Its a holiday weekend. The decorations are up. Presents will soon be unwrapped. A beautiful tree is decorated and lit. But did you know your living room of festivity can be a death trap in the making? For example, the beautiful holly on the window sill, if ingested, has a toxin named saponin which can lead to nausea, vomiting, abdominal cramping and in more severe cases mydriasis, hyperthermia, and drowsiness. Likewise the mistletoe under which you had your first kiss has phoratoxin and viscotoxin which can lead to not only GI symptoms but also, in severe cases, to bradycardia, delirium, or liver/renal/CNS/adrenal gland toxicity with all the complications that can go with them. Even the fake snow which you’ve spread beneath your Christmas tree in easy reach of pets and crawling children can be made from an alkaline polymer which can lead to bronchospasm (watch those asthmatics) or ocular injury.

Fortunately the treatment for all of these poisonings is supportive care, basic labs for some which can have end organ effects, and ekg. Very rarely are ingestions severe enough to warrant extended hospitalizations or ICU stays. Also inducing vomiting is not recommended as it does not seem to shorten duration or decrease severity of symptoms.

Bottom Line: Don’t eat decorations. Don’t make people vomit. And enjoy the holiday weekend.

 

Special thanks to Dr. Trevor Pour for the inspiration for this pearl.

References:

Salts, Lalia, and Francis Counselman. “Holiday Poisonings.” Emergency Medicine, vol. 48, no. 12, Jan. 2016, pp. 538–546., doi:10.12788/emed.2016.0071.

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