The Health bulletin [serial] - University of North Carolina at Chapel Hill

March, 1951 The Health Bulletin 15methods of referring children to a physicianthrough their families.Procedure by which the family physiciancan inform the school of a child'sspecial health needs was found in 64per cent of the communities. Two thirdshave modified physical education tomeet special needs of pupils, and onefourth provide corrective exercise onmedical prescription.Basic health services for athletes arereported by four out of five. First aidfacilities are present in over three fourths,but only one third have completeplans for emergency care.Exclusion and readmission for communicabledisease were found acceptableto school and health officials in 87per cent of the communities. Only halfreported reemployment and periodichealth appraisal of school personnel.The U. S. Office of Education, in cooperationwith the Public Health Serviceis now making a companion surveyof health services in city school systemsof the nation, the article brought out.The report concluded:'"Since the survey conducted by theAmerican Medical Association, addressedto the county medical societies, hascovered the relationship of such societiesto the local school health program, thetwo surveys will provide a rather completepicture of the school health servicesavailable to children."REPORT FATAL EFFECTS OFANTIHISTAMINES ON CHILDRENThe disastrous effects of an overdoseof an antihistamine on young children asa result of accidental swallowing arecompUed in a report by two physiciansof the University of Michigan MedicalSchool. Their observations serve as awarning to parents to keep these andother potent drugs out of the reach ofchildren."The susceptibility of children to theconvulsant action of antihistaminicagents is striking and impressive," Drs.James B. Wyngaarden and Maurice H.Seevers of Ann Arbor say in the Journalof the American Medical Association.They added that "the mortality rate ininfants in whom convulsions develop isvery high." Antihistamines are beingwidely used in treatment of allergic diseasesand cold symptoms.(Dr. Wyngaarden is presently locatedat Massachusetts General Hospital, Boston.)According to the article, there are atleast eight known deaths of childrenimder two years of age attributed to thesedrugs. Five of the deaths were accompaniedby convulsions.Treatment of convulsions from antihistaminicagents in infants has beenfound to be "none too successful," theysaid, since treatment is entirely symptomaticas a specific antidote is lacking.Only two cases of recovery from convulsionscaused by antihistaminic agentsin children under two are known.The doctors described the suddendeath of a 22-month-old boy who hadbeen in good health except for a mildupper respiratory tract infection. He wasbrought to a physician about two hoursafter the alleged swallowing of a numberof dimenhydrinate tablets (used formotion sickness, such as seasickness andcarsickness). At first the baby was overstimulatedand later generalized convulsionsand skin rash developed.Despite efforts to save him, the childdied 41/2 hours after swallowing thedrug. As a result of postmortem examinationthe dimenhydrinate was listedas the cause of death "either as adirect toxic effect or partially as anindirect change resulting from anoxia(oxygen deficiency)."The more violent reaction of a threeyear-oldgirl to an antihistamine wasalso reported in the article though,fortimately, the girl recovered.The girl "was found in a drowsy, listless,fretful state. She became disorientatedand walked with a staggering, awkwardgait. Jerkings of the extremitiesdeveloped, and then she experiencedgeneralized clonic convulsions."She had been playing l^i hours earlierin the bathroom from which 17 capsules