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January 2016

Children's, Health and Safety


Chances are when it was cold outside, your mother would say, “Put your gloves on! You’ll get frostbite!” If it was freezing, your mother wasn’t exaggerating. Frostbite is, literally, frozen body tissue. It usually affects the skin but can sometimes affect deeper tissue. The areas most prone to frostbite are the fingers, toes, face and ears.

Children are at greater risk for frostbite than adults because they lose heat faster than adults, and they may play outside in cold temperatures for longer periods of time.

It’s important for parents to recognize the signs of frostbite so they can get proper treatment.

What to Watch For


Frostnip is a milder form of injury. It usually affects areas of skin exposed to the cold, such as the cheeks, nose, ears, fingers and toes, leaving them red and numb or tingly. Frostnip can be treated at home and gets better with rewarming. Stay alert because frostnip is considered to be an early warning sign of frostbite!


Frostbite is characterized by white, waxy skin that feels numb and hard. It requires immediate emergency medical attention. Frostbite can be associated with hypothermia, which is a serious medical emergency. Blistering may occur as well, which also is considered a medical emergency.

If you believe your child has frostbite, contact a doctor immediately. Get your child into dry clothing and a warm environment. Give your child a warm drink and begin first aid immediately. Immerse frozen areas in warm, but not hot water. Do not use direct heat such as a fire or heating pad on the skin. The skin may be numb and can burn easily.


Of course, it’s best to prevent frostbite before it occurs. To help prevent frostbite in cold weather:

  • Stay updated on weather forecasts. If it’s extremely cold, even brief exposure can cause frostbite.
  • Dress children in windproof, waterproof clothing when in the snow.
  • Dress kids in warm layers and use hats, gloves, scarves, thick socks and well-insulated boots to cover body parts that are most prone to frostbite.
  • Make sure children come indoors regularly to warm up.
  • Change children out of wet clothing and shoes as soon as possible.
  • It’s okay for children to play in the snow, but make sure they are bundled up, check on them often (Remember they may not tell you when they’re cold) and require they take frequent breaks to warm up indoors and change into warm, dry clothes.

For more information about frostbite visit

Children's, Health and Safety

Beware the Dangers of “Safer” E-Cigarettes

Ann P. Slattery  DrPH, RN, RPh, CSPI, DABAT is the Managing Director and Clinical Toxicologist of the Regional Poison Control Center at Children’s of Alabama. She is a registered nurse, registered pharmacist and holds both a Master’s degree and Doctorate in Public Health. Ann is a member of member of the American Association of Poison Control Centers, the American Academy of Clinical Toxicology and the American Board of Applied Toxicology. 

VapingThe dangers and side effects of smoking cigarettes are well documented, but electronic cigarettes that are promoted as a “safer” alternative can be just as harmful.
Electronic cigarettes, or e-cigarettes, are battery-powered smoking devices. They use cartridges filled with a liquid that contains nicotine, flavorings and other chemicals. A heating element in the e-cigarette converts the e-liquid into a vapor that can be inhaled. Using e-cigarettes is sometimes called “vaping.”

“Even without the tobacco, there are several dangers associated with vaping,” said Ann Slattery, managing director of the Regional Poison Control Center at Children’s of Alabama. “When you are vaping, you are inhaling substances that your lungs aren’t equipped to handle.”

One such ingredient in the e-liquid is propylene glycol. This is a substance that has many applications, including aircraft de-icing fluid. When propylene glycol is heated, as in the e-cigarette, it produces known carcinogens. Because the liquid used in e-cigarettes isn’t regulated by the U.S. Food and Drug Administration, there could be other harmful substances lurking there in addition to the listed ingredients.

There are also concerns similar to the secondhand smoke associated with traditional tobacco cigarettes. “If you are using e-cigarettes near children, some of the vapor will escape into the air. Therefore, there is potential that the child is being exposed to the same chemicals that you are inhaling,” Slattery said.

One of the primary dangers associated with the e-liquid is the high concentration of nicotine. One 30 milliliter (ml) bottle of e-liquid with a concentration of 3.6 percent (36 milligrams of nicotine per milliliter) is equivalent to smoking 600 traditional tobacco cigarettes. With the variety of familiar flavorings and bright colors that are added, these e-liquids could easily attract the interest of a curious child. And just a small amount – as little as 1/8 teaspoon – of this e-liquid can be potentially fatal for a child who ingests it. Even touching liquid nicotine is dangerous because it can be easily absorbed through the skin.

“The number of accidental exposures to liquid nicotine reported to poison centers has increased,” Slattery said. Data from across the country between 2011 and 2014 show an alarming 2810 percent increase in the number of calls about children ages 5 and under who had been exposed to liquid nicotine.

Those using e-cigarettes are susceptible to overexposure to liquid nicotine as well. “The devices can leak, and the user could ingest a dangerous amount of the liquid,” Slattery said.

Direct contact with liquid nicotine can cause:

  • eye irritation
  • skin irritation
  • severe stomach pain
  • vomiting
  • seizures
  • difficulty breathing
  • fast heart rate
  • high blood pressure

If you suspect a child has come in contact with liquid nicotine, call 1-800-222-1222 immediately. The hotline to the Regional Poison Control Center at Children’s of Alabama is available 24 hours a day, 7 days a week.