Sandelich Stephen, Hooley Gwen, Hsu George, Rose Emily, Ruttan Tim, Schwarz Evan S, Simon Erin, Sulton Carmen, Wall Jessica, Dietrich Ann M
Department of Emergency Medicine Penn State College of Medicine Penn State Milton S. Hershey Medical Center Hershey Pennsylvania USA.
Department of Emergency Medicine Children's Hospital of Los Angeles Los Angeles California USA.
J Am Coll Emerg Physicians Open. 2024 Mar 7;5(2):e13134. doi: 10.1002/emp2.13134. eCollection 2024 Apr.
Recent increases in pediatric and adolescent opioid fatalities mandate an urgent need for early consideration of possible opioid exposure and specific diagnostic and management strategies and interventions tailored to these unique populations. In contrast to adults, pediatric methods of exposure include accidental ingestions, prescription misuse, and household exposure. Early recognition, appropriate diagnostic evaluation, along with specialized treatment for opioid toxicity in this demographic are discussed. A key focus is on Naloxone, an essential medication for opioid intoxication, addressing its unique challenges in pediatric use. Unique pediatric considerations include recognition of accidental ingestions in our youngest population, critical social aspects including home safety and intentional exposure, and harm reduction strategies, mainly through Naloxone distribution and education on safe medication practices. It calls for a multifaceted approach, including creating pediatric-specific guidelines, to combat the opioid crisis among children and to work to lower morbidity and mortality from opioid overdoses.
近期儿科和青少年阿片类药物致死率的上升,迫切需要尽早考虑可能的阿片类药物暴露情况,以及针对这些特殊人群的特定诊断、管理策略和干预措施。与成人不同,儿科的暴露途径包括意外摄入、处方药物滥用和家庭暴露。本文讨论了早期识别、适当的诊断评估以及针对该人群阿片类药物中毒的专门治疗。重点关注纳洛酮,这是一种治疗阿片类药物中毒的重要药物,文中探讨了其在儿科使用中面临的独特挑战。儿科的特殊考量包括识别最年幼儿童的意外摄入情况、包括家庭安全和故意暴露在内的关键社会因素,以及主要通过分发纳洛酮和开展安全用药实践教育来实施的减少伤害策略。这需要采取多方面的方法,包括制定针对儿科的指南,以应对儿童阿片类药物危机,并努力降低阿片类药物过量导致的发病率和死亡率。