Long infusion racks and rows of sitting children are common scenes in many pediatric hospitals and clinics.
The child has a cold? Infusion!
The child has a fever? Infusion!
The child coughs? Infusion!
It is still the [truth] believed by many parents and some doctors that children receive transfusion quickly.
Little imagine, this will bring unpredictable risks to children.
Today, we invited Dr. Liang Shijia to talk about the right and wrong of intravenous infusion.
Every parent should know the high risk of abuse of infusion.
Intravenous infusion directly enters the human body through blood. Intravenous infusion can achieve relatively direct effects when children cannot take drugs orally or cannot tolerate oral administration, as well as in a small number of cases where infection is serious, disease progresses rapidly and emergency treatment is required.
However, for most of the children’s diseases, intravenous infusion is not only useless, but also brings unpredictable risks to the children.
1. It is more likely to cause adverse reactions.
Common adverse reactions include nausea, vomiting and diarrhea. Especially for infants, excessive intravenous infusion using antibiotics will lead to intestinal flora imbalance, reduce body resistance and increase the probability of fungal infection in children, such as thrush.
In 2018, injections accounted for 83.5% of the ADR/incident reports for children released by the Food and Drug Administration, far exceeding oral and other preparations.
2. It is more likely to cause allergy to children,
Intravenous infusion is easy to lead to rash, pruritus, chills, high fever and even coma, etc. It can also cause local skin redness, swelling and pain, and even tissue necrosis. Clinically, there have also been cases of children dying from infusion.
3. Excessive infusion can lead to bacterial drug resistance.
In addition to oral antibiotics, antibacterial drugs are the most commonly used in children’s infusions, which also leads to bacterial resistance. Antibiotics are a good medicine to save human beings from fire and water, but only if they are used reasonably. Continuous abuse of antibiotics will give birth to a terrible monster-superbacteria.
Superbacteria refer to pathogens with multiple drug resistance, which cannot be killed even if many antibiotics are used.
In short, infection with superbacteria is close to [no medicine can be cured].
In 2015, a 3-year-old boy in Hubei was taken to hospital with stomachache. Examination found that he was infected with Klebsiella pneumoniae, a super bacterium of carbapenem-resistant Enterobacteriaceae, and eventually died of multiple organ failure.
According to the data of 2016 < < Global Antibiotic Resistance Return: Report and Recommendations > >, 700,000 people currently die of antibiotic resistance every year. This figure is really shocking!
Most of the common diseases of children generally do not require infusion.
Intravenous injection is not only risky, but also redundant in most actual situations.
1. Common cold
The common cold is mostly caused by viruses and can usually heal itself. At present, there is no specific medicine to treat it, let alone infusion.
2. Influenza
Infusion is usually not required for simple influenza virus infection. At present, oral anti-influenza virus drugs-oseltamivir phosphate, such as Tamiflu, are preferred for children’s influenza in China.
3. Mild pneumonia
Mild pneumonia is mainly manifested by good mental state, stable breathing, no consciousness disorder, no dyspnea, children’s ability to eat as usual, and no symptoms of dehydration.
The latest 9th edition of Pediatrics clearly states that only children with severe pneumonia or difficult oral absorption due to vomiting need to consider intravenous infusion therapy.
4. Diarrhoeal diseases
Most children with diarrhea do not need intravenous infusion, and it is good to use rehydration salt to prevent dehydration.
Even if antibiotics are really needed, they can be taken orally. Infusion and rehydration are only considered if the child cannot tolerate oral administration or is severely dehydrated.
5. Acute bronchitis
Bronchitis is usually caused by viruses. If you cough up yellow-green sputum, it does not mean that you have bacterial infection. Of course, there is no need to use antibiotics or even intravenous infusion.
Under the above circumstances, as long as the child can take medicine smoothly and eat water and diet normally, there is no need to give the child infusion.
Blind pursuit of good fast, intravenous infusion abuse disaster
According to the statistics of the National Development and Reform Commission, China’s medical infusion reached 10.4 billion bottles in 2009, equivalent to 8 bottles per person for 1.3 billion people, far higher than the international level of 2.5 ~ 3.3 bottles, and growing at a rate of nearly 20% every year, making it the world’s leading [infusion country].
1. Parents Think Infusion Is Good Fast,
Many parents feel that if they do not receive transfusion, prescribe medicine or test, they do not see a doctor. Are they always worried that their children can resist the past when they are so young? What if the disease worsens?
Especially in the concept of some old people, if the child is ill, everything will be fine as long as the infusion is carried out.
As a pediatrician, I often encounter some parents forcing doctors to open infusion lists. If you don’t open them, you may be complained. Many doctors are also forced by this pressure and can only meet the requirements of parents.
2. Infusion therapy is rampant in some hospitals,
The World Health Organization recommends that the usage rate of antibiotics in hospitals is 30%, while in China, the median usage rate of antibiotics for paediatric hospitalized children is 79%, more than twice the world’s recommended usage rate.
Many parents take their children to the hospital to see a doctor. Doctors often give infusion. Whether it is cold, fever or cough, pneumonia, assembly-line treatment also makes many parents feel helpless. This is related to the fact that some doctors’ knowledge system has not been updated and the atmosphere in the hospital.
With small changes in the general environment, intravenous infusion is gradually controlled.
In recent years, the government has also issued a number of measures to control the high risk of intravenous infusion and its abuse.
In 2007, the National Health and Safety Commission issued the “Reference Catalogue of Medication in Community Health Service Institutions” which proposed that oral preparations should be preferred for pediatric medication and intramuscular injection or intravenous injection should be minimized.
In 2018, the Notice on Continuously Doing a Good Job in the Management of Clinical Application of Antibacterial Drugs said that unreasonable preventive use and intravenous infusion of antibacterial drugs should be reduced.
Health administrative departments of Jiangsu, Guangdong, Guangxi and other provinces and cities have also successively issued special measures to stop outpatient infusion.
It is not difficult to see from this that the Government is determined to [regulate intravenous injection].
However, intravenous infusion has long been rooted in the hearts of many people. In some hospitals and small clinics in prefecture-level cities, infusion therapy is still [popular].
As parents, in addition to recognizing the misunderstanding and not taking the initiative to ask for infusion for our children, we can also ask first when facing doctors who give infusion for our children:
Do I have to get an infusion?
Can I take the medicine orally first?
If the doctor has a good reason, then listen to the doctor. If the doctor refuses to answer, or the explanation is not clear, then it is recommended to change to a doctor.
Can take medicine without injection, can give injection without infusion.
In the current big medical environment, parents can really do limited things. But at least, we can learn more knowledge, express our thoughts and doubts to doctors, and do not blindly believe or reject them.