This accuracy directly impacts patient care. With a complete medication history including updates to the patients’ allergies, physicians can order medications from the retail pharmacy to be delivered to the bedside as part of the “Meds to Beds” program. Clinical technicians also assist with clinical tasks, reorder doses and coordinate discharges so patients leave with everything they need. If a patient is not tolerating a medication or has run out, clinical technicians work closely with pharmacists and the care team to resolve issues quickly. In the Neonatal Intensive Care Unit (NICU), they also review transfer records and vaccine administration schedules to support safe care.

Clinical technicians are cross-trained to provide support 24 hours a day, seven days a week, wherever they are needed in the hospital. In the ED, dedicated clinical technicians are available around the clock to assist pharmacists, improving both safety and turnaround time for medications. During codes, clinical technicians coordinate medication delivery to the bedside and assist the pharmacists with drawing up emergency medication doses.

Through the program, clinical technicians help patients identify and resolve issues with their medications.

“When we take medication histories, we sometimes find patients haven’t been taking their medications at all,” Hernandez said. “Other times, their symptoms are actually side effects from taking a medication incorrectly.”

Expanding a Program That Leads the Field
The clinical technician program began in 2013 to support clinical pharmacist activities on the inpatient units. From 2011 to 2012, pharmacy students piloted medication history taking in the ED. As a result of this pilot, medication history technicians were added in 2015 in the ED, inpatient units, and later, Perioperative Services.

In 2022, the medication history program merged with the clinical technician program, creating a more comprehensive, integrated service supported by additional full-time positions.  

Today, the program continues to grow. Pharmacy completion of medication histories has increased from 89% of admissions to 98% in 2025. The team is recognized as a leader in the field.

“We have one of the most robust programs in the country with research dedicated to this,” Yeh said.

That recognition extends beyond Cook Children’s. At a recent Children’s Hospital Association conference, the Cook Children’s program was highlighted as a model for medication history programs nationwide. Hospitals across the country have reached out to learn about the program’s structure and success.

Most importantly, the impact is felt by patients and families every day.

“We take a holistic approach to improving the patient experience, from transitions of care to how we measure success,” Yeh said. “This program makes a difference for patients every day.”

“Our services have grown and we are excited to provide a more convenient location for our families that are visiting the specialty clinic offices,” said Ozioma Olowu, AVP, Pharmacy Administration . “With this new location, we are expanding our ability to dispense more specialty medications for our medically complex patients and have already begun work with clinic staff and their new dedicated pharmacy teams.”

“We are easily accessible from our new parking garage, which has convenient, reserved parking spaces for retail pharmacy customers on the ground floor! We offer the same unique services our families have come to appreciate at our first location such as compounding and flavoring medications,” Olowu said.

Retail Pharmacy

• Address: 1500 Cooper St Suite 1541
• Phone: 682-303-3900
• Email: DodsonRetailPharmacy@cookchildrens.org

By Eline Wiggins and Sydney Hanes. Video by Tom Riehm.

Stepping into a world of color, cowbells echo down the hallway, marking the opening of Cook Children’s Medical Center - Prosper on Jan. 9, 2023. Staff members, patients, and families are a part of something new and feel the buzz of excitement in the air. In the first 50 days, the medical center staff has already provided excellent care as new patients and their families enter the doors.

The newly-built campus provides world-class medical care to children living in the northern sector of the Metroplex. The 23-acre Medical Center at Prosper cares for patients with an emergency department, a surgical and procedural floor, an infusion center, an outpatient imaging center, a retail pharmacy, an inpatient unit with medical-surgical and pediatric intensive care, and two floors of shell space for future needs. 

Since opening day, the Cook Children’s Prosper team has shared smiles and pinky promises with patients. Families and patients explored new floors and new departments throughout the medical center. They met new faces and built relationships with providers who they will know for many years to come.

Here is a glimpse into the beginning of this new chapter in the 105-year history of Cook Children’s.

In the first 50 days, many patients, including Hannah Bland, were seen and treated at Cook Children’s Medical Center - Prosper. Hannah's mother, Megan Green said she is so grateful for the Medical Center in Prosper because it made it easier for their family to be together.

