Phenergan Supp given to toddler; child dies

Good info

Really?? So what are we supposed to give kids now???

In the ER that I work at, we give zofran IV or IM to kids and adults. I LOVE this drug. It is a great antiemetic without the sedating properties of other drugs.

My son just got home from the hospital today after a 4 day stay due to rotavirus. In his 2nd ER visit the doc wanted to give 12.5mg IV Phenergan to my 60 pound 6 year old. My Ped. will not order it and is totally against it! I also thought that was quite a bit to give. I thought maybe 6.25mg would be better. He had been vomiting for 13 hours straight! I questioned the dose and the nurse came back with a 100mg Tigan supp. I really haven't worked with Tigan so 100mg also seemed like alot to me, also knowing how my ped. feels about antiemetics I was very nervous! But he had been vomiting so long I went ahead with it. Luckily nothing untoward happened but I tell ya those working in the ER have a big responsibility on their hands working with ped patients (and anyone else working with kids!) My son still is not taking adequate po intake and is still having some diarrhea so i am watching him like a hawk! This has been a very informative thread. Thanks to all who have posted!!

We don't give phenergan in our peds ed hardly at all. I've given it once to a 17 year old. We do po/im/iv zofran.

All our gastroenteritis peds get boluses and maintenence fluids. NPO until no vomiting for several hours. Then they start on clears and advance diet as tolerated. Occasionally the older ones get Zofran. So far, all my kids have cleared up within a day or two.

(I work in a small hospital, and we usually have only two to three kids at a time.)

I've never given Phenergan to a kid. The adult dosage is 12.5-25 mg. I can't imagine giving that amount to a small child.

I love zofran. we use in the outpatient center I work in. I have noticied some of my er docs ordering it more often than phenergan now adays..

I just read this thread and I am shocked that a little one under 2 was given phenergan at all. I am trying to remember in my 10 years if I have seen it given to a child under that age and I am almost confident I haven't. I gave 6.25 mg to a child that was about 4 not long ago and that's the last time I really remember giving it to a kid in a long time.
I am terribly sorry for your friend's loss. I definately think it warrants looking into but I also think that all things should be considered (dehydration, etc.)
I love Zofran too. It seems to work really well and many providers I work with are giving it first line instead of even trying anything else.

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Rj

No way would this have happened in my er uh huh.
This child should have had at least a 500 bolus of saline or LR if not a liter or 2. We give compazine and benadryl togather in our er. And seriousely the others are right why go to the trouble of actually putting a line in if your not going to use it. I also agree with hotrod this child should have also had an Ng dropped and lavaged to check for bleeding, at my er we probabley also would have put a foley in to check output and kidney fuction and ua would have been sent a whole slew of labwork, and probabley an abd. ct to rule out an appy. Tell ur friend were all so sorry for her loss.