Episode 376: #87-4 Poison Control: Q & A

In months with five weeks, The Virtual Curbside steps away from clinical topics for a pediatric book club discussion. In this month’s book club episode, we explore Humbitious: The Power of Low-Ego, High-Drive Leadership by Amer Kaissi. Our hosts Paul Wirkus, MD, FAAP and Angelo Giardino, MD, FAAP reflect on the concept of “humbition” - balancing humility with ambition - and discuss how these leadership principles apply to pediatric practice. The conversation highlights how low-ego, high-drive leadership can strengthen team dynamics, improve patient care, and support more collaborative, compassionate healthcare environments. No credit available for this episode. See vcurb.com for additional episodes.

In this Q&A episode of our Poison Control series, Host Paul Wirkus, MD, FAAP and guest Michael Moss, MD address emerging trends and high-risk behaviors contributing to pediatric and adolescent poison exposures. Our experts discuss substances sometimes used in social media challenges - including diphenhydramine, combination cold medications like NyQuil, and household items such as salt, nutmeg, cinnamon, and detergent pods - and the real dangers associated with these ingestions.The conversation also highlights serious risks tied to everyday household products, including tiki torch fuel and inhalant (“huffing”) exposures. Throughout the episode, we emphasize early recognition of concerning symptoms, proactive counseling for families and adolescents, and the importance of open, nonjudgmental conversations about risk-taking behaviors.If there is ever a concern about a possible poisoning, contact Poison Control at 1-800-222-1222 for immediate guidance anywhere in the United States.Have a question? Email [email protected]. For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In recognition of Poison Prevention Week, this episode of our Poison Control series focuses on practical strategies to prevent pediatric poison exposures. Host Paul Wirkus, MD, FAAP and guest Michael Moss, MD, discuss the importance of safe medication and household product storage, correct medication dosing, and how tools such as pill imprint codes can help identify unknown medications. The conversation also highlights common pitfalls, including the risks of relying on internet searches or AI tools for guidance during a potential poisoning event. Instead, clinicians and families are encouraged to use trusted, expert resources when questions arise.If there is ever a concern about a possible poisoning, contact Poison Control at 1-800-222-1222 for immediate guidance anywhere in the United States.Have a question? Email [email protected]. They will be answered next week.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In this episode of our Poison Control series, host, Paul Wirkus, MD, FAAP and guest Michael Moss, MD, focus on several high-risk exposures commonly encountered in pediatrics. Our guests review toxic thresholds for medications such as acetaminophen, discuss the dangers of prescription medication ingestions, and highlight particularly hazardous household items, including button batteries, magnets, hydrocarbons, and cleaning agents. The conversation emphasizes early recognition, appropriate initial management, and when to seek expert guidance. Listeners will gain practical insights to help prevent serious injury and respond effectively when exposures occur.If there is ever a concern about a possible poisoning, contact Poison Control at 1-800-222-1222 for immediate guidance anywhere in the United States.Have a question? Email [email protected]. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This month we turn our attention to Poison Control, beginning with an overview of why children are uniquely vulnerable to toxic exposures. In this episode, our host, Paul Wirkus, MD, FAAP and guest Michael Moss, MD review common pediatric ingestions, household risks, and explain factors that increase children's vulnerabilities.We also take a behind-the-scenes look at how the nation’s poison control system works - how calls are triaged, who provides guidance, and how centers collaborate across the country to deliver real-time, evidence-based recommendations. Most importantly, we emphasize when and how to use this invaluable resource.If you have a concern about a possible poisoning, call 1-800-222-1222 to reach your local poison control center anywhere in the United States.Have a question? Email [email protected]. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In this Q&A episode of our neonatal opioid withdrawal syndrome (NOWS) series, we address challenging and nuanced clinical questions surrounding withdrawal, toxicology testing, and newborn exposures. Our host, Paul Wirkus, MD, FAAP, and guest Camille Fung, MD, review the early signs of withdrawal and discuss the process of obtaining consent for neonatal toxicology screening, clarifying when testing is considered diagnostic and how results may have reporting implications.We also explore common clinical scenarios, including the impact of maternal fentanyl administered via epidural on newborn toxicology results, and how in utero SSRI exposure may present with symptoms such as apnea, posturing, or seizure-like activity. The conversation further examines the effects of prenatal THC exposure, addressing common misconceptions, potential neonatal impacts, and the persistence of THC in breastmilk.Throughout the discussion, the emphasis remains on careful clinical assessment, clear communication with families, and a nonjudgmental, evidence-based approach to care.Have a question? Email [email protected] more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In this episode, we continue our series on neonatal opioid withdrawal syndrome (NOWS) with a discussion of substance exposure in the perinatal period and the practical considerations surrounding testing and discharge planning. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the fundamentals of prenatal substance exposure and the rationale for testing, including what different methods - such as urine, meconium, and umbilical cord testing - can and cannot tell us. The conversation explores the limitations of testing and how results should be interpreted in the clinical and social context of each family.We also discuss discharge planning, including referrals to primary care pediatricians and child welfare agencies when appropriate, and what clinicians and families can expect regarding developmental follow-up. Throughout the episode, Dr. Fung emphasizes the importance of a nonjudgmental, supportive approach that fosters trust and promotes the best outcomes for infants and their caregivers.Have a question? Email [email protected]. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In this episode, we continue our series on neonatal opioid withdrawal syndrome (NOWS) with a discussion of substance exposure in the perinatal period and the practical considerations surrounding testing and discharge planning. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the fundamentals of prenatal substance exposure and the rationale for testing, including what different methods - such as urine, meconium, and umbilical cord testing - can and cannot tell us. The conversation explores the limitations of testing and how results should be interpreted in the clinical and social context of each family.We also discuss discharge planning, including referrals to primary care pediatricians and child welfare agencies when appropriate, and what clinicians and families can expect regarding developmental follow-up. Throughout the episode, Dr. Fung emphasizes the importance of a nonjudgmental, supportive approach that fosters trust and promotes the best outcomes for infants and their caregivers.Have a question? Email [email protected]. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In this episode, we continue our discussion of neonatal opioid withdrawal syndrome (NOWS), focusing on clinical features, treatment, and care after discharge. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the signs and symptoms clinicians use to recognize and assess withdrawal, along with current approaches to medication management and supportive care in the hospital setting. The conversation also addresses discharge planning, including criteria for safe transition home and coordination with caregivers. Finally, we explore the important role of the primary care pediatrician in follow-up—monitoring growth and development, supporting families, and coordinating ongoing services to promote the best possible outcomes for these infants. Have a question? Email [email protected]. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This month we are focusing on neonatal opioid withdrawal syndrome (NOWS), with an emphasis on the underlying physiology and clinical presentation. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the mechanisms of opioid exposure and withdrawal, including neuroexcitability and the gastrointestinal and autonomic manifestations commonly seen in affected newborns. The discussion also highlights the role of specialized clinics and coordinated care models that support mothers during pregnancy and the postpartum period. Together, this episode provides a foundational understanding of NOWS to help clinicians recognize symptoms early and deliver informed, compassionate care to both infants and their families. Have a question? Email [email protected]. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.