“Cook Children’s has been a part of our journey since day one," Green said. "I am so grateful for the Prosper campus because it has allowed our family to stay together during Hannah’s admissions. For the first time, Hannah’s siblings can come up to visit her and I am able to go home and check on them when I need to. I know that Cook Children’s knew the Prosper campus would be important for families, but I don’t think they realized what a significant impact it would bring to families like mine. Thank you, Cook Children’s!”

Photo caption: Left - Infusion Center Staff and Anthony Anani, M.D., supported patient Gavin Ellis. He was Prosper's first infusion center patient . Right - Megan Green, Hannah Bland and family say they are grateful for the opening of Cook Children's Medical Center - Prosper.

Teddy Bear Transport

Cook Children's Teddy Bear Transport connects patients and the Cook Children’s Promise from the Medical Center in Fort Worth to the Medical Center in Prosper. Teddy Lori Hill, RN Teddy Bear Transport, was a part of the first patient transport from Prosper to Cook Children’s Medical Center in Fort Worth.

“Everybody was very welcoming there,” she said. “It’s always fun to be one of the first ones to go. Everything just went like clockwork.”

The first OR patient

After months of preparation, each member of the surgical team was ready for the first patient to enter the operating room. 

“We were honored to welcome our first surgical patient,” said LaRisha Glover, nurse manager of surgical services at Cook Children’s Medical Center - Prosper. “Our team was filled with expectation and thrilled to finally work through processes that we have worked so hard on over the last few months. We are looking forward to serving the community and building long-lasting relationships.”

Photo caption: Donna Talreja (RN), Kathryn Dupre (RN), and Kelley Trotter (CST)

Pharmacy is open for prescriptions, medications and more

Our pharmacy team has been hard at work filling prescriptions for our patients, including the first non-sterile oral compound at the CCMCP inpatient pharmacy. 

Pharmacy Clinical Specialist Clifford Ho transferred from Cook Children’s Medical Center Fort Worth to Prosper. Cliffords’ favorite part of the first 50 days in Prosper has been “helping patients and families understand their medications and the time we get to spend with them.”

Retail pharmacy in Prosper

Prosper retail pharmacy provides a wide array of outpatient prescription services, including specialized compounded medications. Our lead technician and compounding specialist, Carmen Rodriguez, completed a compound for a CCMCP patient. Carmen is well-versed in medication compounding and was so excited to complete the first one in Prosper. The first compounded prescription was completed on Jan. 20, 2023.

“Opening a new retail pharmacy in Prosper has been thrilling," Rodriguez said. "The energy here is one of optimism and excitement for both the present and the future, and being a part of something so special is nothing as I have experienced before. Seeing patients in the building after months of hard work and anticipation has really energized my team and we are so excited for every new day and a new opportunity to serve our patients with excellence. Since compounding medications is something I am passionate about, I was so eager to make our first compounded prescription. It was fun having the team involved for one of our ‘firsts’ and we look forward to many more!”

Spiritual Care 

The Spiritual Care team offers spiritual guidance and emotional support to people of all faiths as well as those who practice no particular faith. Amanda Payne Lindsay, MDiv, is our Chaplain at Cook Children’s Medical Center - Prosper.

“The best part of the first 50 days in Prosper is seeing the amazing care that Cook Children’s provides to patients being brought to my hometown,” Lindsay said. “I grew up in this community (McKinney, about 15 minutes away) and love my community dearly. It has been such a joy to watch the place I love to work come to the community I love to live in.”

The Spiritual Care team provides prayer bears to patients who need encouragement or support after a painful procedure, during a lengthy hospital stay or during difficult times. Prayer bears are a way to remind patients that they are not alone.

“It doesn’t matter if you are in Fort Worth or Prosper, giving out prayer bears is one of the favorite parts of my job,” Lindsay said. “It is the most tangible way we as chaplains are able to deliver comfort and joy to even our littlest patients. I am so happy we are carrying this 25-year-old tradition on here in Prosper.”

Successful Joint Commission survey

Cook Children's Medical Center - Prosper had a successful Joint Commission survey. The Joint Commission evaluates, accredits and certifies more than 22,000 health care organizations and programs in the United States for the highest standards, safety and quality.

