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Pediatric caustic ingestion and parental cocaine abuse
Noah Massa1, Jeffrey P Ludemann
1Division of Otolaryngology, ENT Clinic, British Columbia's Children's Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada.
Objective:
To report two cases in which toddlers drank a caustic liquid which their parents had been using to prepare free-base and crack cocaine.
Design:
Case series.
Results:
Two toddlers presented with first- and second-degree burns of the oral cavity, pharynx and esophagus from caustic ingestion. The first had drunk ammonia from an unmarked clear plastic container the morning after "a party at a friend's house". The second had drunk potassium hydroxide from a clear plastic container which was labelled "pH UP" and had a small "Danger" sign. Both children were treated with intravenous hydration, steroids, antibiotics and analgesics. Fortunately, neither child suffered long-term physical sequelae. When questioned, the parents of both children admitted to using these alkalis to prepare free-base and crack cocaine. Appropriate steps were taken by social services to protect these children from further neglect.
Discussion:
Despite federal legislation and public education, pediatric caustic ingestion remains a significant problem. These cases suggest that, in certain cases of pediatric caustic ingestion, caregivers should be questioned regarding possible drug abuse. Larger warning labels and further public education might help prevent many cases of pediatric caustic ingestion.