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Emergency Numbers Every Parent Should Know

It occurred to me the day I went back to work after my maternity leave that I didn’t know any other emergency number besides 10111. Thankfully I have never had to use this but I couldn’t risk leaving my daughter at home with her caregiver without leaving a more comprehensive list of important numbers by the phone.

The last thing you want to do in an emergency is dial the wrong number. In the US, the UK and Europe there is only one toll-free number to call from any landline or mobile phone. In South Africa, things are not as simple. Unfortunately there isn’t one single number for an emergency.

I spent a really long time searching the web and making a couple of phone calls but I finally managed to put together this simple list. It is vital that you as parents and/or caregivers know what number to dial when and it is perhaps even more important that your little ones know this too.

USING YOUR CELL PHONE:

Any emergency nationwide – 112 (this number will still work even if you have no airtime)

USING YOUR LANDLINE OR CELL PHONE:

Police/Fire – 10111

Nationwide ambulance (public EMS) – 10177

Netcare 911 (private EMS) – 082 911

ER 24 (private EMS) – 084 124

Poison Information Centre – 0861 555 777

Remember, before making that emergency call, try to stay calm. You also need to have important information ready such as, the type of emergency, details of any injuries and the exact location of the emergency needing attention.

You can download a list of important emergency numbers here. It may be a good idea to stick this on your fridge or somewhere nearby the phone.

Child Immunisation Schedule SA

South Africa offers an extensive child immunisation program. All these vaccines are available at public clinics for free. Private clinics also offer an immunisation program, however, some fee may be involved, as not all medical aids pay for the vaccines. The private schedule offers more vaccines than state clinics and there may also be differences in schedules between private and public.

The following two tables below outline the different immunisation schedules.

Department Of Health Extended Program Of Immunisation (EPI) Schedule:

AGE OF CHILD VACCINATION PROTECTS AGAINST
Birth BCG Bacillus Calmette Guerin Tuberculosis
OPV (0) Oral polio vaccine: OPV-Merieux/Polioral Polio
6 weeks OPV (1) Polio
RV (1) Rotavirus vaccine: Rotarix Rotavirus
DTaP-IPV-Hib-HBV (1) Hexavalent: Hexaxim Diphtheria, tetanus, acellular pertussis (whooping cough), polio, haemophilus influenzae type B, Hepatitis B
PCV 13 (1) Pneumococcal conjugate vaccine: Prevenar-13 Pneumococcal diseases
10 weeks DTaP-IPV-Hib-HBV (2) Diphtheria, tetanus, whooping cough, polio, haemophilus influenzae type B, Hepatitis B
14 weeks RV (2) Rotavirus
DTaP-IPV-Hib-HBV (3) Diphtheria, tetanus, whooping cough, polio, haemophilus influenzae type B, Hepatitis B
PCV 13 (2) Pneumococcal diseases
6 months Measles (1) MeasBio Measles
9 months PCV 13 (3) Pneumococcal diseases
12 months Measles (2) Measles
18 months DTaP-IPV-Hib-HBV (4) Diphtheria, tetanus, whooping cough, polio, haemophilus influenzae type B, Hepatitis B
6 years Td (1) Diftavax Tetanus, Diptheria
9 years (girls only) HPV (1) (repeat 6 months later) Human papilloma Virus
HPV (2) Human papilloma Virus
12 years Td (2) Diftavax Tetanus, Diptheria

Private Practice Child Immunisation Schedule:

AGE OF CHILD VACCINATION PROTECTS AGAINST
Birth BCG Bacillus Calmette Guerin Tuberculosis
OPV (0) Oral polio vaccine: OPV-Merieux/Polioral Polio
6 weeks OPV (1) Polio
RV (1) Rotavirus vaccine: Rotarix/RotaTeq Rotavirus
DTaP-IPV-Hib-HBV (1) Hexavalent: Hexaxim/Infanrix-Hexa Diphtheria, tetanus, acellular pertussis (whooping cough), polio, haemophilus influenzae type B, Hepatitis B virus
PCV 13 (1) Pneumococcal conjugate vaccine: Prevenar-13/Synflorix Pneumococcal diseases
10 weeks RV (2) Rotavirus
DTaP-IPV-Hib-HBV (2) Diphtheria, tetanus, whooping cough, polio, haemophilus influenzae type B, HBV
PCV 13 (2) Pneumococcal diseases
14 weeks RV (2) or (3) Rotavirus
DTaP-IPV-Hib-HBV (3) Diphtheria, tetanus, whooping cough, polio, haemophilus influenzae type B, HBV
PCV (3) Pneumococcal diseases
6 months + Flu Influenza vaccine Influenza
9 months Measles (1) Rouvax