Surveyors were very complimentary of the Cook Children’s Medical Center – Prosper culture and alignment with our Promise, “Everything for the Child.” They also loved the facilities, with its unique features, one-of-a-kind design elements and beautiful aesthetics at the brand-new campus.

Henry Ford once said, “If everyone is moving forward together, then success takes care of itself.”

“What an amazing last few days!” said Kevin Greene, Vice President and Administrator at Cook Children’s Medical Center – Prosper. “The culmination of hundreds of hours and countless late nights all came together to produce a successful Joint Commission survey for Cook Children’s Medical Center - Prosper. I could not be prouder to serve alongside so many amazing health care professionals all committed to our Pinky Promise and North Star - Everything for the child!

“This is just the beginning of our commitment to providing world-class pediatric care to every child in our care and our communities. Most grateful.”

Pediatric Intensive Care Unit

The Pediatric Intensive Care Unit (PICU) cares for children with life-threatening illnesses or injuries. The unit also cares for children recovering from procedures such as surgeries. 

Zaccheaus Chimedza, PICU RN, said his favorite part has been the team that he gets to work with.

“Having my son here as a patient really made me appreciate the amazing care we give here and the team I get to work with even more,” Chimedza said.

Photo caption: Zaccheaus Chimedza, PICU RN

Social Work

Social Workers provide ongoing supportive counseling and resources for patient families. Social Worker Riley Mullahy, MSW, is one of many social workers at Prosper who help patient families.

“It’s been amazing to work with the families out here and feel like we are really making a difference for the community of Prosper. I’ve also loved the amazing team that I get to work with,” Mullahy said.

Photo caption: Riley Mullahy, MSW, Prosper Social Worker

Lab

Amanda Pulley, Manager Laboratory Operations said it was exciting to begin working in the lab, including when the first specimen came down the tube station.

“The first 50 days have been one of the most memorable and rewarding times in my career as I’ve watched a team of very intelligent, passionate lab professionals, apply their unique skill sets to provide efficient, quality care,” Pulley said. “We handpicked this team to set the standard here at CCMCP in the laboratory, and I couldn’t be prouder of the work we have accomplished, the work we continue to do, and the work we are yet to do. Knowing we are providing quality care to the community we live in, makes all the long hours and hard work worth it. I am confident that we have set a foundation, that we will continue to grow from, for years to come.”

Food and Nutrition Services Team cooks up great meals and cookies for Cookie Wednesday

The Food and Nutrition Services team connects all patients, families and employees when it’s time for a meal or snack, or even just some time to relax in the cafe.

The team said their favorite is “the fun we have working together and providing staff and patients with thoughtful and delicious food. We get to nourish people’s bodies and spirits here.”

Food Services is also bringing the tastiest Cook Children’s tradition, Cookie Wednesday, to Prosper! Each Wednesday afternoon, freshly baked, warm cookies are available from 11 a.m. to 7 p.m. in Over the Moon Hospital Cafe for $1 each. Patients, families and staff members are invited to stop by to enjoy a variety of delicious cookies!

“People look forward to it every week,” said Food and Nutrition Services Manager and Executive Chef DeWayne Pace. “People are asking if they can have cookies for breakfast!”

Photo caption: Ilham Assekkour, Lessby Navas, Macy Magee and Ana Aguilar

This common remedy for itchiness is the reason Director of Pharmacy Ozioma Olowu decided to pursue a pharmacy career.

“In high school, I was given the chance to visit Rutgers University’s pharmacy school and we got to create (or compound) our own calamine lotion,” Ozioma recalled. “My mom used to slather us up in it when we had itchy mosquito bites and I thought it was the coolest thing ever that I made that! I never looked back.” 

From that high school student enamored with the compounding for the first time to leading the charge on the first ever COVID-19 vaccination effort at Cook Children’s, Ozioma continually embraces the challenges in front of her. 

For this most recent challenge, she shared, “With the COVID-19 vaccine, not only was there so much unknown but we’ve had to work through that unknown at a much faster pace than normal.”

