Related Experiment Video

Updated: May 3, 2026

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
09:36

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device

Published on: September 24, 2020

2.5K

Pediatric chloral hydrate poisonings and death following outpatient procedural sedation

Sean Patrick Nordt1, Cyrus Rangan, Madhu Hardmaslani

  • 1Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA, spnordt@gmail.com.

Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology
|February 18, 2014
PubMed

Insights

Chloral hydrate, a sedative hypnotic, poses significant risks in pediatric procedural sedation, including poisoning and death. Safer alternatives with better safety profiles should be prioritized for children.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Toxicology
  • Pharmacology

Background:

  • Chloral hydrate has a long history of use as a sedative hypnotic, particularly for procedural sedation in children.
  • Despite its historical use, safer and more effective alternatives are now available for pediatric sedation.

Observation:

  • Three cases of pediatric chloral hydrate poisoning are presented, all occurring after procedural sedation in outpatient settings.
  • Patients, aged 15 months to 4 years, required resuscitation, with one fatality.
  • Poisoning incidents occurred in outpatient clinic settings, highlighting potential risks outside of supervised hospital environments.

Findings:

  • Chloral hydrate is associated with severe adverse effects, including toxicity and mortality in pediatric patients.
  • The drug's pharmacokinetic and safety profiles are less predictable compared to alternative sedative agents.
  • Procedural sedation with chloral hydrate in outpatient settings carries inherent risks due to potential for overdose and lack of immediate advanced care.

Implications:

  • There is a critical need to identify and utilize safer sedative agents for pediatric procedural sedation.
  • Healthcare providers should transition away from chloral hydrate due to its adverse event profile.
  • Procedural sedation in children should only be administered in settings with continuous cardiorespiratory monitoring and immediate access to resuscitation resources.
Abstract

More Related Videos

In Vitro Method to Control Concentrations of Halogenated Gases in Cultured Alveolar Epithelial Cells04:56

In Vitro Method to Control Concentrations of Halogenated Gases in Cultured Alveolar Epithelial Cells

Published on: October 23, 2018

5.9K
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings06:59

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

Published on: November 9, 2016

33.9K

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
1.0K
Pharmaceutical Poisoning: Potential Scenarios01:26

Pharmaceutical Poisoning: Potential Scenarios

Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
116
Pharmaceutical Poisoning: Treatment Strategies01:26

Pharmaceutical Poisoning: Treatment Strategies

Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
279
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
2.6K
Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal Muscle Relaxants: Adverse Effects

Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
1.2K
Prevention of Further Absorption of Poison01:14

Prevention of Further Absorption of Poison

In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
1.4K