Or

MMR (1) Trimovax/Priorix

Measles

Measles, mumps, rubella

MCV (1) Meningococcal vaccine: Menactra Meningococcal diseases
12 -15 months MMR (1) or (2)

Or

MMRV (1) Priorix Tetra

Measles, mumps, rubella

Measles, mumps, rubella, chickenpox

Varicella (1) Varilrix Chicken pox
PCV (4) Pneumococcal disease
MCV (2) Meningococcal disease
HAV (1) Hepatitis A vaccine: Avaxim 80/Havrix Junior (repeat 6 months later) Hepatitis A virus
18 months DTaP-IPV-Hib-HBV (4) Diphtheria, tetanus, whooping cough, polio, haemophilus influenzae type B, HBV
18-21 months HAV (2) Avaxim 80/Havrix Junior Hepatitis A virus
5-6 years

 

MMR (2) or (3)

Or

MMRV (2)

Measles, mumps, rubella

Measles, mumps, rubella, chickenpox

Varicella (2) Chicken pox
DTaP Infanrix

Or

DTaP-IPV Quadrivalent: Adacel Quadra/Boostrix Tetra

Diptheria, tetanus, whooping cough

DTaP plus polio

9 years + (girls & boys; 13 years) HPV (1) Gardasil/Cervarix (girls only) (repeat 6 months later) Human papilloma Virus
HPV (2) Human papilloma Virus
12 years

 

TdaP-IPV Diphtheria, tetanus, whooping cough, polio

Download a copy of the South African Immunisation Schedule here.

RESOURCES

National Institute for Communicable Disease (2016) Vaccine Information for Parents and Caregivers. [Online] Available from: http://www.nicd.ac.za/assets/files/NICD_Vaccine_Booklet_D132_FINAL.pdf [Accessed 29 June 2018].

Netcare, (2016). Vaccine Schedules for South Africa for 2016. [Online] Available from: http://www.netcarehospitals.co.za/Portals/3/Images/Content-Images/PDF/latest-vaccine-schedule.pdf [Accessed 30 June 2018].

The National Department of Health, (2015). Vaccinator’s Manual “Immunisation That Works” Expanded Programme on Immunisation in South Africa (EPI-SA). [Online] Available from: https://www.westerncape.gov.za/assets/departments/health/vaccinators_manual_2016.pdf [Accessed 29 June 2018].

Medications for Pain & Fever In Children

There are a wide range of medicines on the market for pain and fever that make it confusing for parents to know which one to choose. All medicines are potentially dangerous so it is vital you know what you are buying.

There are two main groups of analgesics – opioids and non-opioids. I will not discuss opioids any further for now as these are usually reserved for severe pain and given the side effects of even the low efficacy opioids, such as codeine, I do not routinely recommend their use in children.

Non-opioids are further divided into three groups. There are a number of generics out there, so it’s important to read the product label carefully to know exactly what it is you are giving your child.

  1. Paracetamol (acetaminophen)
  • Indicated for mild-moderate pain and fever.
  • Has no anti-inflammatory properties.
  • Is non-sedating.
  • Includes but not limited to: Panado, Calpol and Empaped suppositories.
  1. NSAIDs (Non-steroidal anti-inflammatory drugs)
  • NSAIDS have anti-inflammatory, analgesic and antipyretic properties.
  • There are many NSAIDs available but most are not licensed for use in children or for pain and fever.
  • Is non-sedating.
  • Contraindications:
    • Children with asthma;
    • Children with dehydration;
    • Children with impaired renal function;
    • Children with impaired clotting or bleeding; and/or
    • A previous allergic reaction to any anti-inflammatory drug.
  • Includes but not limited to:
    • Nurofen (ibuprofen): >3 months and >5 kgs.
    • Ponstan (mefenamic acid): >6 months
    • Voltaren suppositories (diclofenac): > 2yrs.
  1. Aspirin (acetylsalicylic acid)
  • NOT RECOMMENDED for children and adolescents (<18 years) for routine analgesic and antipyretic use – AVOID!
  • Aspirin is associated with a rare, yet fatal disease known as Reyes syndrome.
  1. Combination preparations
  • These are usually a combination of Paracetamol with any one or more of the following; NSAID, codeine, caffeine, meprobamate, promethazine, dephenhydramine, doxylamine and/or other.
  • Indicated specifically for pain relief only.
  • These preparations are not superior to paracetamol alone for relief of fever.
  • These preparations can be sedating depending on the composition.
  • Includes but not limited to: Ibumol, Lentogesic, Lotem, Mybulen, Myprodol, Stilpane and Stopayne.

PARACETAMOL OR NSAID?

Now that you have a brief overview of what is out there, let’s discuss what to give your kids.

Keep it simple! Avoid combinations, as they are not any more effective than single preparations. Paracetamol is the first line drug for mild-moderate pain and fever. This is because of its high tolerability profile. Do not routinely use Paracetamol AND an NSAID together at the same time or alternatingly. I would recommend using Paracetamol first and if there is no response within an hour, try Ibuprofen.