Typically, the flu vaccination plan begins with an order placed in February and arrives in late August. These several months of preparation for the COVID-19 vaccine was distilled down to only a few weeks this time.

“I filled out the application for the vaccine at the end of October, we began planning these vaccine clinics the week of December 11 and the first employee doses were given on December 17,” she explained. “This was no small feat and I definitely had some sleepless nights since late October. I don’t think I fully exhaled until the vaccine arrived on the loading dock.”

According to an employee survey, the initial employee response was that approximately 60 percent said they would be willing to get the vaccine. Ozioma understands the apprehension by those that replied that they wouldn’t want it. She acknowledged, “There can be mistrust in healthcare, some of which is warranted based upon what has happened historically when ethics have failed disenfranchised populations.”

“Since I think of the pharmacist as the most accessible health care professional in the community right around the corner at a local pharmacy, we have an extra responsibility and accessibility to help build trust in this current situation,” Ozioma added. “And I believe we have done a great job of laying out the facts and clearing up misconceptions, especially with our employee population.” The success of these efforts is evident with a total of 72 percent of employees now saying they would get the COVID-19 vaccine.

This desire to persevere and overcome obstacles is rooted in her own upbringing. Having grown up in New Jersey to Nigerian parents, who immigrated in the late 1970s, Ozioma felt pressure early on. “In our culture, the parents invest so much in the oldest child, which is me, and, even more so, my parents specifically told all their kids, ‘The only option for you is to succeed. We didn’t come all the way here for you to fail,’” Ozioma said with a slight chuckle while thinking back.

Having spent time at the CVS pharmacy at Boston Children’s, Ozioma knew pediatrics was where she wanted to be. What drew her in was the same thing that appealed to her during that Rutgers visit. OK, it wasn’t the calamine lotion, but the ability to compound medications.

With an excited tone in her voice, Ozioma said, “Most medications aren’t dosed for children from the manufacturers; so we have the unique opportunity to create and not just dispense medication. In the pediatric setting, we also get to establish relationships with the staff and the families.”

Pictured: Ozioma with UPS drivers delivering the COVID-19 vaccine. 

Eventually, Cook Children’s showed up on her radar because of her husband, who had met the then-director of Pharmacy at a conference. After hearing about Cook Children’s and the breadth and depth of services offered here, Ozioma made the choice to venture to Fort Worth in 2006 over offers from Children’s Hospital of Philadelphia and University of North Carolina Medical Center.

“I like to think of Cook Children’s as a sleeping giant. While those other hospitals are great and have national name recognition, Cook Children’s is a place that I feel we can blaze our own trail,” she said. “We do so much for so many children with such a wide range of services that people just don’t know about.”

There’s no doubt that her parents are proud of the success that Ozioma has earned in her career, having elevated to the role of director over a team of 193 employees, who fills 1.5 million doses of medication every year.

“That’s an enormous responsibility for m team because that’s 1.5 million chances to help heal a child,” explained Ozioma. “This team is so great at what they do and I have the highest confidence in them. I couldn’t be prouder to be a part of this group.”

“I like to tell my staff that we are in the basement because we are the foundation of the hospital and we hold the building up,” Ozioma said. “Our team is likely one of the only teams in the entire building that has a hand in the care of every patient in our hospital because almost every patient will need medication that we compound or dispense at some point.”

Given the widespread influence and impact that her team can have within our walls, Ozioma recognizes that the diversity of her staff plays just as important of a role. As they spread out and touch the care of every patient, it’s vital to show that Cook Children’s is a place where diversity is valued.

Ozioma humbly said, “One of our Spanish-speaking pharmacists shared with me that she has seen patients and parents physically relax with an easing of their shoulders and letting out a relieved breath when they saw her and heard her. They simply needed to see and hear someone that looked and sounded like them.”

As a woman of color herself, she feels that same sense of responsibility not only at Cook Children’s, but in the community as well.

Following a program presentation at the Tarrant County Public Health, an older woman specifically approached Ozioma to tell her that she was proud to see a Black woman in a position of authority and respect. The lady told Ozioma that 40 years ago when her own child was in our hospital, the only people in the hospital that “looked like her were cleaning the rooms.”

