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Travel Safely: Tips for the Holiday Season

The Bottom Line

Over the river and through the woods, to grandmother's house - or maybe on a cruise - or perhaps to a hotel in a new city or a foreign country? Wherever your destination for the holidays, by automobile, plane, ship or sleigh, a little planning will help keep holiday travel safe and enjoyable.

The Full Story

Millions of Americans will travel to visit loved ones or take a vacation at holiday time. Along with the fun and excitement come hazards that may not be present at home.

Carbon monoxide: Your home should have a properly functioning carbon monoxide (CO) alarm near every sleeping area. Carbon monoxide, commonly referred to as "the silent killer", is a colorless, odorless gas. Common sources other than fires include faulty heating and boiler systems, gas appliances, blocked flues and chimneys and vehicle exhaust. Exposure to high levels of CO may cause headache, dizziness, chest pain, weakness, confusion, loss of consciousness, permanent neurological injury and even death. People at higher risk of CO poisoning include infants, young children, the elderly, and pregnant women. 

According to the Centers for Disease Control and Prevention, approximately 41% of reported cases of CO exposure occur during the winter. Increased use of home heating systems, exposure to car exhaust by those stranded during blizzards, use of gasoline-powered generators after winter storms, and indoor use of charcoal grills, kerosene stoves and other types of space heaters contribute to these increased poisonings during the winter months.

The risk of CO exposure remains high during travel. Not all states have laws requiring CO alarms in hotels, and those laws may not require a CO alarm in each room. Avoid tragedy. When staying in hotels, apartments or others' homes, take your own battery-operated travel CO alarm with you.

Poison-proofing while traveling: Though you may have child-proofed your own home, these protections are probably not in place when you leave home. When staying in a hotel, take a few minutes to inspect and child-proof the room. Look under beds and furniture for stray pills or foreign bodies that may pose a poisoning or choking hazard. Keep medications and personal hygiene items such as mouthwashes, including those provided by the hotel, out of the reach of children. 

But what if you are taking your small children to visit grandparents who have not had little ones around for a long time? Their homes may not be child-proofed. Discuss your concerns, diplomatically, in advance. Emphasize that child-proofing makes the whole visit more fun for everyone by limiting time having to use the word "no" with the children. Offer to bring your own child-proofing supplies and then make sure to take them with you. 

Older persons may be more likely to have unsecured medications in the home. Medications left in sight of small children, often in pill-minders or other containers that are not child resistant, are a major poisoning danger. Most emergency room visits for pediatric medication poisoning in children age 5 and under are due to the child taking the medication themselves. Opioid-containing medications (such as morphine, codeine and oxycodone), muscle relaxants, sleeping pills, diabetes pills, and heart medications are especially dangerous for children. 

Alcohol: Holiday celebrations often include alcoholic beverages. Ensure that there is a designated child "watcher" during the party. Small children are curious. Many alcoholic beverages at parties are sweet and tasty. A small child can be poisoned by drinking alcohol, resulting in excessive drowsiness, vomiting, even decreased breathing and coma. 

Clean up immediately after holiday parties. A young child may wake up early the next morning and drink leftover alcohol, eat cigarettes, or choke on leftovers. 

Speaking of alcohol at holiday celebrations, how often have you heard, "Don’t drink and drive"? Take this advice to heart. You may be visiting an area with which you're not familiar, adding even more danger. Make sure there's a designated driver who has pledged not to drink any alcohol on that occasion. Stop drinking alcohol a few hours before the party ends, keep well-hydrated with non-alcoholic beverages such as water or soda, and eat some food. If you have been drinking and need a ride, call a sober/safe ride service which offers free cab rides to your destination on some holidays.

Button batteries: The holiday season means many more toys and other gifts around children that contain button batteries - such as watches, remote controls, lighted ornaments, singing greeting cards, calculators, flameless candles, and innumerable other products. You may think that there are no button batteries in your home or the homes or other accommodations you’re visiting, but think again! Button batteries are virtually everywhere. 

When a child swallows a button battery, it may stick in the esophagus and cause a severe burn injury in as little as 2 hours. It may not be immediately apparent that an injury has occurred. But the damage to the esophagus, vocal cords and trachea can be severe and require painful treatment and surgery. Search your home, and any home or hotel you visit, especially for anything that may contain coin-size lithium button batteries. Keep these items containing such lithium batteries locked up, or place heavy tape such as duct tape over the item to secure the battery compartment. If you suspect a child has swallowed a battery, call the Battery Hotline (202-625-3333), then go to the nearest emergency room immediately. If you have any doubt, do not take any chances, act right away. 

