What should you do if your child ingests ice pack contents?

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What should you do if your child ingests ice pack contents?

Ice packs are common items found in many households, which make them very accessible to small children. They are used for a wide variety of purposes, whether for icing injuries or keeping food cold, come in many forms and are made with different materials and ingredients, depending on the type of ice pack. Some ice packs are reusable and can turn solid when frozen or soft when thawed. There are also “instant” ice packs, which are good for one-time use and can be found in many first aid kits. These instant ice packs can be stored at room temperature and only turn cold when squeezed. 

The answer to whether an ice pack is toxic or not would depend on the type of ice pack. In this article, we will take a close look at the ingredients of popular types of ice packs. We will then provide some tips and case studies on how to treat your child if they come in contact with ice pack ingredients. 

Contents in different kinds of ice packs

Instant ice packs 

The most concerning type of ice pack is the instant ice pack. These are filled with water and chemicals. When the bag is squeezed, the water interacts with the chemical to start a reaction that lowers the temperature of the water to almost freezing. The chemical reactors in these ice packs are made with ammonium nitrate, calcium ammonium nitrate or urea. Ammonium nitrate is a toxic ingredient if swallowed. Ammonium nitrate can cause gastro-intestinal irritation, with symptoms such as nausea, vomiting and diarrhoea. It can also cause the dilation of blood vessels, which can lower blood pressure and reduce the amount of blood flowing to body organs. It might also cause conditions called methemoglobinemia (impairment of the oxygen-carrying ability of red blood cells) and hemolysis (destruction of red blood cells). Symptoms of methemoglobinemia and hemolysis include bluish coloring of the lips or nail beds, shortness of breath, dizziness, fatigue and headaches.

Calcium ammonium nitrate, on the other hand, is a mixture of calcium carbonate and ammonium nitrate. Since calcium carbonate is non-toxic, calcium ammonium nitrate is less toxic than a comparable amount of ammonium nitrate. Calcium ammonium nitrate still has the same toxic properties as ammonium nitrate, but it requires a larger amount to be swallowed for it to have the same effect. Urea is the least concerning reactor in instant ice packs, but it can cause nausea, vomiting, dizziness, drowsiness and confusion if enough is swallowed.

Reusable ice packs 

Some earlier types of reusable ice packs contained very toxic substances such as diethylene glycol or ethylene glycol (antifreeze). These types of ice packs have been recalled and are generally no longer available. Reusable ice packs nowadays typically contain water, propylene glycol (an ingredient that lowers the freezing temperature), a thickening agent, silica gel and non-toxic blue colouring. Ingesting the liquid contents of the reusable ice pack usually only causes mild irritation, while large amounts could possibly lead to symptoms similar to alcohol intoxication, such as severe drowsiness, unresponsiveness and slowed breathing.

Some reusable ice packs are filled with small gel beads that are made of sodium polyacrylate. Sodium polyacrylate, when inhaled or ingested, can cause damage to your eyes, skin and lungs. 

Most hot-and-cold gel packs have portable plastic bags filled with a gel or liquid that remains cool for hours after it is taken out of the freezer. Because the gel has a lower freezing point than water, it freezes slowly and remains semi-solid when in use. The contents of most gel packs are made with hydroxyethyl cellulose, which is non-toxic and biodegradable.

Hydroxyethyl cellulose is a gelling and thickening agent derived from cellulose. It is widely used in cosmetics, cleaning solutions and other household products. It’s also used in K-Y Jelly, which is lubrication intended to be put on your skin. Some products may also include additives like preservatives, sodium chloride, minerals, water or dye. Small ingestions of these are unlikely to cause any symptoms, except for possibly getting a minor upset stomach or loose stool. If this gel comes into contact with a child’s eyes, it may cause mild irritation.

Treatments for the ingestion of ice pack contents

Treatment for the ingestion of modern ice packs or products is rinsing out the mouth and drinking a few sips of water to clear the mouth and throat. Mild irritation and an upset stomach can be managed at home with small sips of water. 

Eye exposures should receive immediate irrigation of the eyes with room temperature water for 15 minutes. Persistent eye pain or other symptoms might need medical examination and treatment. 

Skin exposed to contact with ice pack contents should be immediately washed with soap and water. Most often, skin and eye exposures will respond quickly to irrigation of the affected area.

Below are some cases documented by The National Capital Poison Center, also known as Poison Control, which show how they responded with cases of children in the U.S. accidentally ingesting ice pack contents. You may refer to these case to know the appropriate actions to take in similar situations:

Case 1

Poison Control was contacted by a school nurse after an 8-year-old boy’s reusable ice pack broke in his lunchbox. He licked some of the gel, thinking it was yogurt. He had no symptoms at the time of the call other than being anxious. Poison Control instructed the nurse to give the boy a drink of his choice to help dilute what he had swallowed. Poison Control called the school nurse 1.5 hours later and learned that the boy remained asymptomatic and had returned to class.

Case 2

Poison Control was called by a father of a 2-year-old girl who was found sucking on an instant ice pack that had a pinhole in it. When the father squeezed the ice pack, some liquid came out, but the girl denied eating any. The ingredients listed in the instant ice pack were calcium ammonium nitrate and water. Poison Control confirmed with the father that the girl had no medical conditions that would increase her risk for methemoglobinemia. Poison Control followed up with the father two hours later, and the girl remained asymptomatic.

Got a question or anything I can help with? My name is Steve Stretton, and I’m the owner and manager at Gelpacks.com. You can drop me a line here. Good luck!

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