This exchange resonated with Ozioma because she understands that she’s a role model for those around her, whether she knows them or not. At Cook Children’s, she embraced the chance to forge her own path and relishes the continued support and opportunities that have been given to her by our administration.

Ozioma concluded, “I have complete faith in our administration and our culture here at Cook Children’s. The supportive and collaborative approach across the system, which is even more evident during this COVID-19 crisis, proves to me that Cook Children’s always strives to make the right decisions in the best interest of the patients each time.”

That’s because together we are better for all of our patients, their families and each other. And together #WeAreCookChildrens.

About Cook Children’s:

Cook Children’s Health Care System embraces an inspiring Promise – to improve the health of every child in our region through the prevention and treatment of illness, disease and injury. Based in Fort Worth, Texas, we’re proud of our long and rich tradition of serving our community.

Our not-for-profit organization encompasses nine companies – a medical center, two surgery centers, a physician network, home health services and a health plan. It also includes Child Study Center at Cook Children's, Cook Children's Health Services Inc., and Cook Children's Health Foundation. With more than 60 primary, specialty and urgent care locations throughout Texas, families can access our top-ranked specialty programs and network of services to meet their unique needs.

We’ve worked to improve the health of children from across our primary service area of Denton, Hood, Johnson, Parker, Tarrant and Wise counties for more than 100 years. Based on the exceptional care we provide, patients travel to Cook Children’s from around the country and the globe to receive life-saving pediatric care built on leading technology, extraordinary collaboration and the art of caring.

For more information, visit cookchildrens.org.

Cook Children’s has been utilizing intranasal ketamine as a rescue treatment to break unrelenting migraine attacks in the emergency room and inpatient setting since December 2016. Originally, the drug was utilized out of necessity due to a shortage of dihydroergotamine – the medication previously used most frequently for persistent migraine attacks which failed to respond to outpatient therapy. The team presented their findings at the International Headache Conference in 2017.

“Until that time, little to no experience with nasal ketamine had been reported in pediatric patients,” said Adrian Turner, a clinical pharmacist at Cook Children’s. “However, our institution’s experience is broadening the horizon of potential treatment options.”

Now the U.S. Food and Drug Administration has approved esketamine, a chemical compound similar to the anesthetic ketamine, to relieve depression in hours instead of weeks. The drug, the first to be approved to fight depression since 1988, is believed to help patients who have been treatment resistant to other depression therapies.

Esketamine, developed by Johnson & Johnson, will be marketed under the name Spravato® and is a nasal spray that allows the drug to be absorbed through the lining of the nose, directly to the blood stream.

Patients using Spravato® will also be required to enroll in a Risk Evaluation and Mitigation Strategy (REMS) program to monitor for serious side effects related to sedation, dissociation, abuse/misuse and to support its safe use. Patients will be required to self-administer the drug under direct observation of a healthcare provider.

“This is potentially a game changer for millions of people,” Dr. Dennis Charney, dean of the Icahn School of Medicine at Mount Sinai in New York, told NPR. “It offers a lot of hope.”

At this time, no plans have been made at Cook Children’s to use ketamine for depression, but intranasal ketamine has been vital for helping patients with severe migraines.

Intranasal ketamine for migraines not only worked for a majority of Cook Children’s patients (almost 70 percent of patients between December 2016 and October 2017), but was safe and well tolerated. Any side effects seen, some dizziness and very mild dissociative effects (i.e. feeling funny, out of body experience) were mild and didn’t last longer than one hour after administration.

No patient had to stop due to side effects.

Turner said using ketamine for migraine offers many benefits:

1. Patients don’t need an IV or injection to receive treatment.
2. The number of medications needed to treat the pain may be reduced.
3. The time needed to treat the pain may be reduced.
4. It provides patient with a wider variety of options to treat their migraine.

Ketamine was first created in the 1960s and was largely used as a battlefield anesthetic and veterinary medicine. By the 1980s, hospitals were using the drug for sedation and severe pain.

Until recently, the FDA approved the drug in patients 16 and older for general anesthesia (dental procedures, outpatient surgery, intubation). Compared to other medications used for sedation/anesthesia, ketamine is relatively safe due to less effects on breathing and blood pressure.

