Posts Tagged ‘medication’

Medication dosing mistakes are common

Wednesday, July 16th, 2014

medicine syringe for kidsWhether you have a child with special needs or not, chances are you have given him medication at some point. A recent study published in Pediatrics revealed that many parents made mistakes when giving their child medication. “Medication errors were common: 39.4% of parents made an error in measurement of the intended dose, 41.1% made an error in the prescribed dose. Furthermore, 16.7% used a nonstandard instrument.”

The study compared parents who used milliliter-only cups or syringes with parents who used teaspoon or tablespoons to describe how they measured their child’s medicine. The researchers found that parents who described measuring the medication in teaspoons or tablespoons were twice as likely to make a mistake in giving the correct dose.

In addition, many parents did not understand the correct amount of medicine to give their child and mixed up the measuring terms. According to the American Academy of Pediatrics (AAP), “Parent mix up of terms like milliliter, teaspoon and tablespoon contribute to more than 10,000 poison center calls each year.”

Why does this happen?

One reason is because all spoons are not created equal. Dosing mistakes happen because people confuse teaspoons with tablespoons. Did you know that one tablespoon equals three teaspoons?!

Another reason is that people use everyday kitchen spoons instead of medication measuring spoons which are specifically designed to give an accurate dose. Again, the differences in the spoons can produce very different amounts of medicine given to your child.

What can you do?

• When measuring meds, use the oral syringe, dropper, or cup that comes with the medication. Do not use one medicine’s cup for another medicine. Measure carefully and exactly.

• Do not use kitchen teaspoons or tablespoons because there is a wide variety of kitchen spoons which can hold vastly different amounts of liquid.

• If you are giving a non-prescription medication (such as Tylenol or any over-the-counter medicine), be sure to give the dose that is based on your child’s weight, not his age. If in doubt, ask a doctor, nurse, physician assistant or pharmacist.

• Keep a log. Use your smartphone or a notebook to record the medication, date, time and amount that you gave your child. It is very easy to forget when you gave your child a medication, especially if you are giving more than one medication at different times during the day. Parental fatigue, multitasking and stress can also cause you to forget.  In addition, a medication “log” is very important if more than one person is giving medicine to your child.

• If in doubt, ask your child’s health care provider or your pharmacist. It could save your child’s life.

Learn more

• Check out the AAP’s video guide on how to measure meds and read about useful medication tips here.

The study’s authors suggest that children’s liquid medications only be prescribed in milliliters to help eliminate dosing mistakes or confusion. The AAP and CDC support this change. What do you think?

Note:  This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. While on News Moms Need and click on “Help for your child” in the Categories menu on the right side to view all of the blog posts to date (just keep scrolling down). We welcome your comments and input.

Exploring Grandma’s purse

Monday, February 24th, 2014

Grandma's purseMy purse, or pocketbook, holds everything I need, from a hairbrush to my driver’s license, cash, credit cards, a few random crayons and scrap paper, and the medications I need to take. Whereas I thought I was quite clever to carry the crayons and paper, it didn’t occur to me that by doing so I was enticing my grandchild to delve into my bag. Moms, this applies to you, too.

Curiosity is a good thing. It helps us venture forth, stretch our limits, learn new things. But in this case, it might have been deadly. I get headaches and take some meds that could be very dangerous to babies if swallowed like the candy they look like. Do you? Child-proof caps seem more like they are adult-proof to me. Fortunately, our little tike grabbed the bottle in my bag and shook it like a rattle rather than tried to open it. I saw this in less than 30 seconds and substituted a toy for the pills, but it certainly got my attention.

Suggestion: Go through your purse and make sure you know exactly what’s in there. Do you carry a small Swiss Army knife, a sharp nail file, keys you’d rather not get lost? Remove any dangerous items and meds (including over-the-counter pain relievers), but if you need to keep some, try this. Hang your purse on the same hanger as your coat. Carry a separate bag with crayons, paper, finger food, toys, a book or two… that your children or grandchildren can be safe with and delight in exploring.

Keeping track of your child’s records

Wednesday, April 17th, 2013

binders_thmWhether your child has a medical condition, disability, receives services through the Early Intervention Program or Special Education, one of the best things you can do is to keep all of your child’s records well organized.

Why is this so important?

If your child is in the early intervention program for babies and toddlers or if he is receiving services through your local school system, you will find that you will amass an enormous amount of paperwork. Keeping it organized will help you tremendously when you need to find documents for IFSP or IEP meetings, visits with other doctors or specialists, and if you need to apply for other programs or services. It is very important that you keep all evaluations and test results so that future specialists can see the history of your child when he evaluates him. Having orderly records will also help you if you need to speak with an attorney in an attempt to try to obtain services you feel your child should rightfully receive.

How should you get organized?

My favorite way to do this is to get an old fashioned three ring binder and put each item in it in chronological order (date order). Put the oldest one on top and the newest one at the bottom (so it reads like a book). You are going to need more than one binder as your child grows, and each one can be labeled a different year (2013, 2014, etc.). This binder method will allow you or your child’s doctors to review your child’s history in a beginning-to-end format. It will also give you a “big picture” of your child, and help you put the details of all the different moving parts into one coherent whole.

