand that I wasn’t interested in placing an order but I needed to speak with someone in charge of product development, to find out what the product was made of. Then I spoke to Shelly, who said I needed to talk to Dave, "but he’s in a meeting right now, may I have him call you?" I explained, yet again, that we had a child that had EATEN their toy and we needed to know sooner, rather than later, what the toy was composed of. Shelly promised to interrupt Dave’s meeting.
A few minutes later, Dave called back. He had obtained the MSDS on the toy and was pleased to report that the white pellets were vulcanized plastic and totally non-toxic. I thanked him for his time and called Vicky back.
"Good news, it’s just plastic, completely non-toxic," I told her. "The only risk would be a concern for obstruction, but that’s unlikely since the format that Ricky swallowed was all tiny pellets." Still I recommended that he be fed a high fiber, high fluid diet for a few days and that he be watched for any signs of an acute abdomen. Of course, if he developed any symptoms, he should be checked by his FMD and that the physician needed to be informed of this exposure.
When Indiana Poison Center opened it’s doors, in 1977, nurses used a microfiche to look up general topics and made a general guess as to their contents. When I joined IPC in 1988, they had recently moved to a computerized database, Poisindex©, which tries to list every possible substance and it’s ingredients, with general directions on managing each. Since the early 2000s, with the advent of the internet, we’ve turned more and more to Google© and other search engines to help us find things that have yet to hit the database. But often technology is still not enough and it comes down to basic research and personal interaction to find the information that we need.
Was all that necessary? Well, I could have slept pretty well that night, knowing that the chance was 99.9% that Ricky’s ingestion was non-toxic... but I’d rather take the extra time, make the extra calls, and make 100% certain there was NO risk – treating that child like my child. So that’s what I did.
Gwenn
To be a registered nurse at Clarian, visit RN Job Opportunities Indiana.
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