If you are thinking about postponing or not having your child receive the chickenpox (varicella) vaccine, please consider the following.
Chickenpox has been preventable by vaccination in the US since 1995. From 1990-1994, the total number of annual US deaths where chickenpox was determined to be the "underlying cause" was 105. (This is not a high number, but devastating event for those families).
In the first 6 years after the vaccination program there was a 66% decline in chickenpox-attributed mortality.
The 12 year data was recently published and shows an 88% mortality reduction for all ages and a 97% mortality reduction in persons 19 and younger.
Lastly, this data is based on the 1-dose vaccination program. With the current 2-dose program, there is potential for even greater mortality reduction.
If you want more details on the varicella (or any other vaccine), check out the CDC's website: www.CDC.gov/vaccine.
- Posted using BlogPress from my iPhone
Tuesday, August 2, 2011
Tuesday, July 19, 2011
Tips on safer dosing of medications for children
Here are some of the best tips I've learned over the years to avoid confusion and errors:
1. Never use a kitchen teaspoon or tablespoon to measure out the volume of medicine to give your child. Eating utensils and cooking measurers are notoriously inaccurate. Instead, use a medicine syringe. These are often found in the package, you can purchase them at your local drugstore, or most pharmacies will give you a dosing syringe or two (especially if you are filling a prescription at the same time).
2. FIRST, figure out what your goal dose is for your child in milligrams (mg) of medicine rather than in volume of fluid. THEN, see what the concentration of mg is per millilter (5ml is one teaspoon, therefore the concentration is often displayed as mg per 5ml). For tablets or capsules you want to verify the mg per tablet/capsule.
Once you know what the goal dose is in mg and how many mg there are per ml, then you can calculate the number of ml you need to deliver the desired dose of mg.
(This also works for tablets or capsules in older children to determine how many tabs or caps to give.)
This is how pharmacists and doctors figure out how much medicine to dose for your child.
The trick is that many medicine come in multiple concentrations so you really have to pay attention to the specific concentration of the medicine you are about to give your child on that occasion.
3. Make sure that shake up your liquid medicine before giving it. This is particularly important liquid medicines that are suspensions. Suspensions are liquids with small solid particles "suspended" in them. Since the active medicine is in the solid particles, it is important to "re-suspend" the liquid by shaking the bottle before dosing each time so that the concentration of mg per ml can remain consistent.
3. Here is the weblink to an article from the AAP on how to most safely dose liquid medications for children: www.healthychildren.org/English/health-issues/conditions/treatments/Pages/Using-Liquid-Medicines.aspx.
4. Teaspoons and Tablespoons are not the same.
Be aware that a teaspoon is 5ml and a tablespoon is 15ml.
This is a three-fold difference, therefore most pediatricians are taught to dose in ml (or teaspoons) and avoid dosing in tablespoons. If you think your doctor wrote for your child's dose in tablespoons, call to clarify before giving the first dose.
1. Never use a kitchen teaspoon or tablespoon to measure out the volume of medicine to give your child. Eating utensils and cooking measurers are notoriously inaccurate. Instead, use a medicine syringe. These are often found in the package, you can purchase them at your local drugstore, or most pharmacies will give you a dosing syringe or two (especially if you are filling a prescription at the same time).
2. FIRST, figure out what your goal dose is for your child in milligrams (mg) of medicine rather than in volume of fluid. THEN, see what the concentration of mg is per millilter (5ml is one teaspoon, therefore the concentration is often displayed as mg per 5ml). For tablets or capsules you want to verify the mg per tablet/capsule.
Once you know what the goal dose is in mg and how many mg there are per ml, then you can calculate the number of ml you need to deliver the desired dose of mg.
(This also works for tablets or capsules in older children to determine how many tabs or caps to give.)
This is how pharmacists and doctors figure out how much medicine to dose for your child.
The trick is that many medicine come in multiple concentrations so you really have to pay attention to the specific concentration of the medicine you are about to give your child on that occasion.
3. Make sure that shake up your liquid medicine before giving it. This is particularly important liquid medicines that are suspensions. Suspensions are liquids with small solid particles "suspended" in them. Since the active medicine is in the solid particles, it is important to "re-suspend" the liquid by shaking the bottle before dosing each time so that the concentration of mg per ml can remain consistent.
3. Here is the weblink to an article from the AAP on how to most safely dose liquid medications for children: www.healthychildren.org/English/health-issues/conditions/treatments/Pages/Using-Liquid-Medicines.aspx.
4. Teaspoons and Tablespoons are not the same.
Be aware that a teaspoon is 5ml and a tablespoon is 15ml.
This is a three-fold difference, therefore most pediatricians are taught to dose in ml (or teaspoons) and avoid dosing in tablespoons. If you think your doctor wrote for your child's dose in tablespoons, call to clarify before giving the first dose.