What should you put in the binder?

Put everything that is related to your child’s health, disability and education in the binder. This would include:

• Medical records – beginning with your child’s birth (and even your pregnancy if it is applicable or if you have it)
• All evaluation reports
• Your child’s ISFPs and/or IEPs
• Report cards
• Educational test results (such as standardized tests)
• Your notes from meetings or phone calls with school personnel, doctors, or other individuals, with dates
• Notes from your child’s teacher
• Samples of your child’s work
• The business cards of all of your child’s doctors. You can either put them in plastic business card holders, or create a master list of all the doctors with their contact info.
• CDs or thumb drives of electronic information that is on your computer (always back up files!)
• A list of all the medications your child is taking, with the dosage, frequency and prescribing doctor.

Some experts say that it is also helpful to create a one page summary sheet, which is almost like a table of contents. It should list each document, the date the document was created or received, and a brief description of what it is (eg. “John’s neurological evaluation, 2009,” “IEP for 5th grade,” “notes from team meeting on January 12, 2011,” etc.).  This will help you to locate valuable information when you need it quickly (such as right before a meeting or a visit to a new doctor). The more organized you are, the easier it will be to manage your child’s journey.

Some people don’t like the binder method. If you find this does not work for you, then you might find it easier to put all of the above items in a file cabinet (in file folders) in chronological order. Whichever method you choose, just be consistent and label your folders so that you can find things when you need them.

When should you stop keeping these files and records?

Besides needing these records for early intervention or school based services, you may need these records for the high school years and beyond graduation. For example, you may need these records in order for your child to qualify for accommodations for college based entrance exams, such as the SAT or ACT. You will also need these records to support a request for testing accommodations at college. Lastly, many of these records will be required to apply for government benefits, such as Supplemental Security Income (SSI).  So, I suggest that you keep your file system going for as long as your child (or later as an adult) has special needs.

Where can you get more help with this?

I often recommend that parents go to the NICHCY website as they have a Sample Record-Keeping Worksheet as well as a description of all of the various kinds of info that you should include in your binder  on page 15.

In addition to NICHCY, you can also go to Wrightslaw, an extensive website dedicated to helping parents navigate the maze of special education.  They offer concrete advice on how to advocate for your child with special needs. They also have great articles on how to organize your child’s records.  

Bottom line

If you begin your record keeping early, you will not be overwhelmed by the avalanche of papers that will undoubtedly come your way. But, if you did not have a method of record keeping before today, don’t worry. Simply start with today and you can go back and organize prior paperwork another time. Being organized will cut down on the stress that occurs when you feel like you are buried beneath a mountain of paper. You have enough to tend to with your child – it is helpful if the paperwork does not get in your way but rather helps you achieve your goals. Of course, the best part of all is that you will feel more confident and in control of your journey.

Let me know if this helps or if you have other suggestions. What has worked for you?

Have questions?  Send them to AskUs@marchofdimes.org.

Note: This post is part of the weekly series Delays and disabilities – how to get help for your child. It appears every Wednesday, and was started on January 16, 2013. Feel free to go back to look at prior posts as the series builds on itself. As always, we welcome your comments and input.

Pills and pregnancy – what’s safe and what’s not

Friday, January 18th, 2013

pillsYou may have been taking meds for a chronic condition for years. Some are fine to continue during pregnancy and some won’t be safe for a developing baby. It’s important to check with your doc before you conceive, if you’re planning ahead, so that you can be shifted to a safer alternative, if necessary.

But let’s face it, more than half of all pregnancies are not planned. Once you find out, you may have questions about your meds during pregnancy.  So how do you know if what you’re taking is still OK? The most important thing is to talk with your health care provider. He/she knows you and your medical history best and can make whatever adjustments are best for you. Don’t stop taking your medication, however, without your doc’s knowledge.

In the meantime, there is an excellent organization that can help give you valuable information about the safety of medications during pregnancy. The Organization of Teratology Information Specialists (OTIS) is a group of highly trained professionals who are dedicated to providing accurate evidence-based, clinical information to patients and health care professionals about medications (prescription or over-the-counter), vaccines, chemical and other exposures during pregnancy and breastfeeding.  They can tell you whether a mother’s exposure might be harmful to her baby. Their toll-free number is 866-626-6847 and calls are kept anonymous and confidential. You can read a number of their fact sheets at this link.

Giving medicine to children

Thursday, February 16th, 2012

taking-medicineWhen our kids need medicine it isn’t always easy to get them to take it. In a new video, Benjamin Ortiz, a pediatrician at the Food and Drug Administration (FDA), explains how to deliver the dose without the battle.

Watch the video, “Giving Medicine to Children”

When they get older, one of the things parents will eventually have to do is teach their children how to use medicines safely. In this video, Dr. Ortiz gives tips on how and when to do it. Watch “Teaching Kids About Using Medicine Safely.”

How to get rid of leftover Rx

Thursday, October 27th, 2011

pill-bottlesHundreds of thousands of children take a trip to the hospital every year due to taking medications that are in the house and are way too easy for them to get their hands on. Often, old prescriptions that were never completely used are sitting around posing an unnecessary risk.