In the past few decades, ketamine became the focus of studies for the treatment of depression. The Department of Health and Human Services reported an estimated 16.2 million adults and 3.1 million adolescents aged 12 to 17 in the United States had at least one major depressive episode. This is especially important when considering the rates of suicide. In 2016, the Centers for Disease Control and Prevention (CDC) reported suicide as the number 10 overall cause of death with more than 44,000 deaths attributed to suicide reported. Even more troubling, suicide was reported to be the number 2 overall cause of death for people aged 10-34, number 4 for people aged 35-54, and number 8 for people aged 55-64.

“Expanding treatment options is not only beneficial to improve the quality of lives of patients with depression, but it may also help save many lives in the future. Depression can be very difficult to treat,” Turner said. “Compared to other diseases and diagnoses, depression is not a one-size fits all treatment. Expanding the treatment options is a huge benefit to patients who have exhausted several treatment options with little to no relief.”

Aside from the new indication for depression, ketamine and esketamine both have potential use in post-traumatic stress disorder (PTSD), migraines, refractory/chronic pain conditions, and seizures. There are active studies underway in the U.S. and internationally examining the use of ketamine to treat PTSD, status epilepticus, and oral ketamine to treat chronic pain in adults and children. Cook Children's Pain team is currently treating patients with chronic/refractory pain with a ketamine IV and oral ketamine.

Some may know ketamine as a party drug. Ketamine (also known as Special K, Super K, and Vitamin K among other street names) is known as a potential drug of abuse and a drug used to facilitate sexual assault crimes. When taken illegally, users often inject, snort, or smoke the drug to feelings of calmness and out of body experiences.

Unfortunately, because these are often taken in very large doses, users also experience complications such as hallucinations, immobility, amnesia, and unconsciousness. It’s especially dangerous when given in very high doses or mixed with other drugs and/or alcohol because this greatly increases the chances of serious health problems and/or death. The World Health Organization notes that ketamine is a potential drug for abuse, but the actual incidence of dependence or overdose is rare. Chronic abuse has been linked to urinary tract problems.

But under the guidance of health care providers, ketamine has been highly beneficial.

“Our experience with ketamine has been positive,” Turner said. “The success we have seen at Cook Children’s combined with the approval of esketamine for refractory depression is very exciting. As a health care professional, it is invigorating to see years of research produce positive outcomes for our patients. I look forward to seeing Cook Children’s on the forefront of contributing to this new frontier. ”

Motion sickness commonly presents as nausea, vomiting, sweating, headache, or drowsiness. Other symptoms may be an increase in saliva, loss of appetite, or general discomfort. There are steps you can take to help prevent or treat motion sickness before turning to medications. First, be aware of what causes your child’s motion sickness and try to avoid those activities when possible. When certain activities cannot be avoided (for example, driving in a car), choose the best seating position for your child to reduce motion or the feeling of motion (for example, sitting by a window). Another way to prevent motion sickness is to make sure your child drinks plenty of water to stay hydrated. Wrist bands are also available that put pressure on a part of the wrist that can help some children.

Medications to treat or prevent motion sickness are also available at your local pharmacy without a prescription from the doctor. Most of these medications are antihistamines, similar to medications used for seasonal allergies. The most common are called dimenhydrinate (Dramamine©) and diphenhydramine (Benadryl©) and these are approved for over-the-counter use in children 6 years of age and older. Meclizine (Dramamine Less Drowsy© or Bonine©) can be given to children 12 years of age and older, and may cause less drowsiness than the first two medications. Doses for these over-the-counter medications are:

• Dimenhydrinate (Dramamine©)
  • Children 6 to 12 years: 25 mg to 50 mg every 6 to 8 hours (maximum of 150 mg/day)
  • Children older than 12 years: 50 mg to 100 mg every 4 to 6 hours (maximum of 400 mg/day)
• Diphenhydramine (Benadryl©)
  • Children 6 years and older: 12.5 mg to 25 mg every 6 to 8 hours (maximum 300 mg/day)
• Meclizine (Dramamine Less Drowsy© or Bonine©)
  • Children 12 years and older: 25 mg to 50 mg once per day

All over-the-counter medications will have dosing instructions, so it is important to read the package before giving them to your children. These medications may be used in younger children, but it is important to ask your child’s doctor or pharmacist if they are appropriate. If you have any questions about the medication, doses, or how to give it to your child be sure to consult your child’s healthcare provider or pharmacist.

