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Welcome to my blog about health, nursing, caring, kindness and positive change. Our world is full of such negative influences and bad choices, today is the day to make a positive change both physically and mentally in your life.
ERNursesCare is a blog incorporating my nearly 30 years of experience in the healthcare field with my passion for helping others, I want it to encourage others with injury prevention, healthy living, hard hitting choices, hot topics and various ramblings from my unique sense of humor. Come along and enjoy your journey......
Showing posts with label cough meds. Show all posts
Showing posts with label cough meds. Show all posts

Monday, December 30, 2013

Croupy cough- Barking noises, nighttime surprises



Croup seems to be on the rise early this season. I have seen many children brought into the Emergency Department with this scary ailment. Most commonly seems to awaken kids at night with this horrible sounding seal like barking noise. If you have ever heard a croupy cough or stridor coming out of a small child's mouth you will remember it well.
If your child wakes up barking loudly do you need to bring them to the Emergency Room? Well, that's a very good question. Not all children need to be rushed to the ER for a croupy cough. You can try a couple of things at home first.
Ask yourself these things first 

  • Does my child have a high fever? ( check it rectally if they can not hold the thermometer in their mouth well, of course you are the parent and you know when your child has a temp. Go ahead and medicate them for fever, it will help with discomfort also. 
  • Does my child have any breathing trouble, like retractions (look at them with no shirt on, does it seem like they are sucking in hard to breath?
  • Does my child have stridor-- a high pitched noise when they breath, not just the barky cough?
  • Are you freaking out and just don't know what to do (its ok if you are, better to bring them in to be checked out than not)
OK-- If your child is limp, lethargic and turning blue around the lips, call 911!! 
IF your child is happy, playful, and looks normal, but still has that terrible sounding cough- take a deep breath and calm down, its gonna be just fine.

Try these methods at home if your child seems ok at home first:
  • Turn on the shower water to hot--get the bathroom nice and steamy (of course don't put your child in the hot water) take your child in the bathroom and stay with them, help them to breath in the nice steamy air in the bathroom for around 5-10 min or so.
  • Take them immediately outside into the cool nighttime air (its ok, you are not gonna make them sicker doing this--no matter what your grandma told you) 
  • The alternating of the steam and the cool air will most of the time help stop the bronchospasm-like coughing  and help them calm down and settle back to sleep.
  • Don't medicate your child with any sedating cough syrups, alcohols or home remedies. Cool mist vaporizers or humidifiers in their room is fine. I use the old Vicks vapor rub on their chest and feet remedy myself (unless they are infants)
  • Call your peds doctor or advice line if you want more advice before traveling to the ER, they are a wealth of good information.
So What is Croup?? 



Croup is a condition that causes an inflammation of the upper airways — the voice box (larynx) and windpipe (trachea). It often leads to a barking cough or hoarseness, especially when a child cries.
Most cases of croup are caused by viruses, usually parainfluenza virus and sometimes adenovirus or respiratory syncytial virus (RSV).Viral croup is most common — and symptoms are most severe — in children 6 months to 3 years old, but can affect older kids too. Some children are more prone to developing croup when they get a viral upper respiratory infection.
Most cases of viral croup are mild and can be treated at home. Rarely, croup can be severe and even life threatening.
The term spasmodic croup refers to a type of croup that develops quickly and may happen in a child with a mild cold. The barking cough usually begins at night and is not accompanied by fever. Spasmodic croup has a tendency to come back again (recur).
Treatment of symptoms is the same for either form of croup.

Signs and Symptoms

At first, a child may have cold symptoms, like a stuffy or runny nose and a fever. As the upper airway (the lining of the windpipe and the voice box) becomes more inflamed and swollen, the child may become hoarse, with a harsh, barking cough. This loud cough, which is characteristic of croup, often sounds like the barking of a seal.
croup illustration
If the upper airway continues to swell, it becomes even more difficult for a child to breathe, and you may hear a high-pitched or squeaking noise during inhalation (called stridor). A child also might breathe very fast or have retractions (when the skin between the ribs pulls in during breathing). In the most serious cases, a child may appear pale or have a bluish color around the mouth due to a lack of oxygen.
Symptoms of croup are often worse at night and when children are upset or crying. Besides the effects on the upper airway, the viruses that cause croup can cause inflammation farther down the airway and affect the bronchi (large breathing tubes that connect to the windpipe).
Hope this helps you understand Croup a little better, have questions? Feel free to post in the comments.

