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Pediatric exploratory ingestions involving novel pill pack packaging
Christopher J Gable1, Sandra P Spencer1, Leah K Middelberg1
1Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States.
The American Journal of Emergency Medicine
|September 20, 2021
Summary
Novel pill packs, while convenient, pose significant risks for pediatric ingestions due to their lack of child resistance. These packaging systems can lead to serious health emergencies in children.
Area of Science:
- Toxicology
- Pediatric Emergency Medicine
- Pharmaceutical Packaging
Background:
- Novel pill packs are emerging as a convenient medication delivery system.
- These packaging systems are designed to hold multiple medications, potentially improving access.
- However, current pill pack designs lack child-resistant features.
Observation:
- Two cases of pediatric ingestion involving suspected pill packs are presented.
- Case 1: A 19-month-old male ingested clonidine and buspirone from mail-delivered "baggies".
- Case 2: A 21-month-old female ingested an unknown substance from mail-delivered "plastic packs", with clonazepam metabolites later detected.
Findings:
- Pill packs increase the risk of accidental pediatric ingestions.
- The multi-medication nature of pill packs can complicate diagnosis in emergency settings.
- Symptoms observed in cases include altered mental status and unsteady gait.
Implications:
- Emergency physicians must be aware of pill packs as a potential source of pediatric poisoning.
- Manufacturers and regulatory bodies should evaluate and mitigate the risks associated with these packaging systems.
- Public health initiatives may be needed to address the dangers of non-child-resistant pill packs.
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