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March
1998
Drugs
for Pediatric Emergencies (Electronic Article)
Committee
on Drugs, 1996 to 1997: Berlin, Jr CM, McCarver DG, Notterman DA, Ward
RM, Weismann DN, Wilson GS, Wilson JT. Liaison Representatives: Bennett
DR, American Medical Association/United States Pharmacopeia; Mulinare
J, Centers for Disease Control and Prevention; Hoskins IA, American College
of Obstetricians and Gynecologists; Kaufman P, Pharmaceutical Research
and Manufacturers of America; Mithani S, Health Protection Branch, Canada;
Troendle G, Food and Drug Administration; Yaffe SJ, National Institutes
of Health. AAP Section Liaisons: Section on Anesthesiology Cot� CJ, Section
on Allergy and Immunology Szefler SJ; PEDIATRICS Vol. 101 No. 1 January
1998, p. e13
[ see
abstract below ]
The Committee on Drugs of the American Academy of Pediatrics published
the revision of the statement on Drugs for Pediatric Emergencies (Click
here to read the full article on the Pediatrics web site).
This statement is meant as a supplement to and not a replacement for more
advanced sources of information such as the Advanced Pediatric Life Supports
(APLS) and Pediatric Advanced Life Support (PALS). When possible the drug
doses presented in this document are consistent with those contained in
APLS or PALS.
This statement provides current drug dose recommendations and represents
the efforts of a large committee as well as input from a variety of subspecialties
but in particular the section on Emergency Medicine. Once again the recommendations
listed in this document are somewhat limited in the sense that industry
never supported pediatric studies for the vast majority of the drugs listed
therefore leaving pediatric practitioners to develop their own information
often times based on small studies or anecdotal use. Although there is
often little scientific pediatric data to support the recommendations
in the form of blinded, randomized trials, this is the best data available.
This document is a step forward from the standpoint of anesthesiologists
because for the first time the importance of airway management is emphatically
presented and a general approach to endotracheal intubation is provided.
The evolution and final wording of this section of the document demonstrates
the wonderful give and take relationship between Pediatric Emergency Medicine
specialists and Pediatric Anesthesiologists. In particular, a discussion
of hypovolemic patients and patients with head injury is presented. A
brief discussion of succinylcholine and possible substitutes is presented
as well.
This document should be available to anyone who may deliver emergency
medical care to pediatric patients and in particular should be prominently
posted in all emergency rooms.
Return to the Current
Literature Review Front Page , or read the abstract:
ABSTRACT
This statement provides current recommendations about the use of emergency
drugs for acute pediatric problems that require pharmacologic intervention.
At each clinical setting, physicians and other providers should evaluate
drug, equipment, and training needs. The information provided here is not
all-inclusive and is not intended to be appropriate to every health care
setting. When possible, dosage recommendations are consistent with those
in standard references, such as the Advanced Pediatric Life Support (APLS)
and Pediatric Advanced Life Support (PALS) textbooks. Additional guidance
is available in the manual Emergency Medical Services for Children: The
Role of the Primary Care Provider, published by the American Academy of
Pediatrics, as well as in the PALS and AILS textbooks
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