The U.S. Drug Enforcement Administration has organized another prescription drug “take back” day to provide drop sites for people who want to properly dispose of unwanted and unused prescription drugs. The two take back days in 2010 collected nearly 309 tons of prescription drugs. This year’s event is on Saturday October 29, 2011, from 10 a.m. until 2 p.m. You can locate a drop site near you at this link or by calling 800-882-9539.

Drop by and drop off your old drugs. Do it for your kids.

“Child-proof” caps

Monday, December 20th, 2010

pill-bottlesAre your kids’ grandparents going to be visiting you over the holidays?  If so, they’ll be bringing their medications with them and these little bottles can be a big temptation for tiny hands.  Pill boxes come in all shapes and sizes and, for seniors who may have difficulty opening tight lids, they’re often not child-proof. This can turn into pretty poison for little ones.

Age two has proven to be the most dangerous year for children regarding accidental overdoses, according to hospital ER visits. Prescription containers with easy-open lids can be opened by a toddler in less than a minute.  The most secure bottles have the push down and twist caps.  Please make sure any visiting guests keep their medications up high, out of sight and out of reach.  This includes bottles, like cough syrup.

By the way, the most common and deadly accidental overdose involving children is with acetaminophen (Tylenol).  It’s in most houses because it works well, but it is a danger to kids.  Keep it high and away at all times.  Better yet, keep meds in a locked box or medicine cabinet.

Breastfeeding and medications

Monday, August 2nd, 2010

breastfeeding37468747_thmFrom over-the-counter to prescription, we need more research to know how each medicine can affect your breastmilk. Below are some basic guidelines, but it’s important to always talk to your baby’s health provider before taking any medication and to tell her you’re breastfeeding.

In general, most over-the-counter medications and those prescribed by a health care provider are probably okay to take while breastfeeding, (but check with your baby’s doc first.) Since the amount of medication transferred to breastmilk is very small and won’t affect a nursing baby very much, most over-the-counter medications (like pain relievers) are okay for mom to take, but be sure to read the label and package insert.

Medications that are given to you by a health provider are OK so long as your health provider knows you’re breastfeeding. Some prescription medicines (like those to treat cancer or that have radioactive ingredients) aren’t safe to take while nursing.  In most cases, if a medication was safe for you to use when pregnant, it should be okay for you to use when breastfeeding.   There are a few exceptions to this guideline (like some medicines used to treat anxiety or sleeplessness), so it’s important to check with your health provider first.

Other tips
• Stay away from extra-strength doses of medicine. When possible, take the smallest dose for the shortest amount of time. This lowers the chance your  baby will get the medication through breastmilk.
• Take the medication either right after breastfeeding or at least 2 to 4 hours before the next breastfeeding. This gives the medication time to clear your body before your baby’s next feeding.
• If you’re taking a long-acting medication, take the medication before baby’s longest sleep time but after feeding baby. This way, you give yourself the time you need to clear it from your body while your baby is sleeping.
Contact your baby’s health provider if she shows any signs of having a reaction (diarrhea, sleepiness, excessive crying, etc.).
• Read the label on the medication for any information about how it may affect breastfeeding. Some medications may affect how well your body makes breastmilk.

Got questions about pills?

Tuesday, March 16th, 2010

pillsWhile I know not to take any pills that aren’t mine or that I don’t recognize, once in a while I’ll find some in my medicine cabinet that make me think, “What the heck is this?”  Sound familiar?  More recently, I was visiting my elderly mother who is getting a bit forgetful and I wanted to know what medications she is taking these days in case of an emergency. (She likes to say “I’m fine, just fine,” but her medicine cabinet has a bunch of different pills in it, some not labeled.) The National Library of Medicine’s Pillbox Web Site for medication identification can be helpful in these situations.  The site is in a test stage, but it’s getting plenty of use.

If you’re thinking of getting pregnant, make sure that any medication you’re taking is safe.  Always check with your health care provider, but you can check out this site too.  The National Library of Medicine is partnering with the Food and Drug Administration to enhance patient safety and provide a reference system for solid-dosage (tablets and capsules, not liquids) medications.  Photos of pills and descriptions are linked with FDA databases to provide information on each medication’s clinical uses and toxicity. According to an article in Government Computer News, project organizers are working to get the site approved for clinical use.  Eventually, they hope to be able to be capable of searching for pills by size, shape or color.

Depression during pregnancy: Acupuncture may help

Thursday, February 25th, 2010

depressionAs many as 1 out of 5 women have depression while they’re pregnant. If you’re pregnant, depression can threaten your health and the health of your baby. The good news: Several different types of treatment, including counseling and medication, can help.

A new study has found that acupuncture may help pregnant women who suffer from major depression, the most serious form of the illness. The study was very small; only 150 women participated. So more research needs to be done to confirm the findings.

For information about the symptoms of depression, see the March of Dimes article. If you think you may have depression, talk to your health care provider right away. Discuss with him or her the various treatments that are available. But don’t start acupuncture or any treatment without first checking with your prenatal care provider.