Preventing Accidental Death. Mistakes Giving Medications to Children are Avoidable.
Eighty percent of deaths of children under five-years of age are avoidable. More then half of those deaths are caused by mistakes in the administration of medications given to benefit the child. An even greater number of children are injured or suffer serious side effects from inadvertent errors of common health aids found in most homes. This article informs all child care providers how to prevent tragedy when administering medication to children.
Parents, family, and child care professionals devote themselves to the welfare of children. Yet, even with love and devotion, 80 percent of deaths of children under five-years of age are avoidable. More then half of those deaths are caused by mistakes in the administration of medications given to benefit the child. An even greater number of children are injured or suffer serious side effects from inadvertent errors of common health aids found in most homes.
Before giving any medication, whether prescription or over-the-counter, (OTC), child care providers must know the weight, age, allergies, and sensitivities of the patient. Plus, it is vital that caregivers know what and when other medications and foods have been ingested by the child. An up to date list of medications and dosages should always be available. A great way to record food and medications given to children is with a daily log kept in a visible place for all adults, (parents, family, and nannies), to use and communicate with one another.
Before administrating any prescription medication to a child, the caregiver must assess the child's needs: know what to give, why the child needs it, how to contact the professional that is prescribing it, when to give it, how to store it, where to refill it, and at what cost the medication can purchased.
Caregivers should be aware of probable side effects and how to manage them if they occur. Know whether to give the medication until it is finished or only until symptoms abate. Keep the phone number of the prescribing physician and pharmacy visible in the event of questions regarding reactions or directions.
Since each person has a unique chemical composition, side effects and each individual's reaction to a medication cannot be anticipated. Therefore, unexpected reactions must be reported to a licensed medical provider.
No medications that have expired should be given to anyone at any time. Do not follow the advice of a friend, neighbor, or grandparent, however well meaning, regarding the treatment for a child. Only seek the best advice from a trained professional and not merely from a convenient source.
Over-the-counter, (OTC), preparations pose a special challenge for child care providers. They require no prescription, are widely available, and are relatively inexpensive. Yet, they can be hazardous if used inappropriately. Adults must carefully read and understand the labeling found on every package.
The following categories are found on every medicine package label:
Active Ingredients: The first panel on the label lists the active ingredients and their purpose(s). This section provides the chemical name of the active chemical and how it is intended to work for the patient.
Uses/Indications: The next panel named uses or indications explains which symptoms the active ingredient is supposed to treat.
Warnings: The warnings section of the label alerts the caregiver to conditions, or people, that should not use the particular medication without the specific advice of a physician.
Directions: The directions explain the dosage and administration of the medication. Adults should always use a manufacturer provided measuring device and not a kitchen teaspoon, tablespoon, or dropper. Household goods vary widely in size and cannot be depended upon for proper dosage. Never dispense medicine in low or poor light, and certainly not in the dark. Always read the label and be sure you are using the intended medicine.
Other Information: The other information listed often notes proper storage and gives pertinent information about how and when the product should be taken.
Inactive Ingredients: The inactive ingredients listed on the medication label are the chemicals in the compound that are presumed to have no effect on the body. Dyes, preservatives, fillers, and food colors are among the compounds listed on this part of the label. A child may be allergic or sensitive to any of these ingredients, even though they are called "inactive." That also explains why one person may have a reaction to a generic drug but not the brand name of the same product.
When treating sick children remember that kids are not small adults. Do not dilute or reduce the dosage of adult products and dispense them to children. Always check ingredients to be certain that there is no duplication or conflict between ingredients of different products. Pediatric oral medications are often sweetened to make the palatable. However, they are not candies and like all medications, should be kept out of the reach of children.
Adult medications that are especially dangerous to children are analgesics, anti-depressants, sleeping pills, and tranquilizers. Safety caps should be used and tightly secured, whether prescriptions or OTC preparations.
It is vital for caregivers to be aware of some common ailments and popular products used as treatments and the problems those medications may cause. Runny noses, stuffed noses, and post nasal drips are among the conditions that prompt a doctor to prescribe an antihistamine or a decongestant, or a combination of the two. Dry coughs and incessant coughs typically require expectorants and/or cough suppressants. Some common side effects include:
Antihistamines generally cause fatigue, loss of appetite, and dryness of the mouth and throat. Overuse can cause respiratory failure and weight loss.
