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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

Medications associated with clinical deterioration in hospitalized children

Emily J Huang1, Christopher P Bonafide, Ron Keren

  • 1Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Journal of Hospital Medicine
|April 17, 2013
PubMed

Insights

Certain medication classes, including antibiotics and corticosteroids, are linked to clinical deterioration in children. Incorporating these into early warning scores may improve patient monitoring and outcomes in pediatric hospitals.

Area of Science:

  • Pediatric critical care medicine
  • Clinical informatics
  • Pharmacovigilance

Background:

  • Medical emergency teams reduce pediatric mortality but face activation barriers.
  • Electronic health record (EHR) surveillance tools identify at-risk children.
  • Current early warning scores (EWS) primarily use vital signs, potentially missing medication-related risks.

Purpose of the Study:

  • To identify medication classes associated with clinical deterioration in hospitalized children.
  • To explore incorporating these medications into EHR-based surveillance tools for improved patient monitoring.

Main Methods:

  • A case-crossover study design was employed.
  • Data were collected from pediatric ward patients experiencing clinical deterioration (cardiopulmonary arrest, respiratory compromise, ICU transfer).
  • Intravenous medication administrations from frequently used therapeutic classes were analyzed.

Main Results:

  • Nine medication classes showed significant association with clinical deterioration.
  • These include specific antibiotics (glycopeptides, anaerobics, cephalosporins, aminoglycosides), systemic corticosteroids, benzodiazepines, loop diuretics, opioid agonists, and hypersensitivity antidotes.
  • These findings highlight medications as potential indicators of evolving patient risk.

Conclusions:

  • Several medication classes are associated with an increased risk of clinical deterioration in pediatric patients.
  • Future research should validate the inclusion of these medication classes in multivariable models to enhance EWS accuracy.
  • Improved surveillance tools could lead to earlier medical emergency team activation and better patient outcomes.
Abstract

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