Tuesday, December 11, 2012

Flu Season :Common sense people!

 
It is still not to late to think about your flu shot, think about those around you!
We are seeing an increased number of patients in the ED and all over with various cold/ flu and viral type complaints. Please consider staying home if you are ill with " flu like symptoms" and are not extremely sick. The Emergency department is just that, for emergencies. The flu is not an emergency, your symptoms can be treated just fine at home unless you develop secondary infections like pneumonia or become severely dehydrated. Coming to the ED with the complaints " flu like symptoms",coughing all over other people who might be in the ED waiting room due to real emergent conditions is not cool. Please don't bring your children to the ED either just because you want them checked out to make sure they don't have the flu. If they didn't have it before you brought them, they will when you leave.
Please use some common sense people! Take care of yourself!

Treatment: what do I do?

If you have been diagnosed with the flu, you should stay home and follow your health care provider’s recommendations. Talk to your health care provider or pharmacist about over-the-counter and prescription medications to ease flu symptoms and help you feel better faster.

  • You can treat flu symptoms with and without medication.
  • Over-the-counter medications may relieve some flu symptoms but will not make you less contagious.
  • Your health care provider may prescribe antiviral medications to make your illness milder and prevent serious complications.
  • Your health care provider may prescribe antibiotics if your flu has progressed to a bacterial infection.
  • How can I treat congestion?

    Decongestants can ease discomfort from stuffy noses, sinuses, ears, and chests. Talk to your health care provider or pharmacist about which kind is right for you.

    How can I treat coughing and sore throat?

    Cough medicine, cough drops, and throat lozenges can temporarily relieve coughing and sore throat. Talk to your health care provider or pharmacist about which kind is right for you.

    How can I reduce fevers and discomfort?

    Fevers and aches can be treated with a pain reliever such as acetaminophen (Tylenol®, for example), ibuprofen (Advil®, Motrin®, Nuprin®), or nonsteroidal anti-inflammatory drugs (NSAIDS) (Aleve®).If you have kidney disease or stomach problems, check with your health care provider before taking any NSAIDS.

    Is it safe to take flu medications with other over-the-counter or prescription medicines?

    Many over-the-counter medications contain the same active ingredients. If you take several medicines with the same active ingredient you might be taking more than the recommended dose. This can cause serious health problems. Read all labels carefully.

    If you are taking over-the-counter or prescription medications not related to the flu, talk to your health care provider or pharmacist about which cold and flu medications are safe for you.

    When should I seek emergency medical attention?

    Seek medical attention immediately if you experience any of the following:

    • Difficulty breathing or shortness of breath
    • Purple or blue discoloration of the lips
    • Pain or pressure in the chest or abdomen
    • Sudden dizziness
    • Confusion
    • Severe or persistent vomiting
    • Seizures
    • Flu-like symptoms that improve but then return with fever and worse cough
 

Aggravated ED RN ;)
 

Friday, May 18, 2012

Tripping over a Rainbow with Skittles in my hand?

Tripping or Skipping over any rainbow with these drugs in your hand is playing with a hand of deadly cards. Robotripping or Skittling is real, and real close to home!


DXM or Dextromethorphan 

Street names
CCC, Dex, DXM, Poor Man's PCP, Robo, Rojo, Skittles, Triple C, Velvet

 
 Not Skittles
Looks like
DXM can come in the form of: cough syrup, tablets, capsules, or powder.

DXM is a cough suppressor found in more than 120 over the counter
(OTC) cold medications, either alone or in
combination with other drugs such as analgesics (e.g.,
acetaminophen), antihistamines (e.g., chlorpheniramine),
decongestants (e.g., pseudoephedrine), and/or expectorants
(e.g., guaifenesin). The typical adult dose for cough is 15 or 30
mg taken three to four times daily. The cough-suppressing effects
of DXM persist for 5 to 6 hours after ingestion. When taken as
directed, side-effects are rarely observed.