Heat illness and other Sports Injuries
At this time of year I usually get questions about sports injuries including heat-realted illnesses. As I've mentioned to many parents before, I'm a great fan of the AAP's website for parents-- www.healthychildren.org.
In particular, this website has a whole section dedicated to sports injury prevention and treatment (www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/default.aspx).
Making sure that your young athlete pre-hydrates well by drinking >6-8 glasses of water a day, with frequent water breaks during exercise (especially when outside in the heat). Water is the preferred fluid for hydration when exercising for less than 3 consecutive hours. In general, commercial sports drinks are not necessary and provide unnecessary calories which can lead to excess weight gain.
Sunday, July 10, 2011
Change in OTC liquid Acetaminophen (Tylenol)
It's been way too long since I last posted, but I've been busy with the new practice location and my now 3 month-old daughter.
Anyway, I thought my first post in a while would be about the "simplification" of over-the-counter liquid acetaminophen dosing.
Starting this summer, parents will no longer be able to find new packages of "infant concentrated" acetaminophen. Up until now, there have been 2 different OTC concentrations available: "Infant" 80mg per 0.8ml and "Children's" 160mg per 5ml (5ml = 1 teaspoon). Unfortunately this substantial difference has led to confusion among parents leading to the accidental overdosing of some children. Therefore, starting soon all liquid acetaminophen will be sold in the 160mg per 5ml concentration.
It is always best to base your child's dose on his/her current weight. Soon, we will be updating the dosing recommendations on http://www.bluefishmd.com/ to include dosing by weight for young infants using the 160mg per 5ml.
Also, here is a pretty good summary of the reasons behind the changes from the abcnews website: http://abcnews.go.com/Health/w_ParentingResource/infant-dose-counter-acetaminophen/story?id=13535850.
And finally, a good summary on when a parent should use fever reducers in the first place from the AAP's parent website: http://www.healthychildren.org/English/news/Pages/AAP-Issues-Advice-on-Managing-Fevers-in-Children.aspx.
I hope this helps clear up some of this confusion.
I plan to blog more often again so stay tuned.
-RAC
Anyway, I thought my first post in a while would be about the "simplification" of over-the-counter liquid acetaminophen dosing.
Starting this summer, parents will no longer be able to find new packages of "infant concentrated" acetaminophen. Up until now, there have been 2 different OTC concentrations available: "Infant" 80mg per 0.8ml and "Children's" 160mg per 5ml (5ml = 1 teaspoon). Unfortunately this substantial difference has led to confusion among parents leading to the accidental overdosing of some children. Therefore, starting soon all liquid acetaminophen will be sold in the 160mg per 5ml concentration.
It is always best to base your child's dose on his/her current weight. Soon, we will be updating the dosing recommendations on http://www.bluefishmd.com/ to include dosing by weight for young infants using the 160mg per 5ml.
Also, here is a pretty good summary of the reasons behind the changes from the abcnews website: http://abcnews.go.com/Health/w_ParentingResource/infant-dose-counter-acetaminophen/story?id=13535850.
And finally, a good summary on when a parent should use fever reducers in the first place from the AAP's parent website: http://www.healthychildren.org/English/news/Pages/AAP-Issues-Advice-on-Managing-Fevers-in-Children.aspx.
I hope this helps clear up some of this confusion.
I plan to blog more often again so stay tuned.
-RAC
Thursday, November 11, 2010
More information
I started at Blue Fish on Monday November 8th and things are going well so far.
Here are some answers to a few FAQ's:
1. Does Blue Fish take my insurance?
More than likely, the answer is yes.
If you want to make sure either call Blue Fish at 713-467-1741 or check directly with your insurance provider by Internet or telephone. Since we are in the process of changing my location with all insurances, use the name of one of the other doctors at the Blue Fish Memorial location (www.bluefishmd.com) to verify coverage because I will have the same insurance plan profile.
2. Which patients am I accepting?
See my profile at http://www.bluefishmd.com/about/blue-fish-memorial/dr-r-adrian-clarke/.
Feel free to call or email the office for further clarification.
Basically the current plan is to limit my panel to existing patients who wish to "follow me" to Blue Fish, existing patients of Dr. Eddings who do not wish to transfer to Blue Fish Cypress, any siblings of either of these first two groups, and infants 2 months and younger with commercial insurance.
3. What is the parking like?
There is free parking in Garage 3 on the Memorial Hermann Memorial City Hospital campus. The entrance to Garage 3 is easiest to find off Kingsride. The entrance is on Kingsride between Gessner and Frostwood, next to the Chase bank branch. There is usually ample parking the higher up you go in the garage. There is a pedestrian bridge from the 2nd floor of the garage directly into 915 Gessner (our building). There is paring on the ground floor of Garage 3, but it is intended for ER parking and costs $20 unless you are seen in the ER that day.