If your child is under 6 years old, call your pediatrician for guidance.

About the Author

Lauren Duran is a pediatric Hematology/Oncology Pharmacy resident at Cook Children's. Cook Children's pharmacists are here to help parents and make their child feel better. They are always happy to answer any questions you may have about your child's medications with a call or an email. The pharmacy is located on the first floor of the medical center, next to the Emergency Department. To learn more about Cook Children's Retail Pharmacy, click here.

Parents using dosing cups had four times the odds of making a dosing error, compared to when they used an oral syringe and that the most common mistake was overdosing: 68 percent of the participants gave too much medicine, rather than too little.

Children should receive their liquid medications only through milliliters to reduce dosing errors, according to a policy statement from the American Academy of Pediatrics. The AAP recommends medicine to children be administered by a syringe with flow restrictions, but cups and spoons are acceptable, as long as the dosage is marked in milliliters.

The AAP’s research found that more than 70,000 children went to the emergency room because of unintentional medication overdoses.

The AAP says parents should not be using household spoons or any other measuring device to give kids their medicine, other than measuring in milliliters (mL).

“Sadly, some may feel that liquid medication accuracy just isn’t very important. They may think, ‘It’s just cough syrup or to reduce fever,’” said Jason Evans, a pharmacist at Cook Children’s. “While an adult may be able to tolerate a huge discrepancy from a dessert spoon, a child can be seriously hurt or even killed. There have been several children fatally overdosed in this manner from mere cold medication. “

Household spoons simply aren’t accurate. Three teaspoons are in one tablespoon and a household teaspoon can vary in size. Depending on the spoon, a parent can give a child as little as 2 mL and much as 8 mL, when the intended dose was actually 5 mL. That large discrepancy is the danger that has made the AAP take this stance.

Evans said most hospitals have been using the mL standard for 10 to 20 years because it’s a much safer practice and avoids errors. Cook Children’s follows the mL system, even for oral syringes.

“We don’t have teaspoon or tablespoon markings anywhere,” Evans said. “Syringes are more accurate than dosing spoons and dosing cups. There is scientific evidence for this. Now, we just need to complete the puzzle and use the same terminology for patients at home.”

Evans gives the following advice to parents:

• Know your child’s medication in terms of the metric system.
• Ask your pharmacy for a medication syringe, not a dosing spoon or cup.
• Use a medication syringe, even if a dropper came with your prescription.
• Ask for a bottle adapter that will allow you to turn the bottle upside down to draw out the medication.
• Hand wash syringes to avoid melting or rubbing the markings off.
• Ask your pediatrician or pharmacist if you are confused about how much medication to give.
• It might not just be the parent giving the medications. If necessary, have your babysitter or other caregivers (e.g. grandparents) demonstrate to you how to measure the medication with the syringe.

Read more from the American Academy of Pediatrics on this topic here.

Imagine you are 5 years old. It’s a beautiful day and you are stuck in the house with a fever. Your wonderful mother gives you little orange tablets that taste like oranges. You think taking these little tablets that look a lot like M&M’s will make you feel better really soon. What a wonderful Mom! Then she leaves the bottle with the little orange flavored tablets on the table just a few feet away. What would you do?

I was the child that decided if a couple of little orange things would make me feel better than the bottle of little orange things would get me well quicker and I could get back to playing with my friends. What I didn’t know was that there were enough tablets in that bottle to cause a very large overdose. After I took the pills, my mom noticed that I wasn’t responding to my name. I was nearly unconscious. So I was given a trip to the emergency room at our local hospital. I was fortunate that someone noticed and that it wasn’t something worse. 

A recent study in Pediatrics found that 640,000 emergency department visits were made in the U.S. from 2004 to 2013 because children were able to to get medication without adult supervision.