Methods of abuse
DXM is abused in high doses to experience euphoria and visual and auditory hallucinations. Abusers take various
amounts depending on their body weight and the effect they are attempting to achieve. Some abusers ingest 250 to
1,500 milligrams in a single dosage, far more than the recommended therapeutic dosages described above. Illicit use of
DXM is referred to on the street as “Robotripping,” “skittling,” or “dexing.” The first two terms are derived from the
products that are most commonly abused, Robitussin and Coricidin HBP. DXM abuse has traditionally involved drinking
large volumes of the OTC liquid cough preparations. More recently, however, abuse of tablet and gel capsule
preparations has increased. These newer, high-dose DXM products have particular appeal for abusers. They are much
easier to consume, eliminate the need to drink large volumes of unpleasant-tasting syrup, and are easily portable and
concealed, allowing an abuser to continue to abuse DXM throughout the day, whether at school or work. DXM powder,
sold over the Internet, is also a source of DXM for abuse. (The powdered form of DXM poses additional risks to the
abuser due to the uncertainty of composition and dose.) DXM is also distributed in illicitly manufactured tablets
containing only DXM or mixed with other drugs such as pseudoephedrine and/ or methamphetamine. DXM is abused by
individuals of all ages, but its abuse by teenagers and young adults is of particular concern. This abuse is fueled by
DXM’s OTC availability and extensive “how to" abuse information on various web sites.

Some of the many psychoactive effects associated with high-dose DXM include: confusion, inappropriate laughter,
agitation, paranoia, and hallucinations. Other sensory changes, including the feeling of floating and changes in hearing
and touch. Long-term abuse of DXM is associated with severe psychological dependence. Abusers of DXM describe
the following four dose-dependent “plateaus”: Plateau Dose (mg) Behavioral Effects 1st 100-200 Mild stimulation 2nd
200-400 Euphoria and hallucinations 3rd 300-600 Distorted visual perceptions Loss of motor coordination 4th 500-1500
Out-of-body sensations


DXM intoxication involves: over-excitability, lethargy, loss of coordination, slurred speech, sweating, hypertension, and
involuntary spasmodic movement of the eyeballs. The use of high doses of DXM in combination with alcohol or other
drugs is particularly dangerous, and deaths have been reported. Approximately 5-10% of Caucasians are poor DXM
metabolizers and at increased risk for overdoses and deaths. DXM taken with antidepressants can be life threatening.
OTC products that contain DXM often contain other ingredients such as acetaminophen, chlorpheniramine, and
guaifenesin that have their own effects, such as: liver damage, rapid heart rate, lack of coordination, vomiting, seizures,
and coma. To circumvent the many side effects associated with these other ingredients, a simple chemical extraction
procedure has been developed and published on the Internet that removes most of these other ingredients in cough
syrup.


Overdose effects
DXM overdose can be treated in an emergency room setting and generally does not result in severe medical
consequences or death. Most DXM-related deaths are caused by ingesting the drug in combination with other drugs.
DXM-related deaths also occur from impairment of the senses, which can lead to accidents. In 2003, a 14-year-old boy
in Colorado who abused DXM died when he was hit by two cars as he attempted to cross a highway. State law
enforcement investigators suspect that the drug affected the boy’s depth perception and caused him to misjudge the
distance and speed of the oncoming vehicles.

credit to : Drug Enforcement Administration • For more information, visit www.dea.gov

Don't believe that cough syrup can kill, bet these parents can tell you different
http://www.andymaxfield.com/ 

More links and resources : 
Facts about Dextromethorphan
Walgreens becomes drug dealers
Medicine Abuse DXM
Home to Homeroom
Stop Medicine Abuse
Parent Resources
Join Together Resources







Previously posted by myself on blog Ed4Ed4all "Deadly Games" thought it was worth a repeat here on my own blog. Stay Safe this weekend!!

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