This is from an agency letter for colorado:
COLORADO DEPARTMENT OF HUMAN SERVICES
1575 SHERMAN ST., DENVER, COLORADO 80203-1714
NUMBER: CW-02-10-I
AGENCY LETTER
CROSS REFERENCE
NUMBER:
DIVISION OR OFFICE: Child Welfare Services DATE: April 16, 2002
PROGRAM AREA: Child Welfare – CW DIVISION DIRECTOR:
TITLE: USE OF CHLORAL HYDRATE IN OUT OF HOME
PLACEMENTS
TYPE: I - Information
MANAGER:
Jane Beveridge
PROPOSED DISTRIBUTION: County Directors, Child Welfare Staff, Caseworkers, Case Service
Aides, County foster homes and group homes.
Purpose:
1.
To alert care providers and county department staff who supervise children in out of
home placement about the appropriate use of Chloral Hydrate.
2.
2. To prevent misuse of this medication on children in out of home placement.
Background:
The State Institutional Child Abuse Review Team has reviewed several cases where the use of
Chloral Hydrate seemed inappropriate. The consulting Doctor on the team wrote the attached
letter of medical information and recommendations about this medication.
Procedure or Information:
County departments should distribute this information to county foster homes and group homes
as soon as possible.
Effective Date:
Immediately
Contact Person:
Janet Motz
Division of Child Welfare
1575 Sherman Street
2nd Floor
Denver, Co 80203
FAX: 303-866-5563
e-mail: [email protected]
Telephone:
303-866-5137
COLORADO DEPARTMENT OF HUMAN SERVICES
DIVISION OF CHILD WELFARE
Child Protection
1575 Sherman Street, 2nd Floor
Denver, Colorado 80203-1714
Phone (303) 866-5137 or (303) 866-4707
TDD (303) 866-6293
FAX (303) 866-5563
CHLORAL HYDRATE
Chloral hydrate is an older sedative hypnotic drug first used clinically
in 1869. It is rapidly absorbed orally with onset of action of 10 to 20
minutes and peak of action of 30 to 60 minutes. The recommended dose for
pediatric sedation is 25 to 50 mg./kg. of body weigh /24 hours, (1 kg=2.5
lbs.), with a maximum dose of 2,000 mg./day. It is contraindicated in
children with liver or kidney disease and those with severe heart problems.
Chloral hydrate may also cause fatal cardiac arrhythmias as was seen in a
recent child fatality in Colorado.
Its use in pediatrics at the present time is mainly for sedation prior to
medical procedures such as cardiac catheterization and is used only with
close cardiorespiratory monitoring. It can be used for inducing sleep but is
indicated only for short term use of less than 2 weeks as tolerance to the
hypnotic effect developes quite rapidly. If you have a child that has been
placed on longer term chloral hydrate for sleep, please check with the child’s
doctor to ask if a safer long term alternative to chloral hydrate is indicated.
If the doctor prefers to keep the child on the chloral hydrate, please ask for a
letter of justification, which can then be placed in the child’s records.
It is in the childs best interest to give only medications that are
necessary to the childs wellbeing and to use the safest possible drugs
available.
Larry J. Matthews, M.D.
chloral hydrate
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