New Guidelines: What your pediatrician might not have told you

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New Guidelines: What your pediatrician might not have told you

 

by Julie Silver, MD and Linda Cozzens, MD.

 

Dr. James Leiferman, a pediatrician at East Valley Children’s Center in

Tempe, has fielded hundreds of phone calls from frantic parents whose

children have ingested possibly harmful substances. While his compassionate

manner and efficient style have not changed in the past year, his advice

certainly has.

 

For years physicians have urged parents to have ipecac, a medication that

induces vomiting, in the home in case of unintentional poisoning. In the

past year, however, the American Academy of Pediatrics (AAP), which

represents more that 57,000 pediatricians and pediatric specialists, has

published new guidelines about what to do for toxic ingestions, and these

guidelines urge parents to dispose of ipecac.

 

This is one of several recently updated guidelines by the AAP, which relies

on the most recent scientific research when making recommendations to

improve children’s health. Often, in a well-child visit with so many topics

to cover, pediatricians do not have ample time to inform parents about all

the latest changes. Here’s a quick update.

 

No More Ipecac

 

Recently the AAP published a new policy statement urging parents to dispose

of ipecac, a medication that induces vomiting. A new study revealed that

using ipecac does not improve the outcome of an unintentional poisoning, nor

does it reduce trips to an emergency department.

 

This lack of benefit is even more striking when the shortcomings of ipecac

are considered. Even when ipecac is administered immediately after a child

ingests poison, it does not remove the poison completely or reliably from

the stomach. Often the vomiting ipecac induces can be persistent, making it

difficult for the child to keep down other treatments. Moreover, some

anxious parents give ipecac even though it is not needed. This is especially

concerning because certain substances are actually more toxic if they are

vomited up. Additionally, people with eating disorders can misuse ipecac and

repeated misuse of ipecac can endanger the heart muscle.

 

The AAP policy statement recommends that parents dispose of ipecac. The new

recommendation is that the first action for a caregiver of a child who may

have ingested a poison should be to call a poison control center by dialing

800-222-1222 from anywhere in the United States.