Citation

Nordt SP, Rangan C, Hardmaslani M, Clark RF, Wendler C, Valente M. J. Med. Toxicol. 2014; 10(2): 219-222.

Affiliation

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

Copyright

(Copyright © 2014, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s13181-013-0358-z

PMID

24532346

Abstract

INTRODUCTION: Chloral hydrate has been used medicinally since the 1800 s as a sedative hypnotic, most commonly for procedural sedation. As it is administered orally and available in a liquid formulation, it is used almost exclusively in pediatric patients despite many safer and more effective alternative agents being available. CASE SERIES: We present three cases of pediatric chloral hydrate poisoning, all occurring following procedural sedation in outpatient clinic settings and presenting to the emergency department. The ages ranged from 15 months to 4 years of age and all required resuscitation. Unfortunately, the 4-year-old died. CONCLUSION: Choral hydrate is associated with significant adverse effects, including death, and safer alternatives for pediatric procedural sedation should be sought and utilized. There are a number of more effective sedative agents with more predictable pharmacokinetic and safety profiles than chloral hydrate including parenteral and oral agents. The practice of pre-procedure sedation should be performed only in a supervised setting where cardiorespiratory monitoring can occur in all cases.

Language: en