4. Will I be notified directly?
Official notice has already appeared in the Houston Chonicle, will appear in the Katy Times, and is posted at TCPA-Katy. Patients who have seen me at TCPA-Katy in the last few years will also receive a letter in the mail.
5. What do I do if I decide I want to transfer to Blue Fish?
The easiest way to do this is to check out the Blue Fish website (http://www.bluefishmd.com/new-patients/).
In order for any doctor's office to obtain a patient's medical records from any other doctor's office, the patient him/herself or his/her parent or guardian must give written authorization. Click on this link to get the Blue Fish Transfer of Medical Records Authorization form ( http://www.bluefishmd.com/files/Transfer_Medical_Records_Authorization.pdf).
Don't forget to fill out the child's name and date of birth clearly at the top of the form, complete the "From" section identifying the name of the office that you wish to have the records "released" from, fill in the date range that you want released and sign and date the bottom of the form. The form can then be faxed, mailed or hand delivered to the office that you wish to have the records sent from.
Here are some answers to a few FAQ's:
1. Does Blue Fish take my insurance?
More than likely, the answer is yes.
If you want to make sure either call Blue Fish at 713-467-1741 or check directly with your insurance provider by Internet or telephone. Since we are in the process of changing my location with all insurances, use the name of one of the other doctors at the Blue Fish Memorial location (www.bluefishmd.com) to verify coverage because I will have the same insurance plan profile.
2. Which patients am I accepting?
See my profile at http://www.bluefishmd.com/about/blue-fish-memorial/dr-r-adrian-clarke/.
Feel free to call or email the office for further clarification.
Basically the current plan is to limit my panel to existing patients who wish to "follow me" to Blue Fish, existing patients of Dr. Eddings who do not wish to transfer to Blue Fish Cypress, any siblings of either of these first two groups, and infants 2 months and younger with commercial insurance.
3. What is the parking like?
There is free parking in Garage 3 on the Memorial Hermann Memorial City Hospital campus. The entrance to Garage 3 is easiest to find off Kingsride. The entrance is on Kingsride between Gessner and Frostwood, next to the Chase bank branch. There is usually ample parking the higher up you go in the garage. There is a pedestrian bridge from the 2nd floor of the garage directly into 915 Gessner (our building). There is paring on the ground floor of Garage 3, but it is intended for ER parking and costs $20 unless you are seen in the ER that day.
4. Will I be notified directly?
Official notice has already appeared in the Houston Chonicle, will appear in the Katy Times, and is posted at TCPA-Katy. Patients who have seen me at TCPA-Katy in the last few years will also receive a letter in the mail.
5. What do I do if I decide I want to transfer to Blue Fish?
The easiest way to do this is to check out the Blue Fish website (http://www.bluefishmd.com/new-patients/).
In order for any doctor's office to obtain a patient's medical records from any other doctor's office, the patient him/herself or his/her parent or guardian must give written authorization. Click on this link to get the Blue Fish Transfer of Medical Records Authorization form ( http://www.bluefishmd.com/files/Transfer_Medical_Records_Authorization.pdf).
Don't forget to fill out the child's name and date of birth clearly at the top of the form, complete the "From" section identifying the name of the office that you wish to have the records "released" from, fill in the date range that you want released and sign and date the bottom of the form. The form can then be faxed, mailed or hand delivered to the office that you wish to have the records sent from.
Wednesday, October 27, 2010
Update
Wow. What a few days.
I have decided to join Blue Fish Pediatrics in the Memorial City area of West Houston.
Although this has been a difficult decision, I feel fortunate to have the opportunity to practice closer to home in another high-quality pediatric practice. This opportunity at Blue Fish is especially attractive since Drs. Jung and Pielop are trusted colleagues that I have known since we started pediatric residency training together at Texas Children's in 1999.
More information is available through my current practice upon request.
The notification process for patient families is underway.
I have decided to join Blue Fish Pediatrics in the Memorial City area of West Houston.
Although this has been a difficult decision, I feel fortunate to have the opportunity to practice closer to home in another high-quality pediatric practice. This opportunity at Blue Fish is especially attractive since Drs. Jung and Pielop are trusted colleagues that I have known since we started pediatric residency training together at Texas Children's in 1999.
More information is available through my current practice upon request.
The notification process for patient families is underway.
Monday, October 18, 2010
Flu Vaccine Update 10/18/10
There continues to be a good supply of both injectable and nasal flu vaccine in our office and at local pharmacies.
Please refer to earlier posts for details on which patients should get the flu vaccine, how many doses should be given, and which version of the flu vaccine is most appropriate for your child.
Please refer to earlier posts for details on which patients should get the flu vaccine, how many doses should be given, and which version of the flu vaccine is most appropriate for your child.
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