SafeRide Health (SRH) is the new provider for all NEMT rides to doctor appointments and pharmacy visits.
Depending on your needs, rides may include wheelchair-lift-equipped vehicles, stretcher vans, minivans, or ambulatory vans. Please let SRH know what type of ride you need when scheduling.
SafeRide Health (SRH) es el nuevo proveedor de todos los servicios de transporte médico que no son de emergencia (NEMT, por sus siglas en inglés) hacia consultas médicas y farmacias.
Según tus necesidades, los servicios de transporte pueden incluir vehículos con elevador para sillas de ruedas, camionetas con camilla, minivans o camionetas ambulatorias. Por favor, informa a SRH qué tipo de transporte necesitas al programar tu traslado.
The American Academy of Pediatrics (AAP) has recently released a Clinical Report strongly advising against codeine use in children. The rationale of the AAP is as follows:
“Codeine is a prodrug with little inherent pharmacologic activity and must be metabolized in the liver into morphine, which is responsible for codeine’s analgesic effects. However, there is substantial genetic variability in the activity of the responsible hepatic enzyme, CYP2D6, and, as a consequence, individual patient response to codeine varies from no effect to high sensitivity. Drug surveillance has documented the occurrence of unanticipated respiratory depression and death after receiving codeine in children, many of whom have been shown to be ultra-rapid metabolizers. Patients with documented or suspected obstructive sleep apnea appear to be at particular risk because of opioid sensitivity, compounding the danger among rapid metabolizers in this group.”
This statement strongly advises against the use of codeine both as an analgesic agent and as an antitussive agent. The AAP notes that an FDA advisory panel (in December 2015) recommended that the use of codeine for cough should be considered as contraindicated in all children under 18 years.
Texas Children’s Health Plan endorses the AAP and FDA recommendations and strongly advises providers NOT to prescribe codeine-containing medications for children.
Clinical Pearls for Analgesia
Avoid the use of codeine containing products in children.
Consider prescribing alternative analgesics such ibuprofen or acetaminophen. If opioids are required, consider hydrocodone preparations.
When prescribing opioids, use lowest effective dose for shortest period of time.
Avoid prescribing opioids “round the clock”.
Counsel patients and caregivers on how to recognize signs of opioid toxicity, and advise them to seek medical attention or call 911.
Harold J. Farber, MD, MSPH, FAAP, Associate Medical Director, Texas Children’s Health Plan
Joy P Alonzo, M.E., PharmD, Associate Pharmacy Director, Texas Children’s Health Plan
Source:
Tobias JD, Green TP, Coté CJ, AAP SECTION ON ANESTHESIOLOGY AND PAIN MEDICINE, AAP COMMITTEE ON DRUGS. Codeine: Time To Say “No”. Pediatrics. 2016;138(4):e20162396
http://pediatrics.aappublications.org/content/pediatrics/early/2016/09/15/peds.2016-2396.full.pdf
Accessed September 21, 2016