Decongestants can cause nervousness, sleeplessness, and heart palpitations.
Expectorants can cause nausea and vomiting.
Suppressants can cause chest pain and lethargy.
Paradoxical side effects may occur at anytime. That means that for a small minority of patients, what normally causes lethargy, may cause excitation in a particular patient. </blockquote>
Unless recommended by a physician no OTC cold preparations are suitable for a child under four-years-old. Any instance of overdose of any medication requires prompt emergency medical care. Be aware that any sudden change in behavior or health requires medical attention. The side-effects cited in this article are representative only and not nearly a complete list of all possible problems medications can pose for children.
Parents may give certain herbs to children to prevent or lessen the symptoms of a cold. Herbs are used because of the inaccurate belief that they are all natural and cannot hurt, and might help, children.
The most popular herb is <b>Echinacea.</b> According to the German government, only one of the four species of Echinacea is useful as a cold preventative. That form is not even available in the United States. Some children, especially those who are allergic to ragweed, may be allergic to Echinacea. The alcohol-based tincture form of Echinacea can be irritating to mucus membranes.
Some people use large doses of <b>Vitamin C</b> to prevent or to treat a cold. Large doses of Vitamin C can cause stomach upset, diarrhea, and heartburn.
Honey is popularly used to relieve sore throat, or to mix with lemon to relieve colds. Honey should not be given to any child under one-year-old because of the risk of infant botulism.
Iron containing vitamins are a threat to children and all vitamins should be kept out of the reach of children.
Headaches, sore throats, and other pain should be treated with ibuprofen or acetaminophen, but never aspirin. Aspirin should not be give to anyone under 19-years-old because it is a salicylate that can react with a virus that can cause the dangerous Reyes Syndrome. The adult formulation of Pepto Bismol, Kaopectate, and willow bark are also salicylate-containing compounds and must be avoided by infants, children, and teenagers. Use ibuprophen or acetaminophen in forms designed for pediatric use, rather than smaller doses of adult formulations.
Vomiting, nausea, and diarrhea are all potentially dangerous conditions that may lead to dehydration. Pediatric electrolyte replacement drinks are appropriate. Diluting adult electrolyte replacement drinks will give the patient a drink that is too acidic for a child.
There are many effective strategies to relieve the discomfort of teething but adult Anbesol and liquor may burn the gums and should be avoided. Cold gel pacifiers are a better choice.
Intestinal gas and heartburn are treatable with a large variety of safe products. Use those made for the age of the child. Too much antacid can cause constipation, diarrhea, or stomach cramps. Over dosage of acid blockers can inhibit digestion. Track the diet of children with stomach or digestive discomfort for a few days to check if there is a sensitivity to some food.
Among the most effective methods to prevent the spread of illness is careful and frequent hand washing. Plain soap and water are all that is necessary. Do not insist on antibiotics for a virus.
If a child is cranky because of fatigue, do not give medication to quiet the child. Most complaints are temporary and self-limiting and do not require medication. Sufficient sleep and a nutritious diet often allows the body to heal itself.
Child care providers must know the age, weight, allergies, and health conditions of the children to whom they provide care. All caregivers must have access to all medical insurance information, emergency contact numbers, understand what medications the child is supposed to be given, follow and understand dosages, and be alert to side effects and adverse reactions. Parents should sign an Authorization for Consent Form, for child care professionals to keep on her at all times, in case of an emergency when the parents are not available to sign for emergency treatment immediately. Accept advice only from qualified professionals. The goal is to benefit the child and to prevent tragedy.
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ABOUT THE AUTHOR
Stephanie Felzenberg has been the executive editor of the nationwide nanny trade publication Be the Best Nanny Monthly Guide since 2001 and a professional nanny since 1993. After earning a Bachelor Degree in Psychology she worked with mentally handicapped children and adults, and neglected and abused teen-aged girls. Stephanie also volunteered as the International Nanny Association newsletter editor for more than four-years. Stephanie finished editing a nanny textbook to be published later this year.