From personal experience, Paracetamol works wonders and within 30-60 minutes your child will be running around like his/her normal self again.

Please use analgesics and antipyretics only if necessary and regardless of which one you choose, use it for the shortest time needed to control symptoms.  If you decide to use an NSAID DO NOT use more than one type at a time.

VOMITING

  • If your child vomits within 30 minutes of having ingested a dose of Paracetamol or NSAID it is safe to give that same dose again.
  • If your child vomits more than 30 minutes after having a dose of Paracetamol or NSAID DO NOT give another dose. Wait until the next normal dose.

SUPPOSITORIES

  • Oral administration of medicine is preferred since the rectal absorption of medicine is unpredictable, however, if your child is refusing to take medicine or vomiting, a suppository can initially be used.
  • Do not give an oral dose together with a suppository of the same drug at the same time.
  • Rectal administration of NSAIDs has fewer GUT side effects.

SIDE-EFFECTS*

Paracetamol:

  • Rarely causes any side effects if given at the correct dose.
  • Paracetamol overdose is VERY toxic to the liver and can cause liver failure and death.

NSAIDs:

  • Stomach pain, indigestion and/or heartburn;
  • Nausea and/or vomiting;
  • Diarrhoea;
  • Allergic reaction;
  • Bronchospasm;
  • Ringing in the ears; and/or
  • Kidney damage (little or no urine and/or blood in the urine).

*This is not a comprehensive list of all the side effects but rather a list of the more common and/or dangerous ones.

DOSAGE

When it comes to dosing, weight is more important than age, so please read the product label carefully and familiarize yourself with your child’s weight.

I suggest administering medicine using a syringe in order to measure up the dose correctly. Squirt the medicine into the space between the gum and cheek. This will reduce contact with the tongue and taste receptors making the medicine more palatable and having a higher chance of being swallowed.

Paracetamol:

  • 3 months: 15mg/kg/dose every 4-6 hours
  • < 3 months: 10mg/kg/dose every 4-6 hours
  • Max: 60mg/kg/day, up to 1000mg/dose or 4000mg/day, up to 4 doses/24 hrs.

Ibuprofen:

  • 5 mg/kg/dose every 6-8 hours
  • Max: 20mg/kg/day, up to 3 doses/24 hrs.
  • Administer Ibuprofen with food in order to reduce gastric side effects.

 

RESOURCES

de Martino, M. & Chiarugi, A. (2015) Recent Advances in Pediatric Use of Oral Paracetamol in Fever and Pain Management. Pain and Therapy. [Online] 4 (2), pp. 149-168. Available from: https://doi.org/10.1007/s40122-015-0040-z [Accessed 18 June 2018].

Gazarean, M. and Graudins, L.V. (2006) Safe use of NSAIDs in infants and children. Medicine Today, 7 (11), pp. 71-73.

Green, R., Jeena, P., Kotze, S., Lewis, H., Webb, D. and Wells, M. (2013) Management of acute fever in children: Guideline for community healthcare providers and pharmacists. S Afr Med J. [Online] 103 (12), pp. 948-954. Available from: doi:10.7196/SAMJ.7207 [Accessed 20 June 2018]

Jannin, V., Lemagnen, G., Gueroult, P., Larrouture, D. and Tuleu, C. (2014) Rectal route in the 21st Century to treat children. Advanced Drug Delivery Reviews. [Online] 73, pp. 34-49. Available from: doi: 10.1016/j.addr.2014.05.012 [Accessed 20 June 2018].

Marzuillo, P., Guarino, S. & Barbi, E. (2014) Paracetamol: a focus for the general pediatrician. European Journal Of Pediatrics. [Online] 173 (4), pp. 415-425. Available from: https://doi.org/10.1007/s00431-013-2239-5 [Accessed 18 June 2018].

Raffaeli, G., Orenti, A., Gambino, M., Peves Rios, W., Bosis, S., Bianchini, S., Tagliabue, C. and Esposito, S. (2016) Fever and Pain Management in Childhood: Healthcare Providers’ and Parents’ Adherence to Current Recommendations. Int. J. Environ. Res. Public Health. [Online] 13 (5), 499. Available from: https://doi.org/10.3390/ijerph13050499 [Accessed 18 June 2018].

Sharif, M.R., Rezaei, M.H., Aalinezhad, M., Sarami, G. and Rangraz, M. (2016) Rectal Diclofenac Versus Rectal Paracetamol: Comparison of Antipyretic Effectiveness in Children. Iranian Red Crescent Medical Journal. [Online] 18 (1): e27932. Available from: doi:10.5812/ircmj.27932 [Accessed 20 June 2018].

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