Enter the National Battery Ingestion Hotline (202-625-3333) into your phone right now. Share this information with everyone you know. You could save a child's life!

Poison Control is standing by, on holidays and every day of the year, 24/7. If you suspect any kind of poisoning, use the webPOISONCONTROL® online tool for guidance or call 1-800-222-1222.

Mary Elizabeth May, RN, BA, MPH
Certified Specialist in Poison Information


For More Information

Carbon monoxide and carbon monoxide alarms:

Grandparents and child safety: 

Safety Tips for Button Batteries:

Poison prevention:


References

Iqbal S, Law H-Z, Clower JH, Yip FY, Elixhauser A. Hospital burden of unintentional carbon monoxide poisoning in the United States, 2007. American Journal of Emergency Medicine. 2012; 30(5): 657-664. 

Annest J, Haileyesus T, Clower J, Yip F, Stock A, Lucas M, Iqbal S.  Nonfatal, unintentional, non-fire-related carbon monoxide exposures – United States, 2004-2006. Morbidity & Mortality Weekly Report. 2008; 57(33): 896-9.  

Poisoned?

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Prevention Tips

  • Prevent carbon monoxide (CO) poisoning.
  • Take a battery-operated portable carbon monoxide detector with you while traveling.
  • Do not sit in an idling car with the windows closed, especially if snow could be blocking the exhaust pipe.
  • Child-proof your destination.
    • Inspect your accommodations. Child-proof before moving in.
    • Keep medications and personal hygiene items out of the reach of children.
  • Keep holiday parties safe for children.
    • Designate a child "watcher" throughout the celebration.
    • Keep alcoholic beverages out of the reach of children.
    • Clean up immediately after the party.
  • Don't drink and drive - ever.
  • Be on the alert for button batteries.
    • Lock up button batteries, lithium cell batteries, and gadgets which they power. Or, put duct tape over the battery compartment to keep kids away from the batteries.
    • Enter the National Battery Ingestion Hotline (202-625-3333) in your phone right now.

This Really Happened

Case 1: A 50-year-old man stayed in a hotel overnight on business. He normally took his own battery-operated carbon monoxide (CO) detector when traveling, but since it was only a one-night trip, he decided not to. When he went to bed that night, he had a headache and felt dizzy. He woke up hours later, confused but alert enough to call for help on his cell phone. He was found unconscious a short time later. The fire department found high levels of CO in his room. He was transported to the nearest emergency room on 100% oxygen. The patient’s blood levels indicated a significant CO exposure. The emergency physician called Poison Control. The poison specialist recommended hyperbaric oxygen (HBO) as soon as possible. The patient underwent 3 HBO treatments.Two days after exposure to carbon monoxide he was doing well and was discharged. 

Case 2: A 20-year-old man was found unconscious in a running car, apparently trying to keep warm during a heavy snow storm. High levels of CO were detected at the scene. He was flown to a shock-trauma center where a breathing tube was placed. His physician consulted Poison Control. He received several HBO treatments but had suffered brain damage. He remained on a ventilator for several weeks in the hospital and was then admitted to a rehabilitation facility, still minimally responsive. 

Case 3: While visiting the home for a holiday, a 3-year-old boy swallowed an unknown amount of a relative's glipizide. Glipizide is a diabetes medication that can cause severe and prolonged low blood glucose (hypoglycemia) in overdose. His mother called Poison Control and was referred to the nearest emergency room. He was admitted to the hospital. The little boy developed significant hypoglycemia and required several high doses of dextrose (a sugar solution) intravenously. His blood glucose returned to normal about 24-hours later and he was sent home. 

Case 4: A 1-year-old boy was brought to the emergency room with a history of constantly crying, drooling and gurgling for the prior 12 hours. The emergency physician obtained a chest x-ray. The film revealed what appeared to be a large bottle cap stuck in his esophagus. The child began having trouble breathing. He underwent emergency surgery to remove what were discovered to be two 20 mm lithium cell button batteries. He may have removed them from a toy. The child had severe burns of his esophagus. A breathing tube was placed and he was admitted to intensive care. He developed scarring and strictures of his esophagus requiring several surgeries and dilation to keep his esophagus from closing. He was in the hospital for 2 weeks. During the following year he needed regular dilations of his esophagus. A year after swallowing the batteries, he was improving and starting to eat soft foods.