When I became a mother myself, I was very diligent in keeping medications away from little hands by keeping the medications in a high or locked cabinet. We can protect our children from an accidental poisoning at home by looking at things from their eyes. Everything that looks like candy is interesting to them.

Every year Cook Children’s receives more than 600 children due to poisonings. Seventy-five percent are medication related. Children can be accidentally poisoned by finding medication belonging to a friend or family member at their house or in their purse or bag. Or by getting into a cabinet that contains household cleansers like bleach or window spray. Remind your friends or family members to keep medication and household cleaners out of the reach of your children. Often Grandmother’s medication looks like candy, just like my little orange pills, or the cleanser bottle looks like lemon/lime drink.

Sometimes it’s as simple as not measuring a liquid medication correctly. Ask your pharmacist for a medication measuring spoon or oral syringe so you give the correct amount of medicine to your child. The spoons in your kitchen will not always measure the same amount as a medication spoon.

Also, make sure to keep the poison control number (1-800-222-1222) near your phone in case you need it.

Rosanne Thurman is director of Pharmacy at Cook Children's. Cook Children's pediatric pharmacists are available at the medical center to make sure your child's medicines are safe and effective.That includes helping parents understand what their child's medicine is for, the best times to take the medicine, the right dose, side-effects and any possible drug interaction with other medications that their children may be taking, such as other prescriptions, over-the-counter medications like cough syrup or antihistamines and herbals. They can even tell parents what food and drinks might cause an interaction.

Six days after her high school graduation, Harkey found out she was pregnant. During her pregnancy she faced several complications due to the fact that her son’s intestines were located outside his belly, a condition known as gastroschisis.

Once Aiden Wayne Harkey-Ellis entered the world, Harkey got to hold her son. But only briefly before he was rushed to Cook Children’s Medical Center where Chip Uffman, M.D., performed surgery on Aiden.

Healthy babies are born with about 200 centimeters of the small intestine. Aiden now has 20 centimeters and only one-third of his colon. He has severe short bowel syndrome (SBS) and will always have trouble gaining weight and absorbing nutrients.

He has had 26 surgeries since birth, including  two transverse enteroplasty procedures to lenghten his bowels and exploratory bowel surgery, a G-button where he receives feeding through a tube and several line placements.

“He is now home safe and sound, however we have been in and out of the very place that saved his life, Cook Children’s, and will be here for years to come,” Harkey said. “I was recently reminded, even if it seems like we’re not progressing, every breath is a miracle and progress.”

Short bowel syndrome occurs any time enough intestine is lost to cause poor absorption of nutrients. There are many causes of SBS. The most common cause in children is necrotizing enterocolitis, a rare complication of prematurity or other serious illness in the newborn period. Other causes include congenital intestinal anomalies (such as gastroschisis, malrotation or intestinal atresias), surgical resection for Crohn disease, trauma, malignancy, radiation, or vascular insufficiency, to name a few.

“SBS is a problem because affected individuals may not be able to absorb enough nutrition and water to grow and thrive,” said Danny Rafati, M.D., Ph.D., a gastroenterologist at Cook Children’s. “Also, because certain parts of the gastrointestinal tract perform unique roles, even losing relatively short segments can lead to a problem absorbing important nutrients.”

Individuals with SBS may need special formulas or even intravenous supplementation (often called TPN) to ensure they have enough nutrition and fluid to stay healthy and thrive. Due to these special needs some children require feeding tubes or long-term central venous lines.

And this is where Harkey becomes upset. She’s seen in the news lately where celebrities have been using the same IV nutrition that children with conditions like SBS need to survive for preventing hangovers or jet lag.

Beth Deen, a pharmacist at Cook Children’s, says that most of the components of the parenteral nutrition solutions have been on back order at some time in the past few years. One of most problematic has included intravenous calcium that premature neonates and cardiac infants cannot live without.

The reasons for shortages include a shutdown of a manufacturing plant due to contamination, which has stopped the production of important products.

When this happens, it creates shortages of needed medication.

Deen said the government and agencies such as the Food and Drug Administration have been involved in the past five years to help solve this problem, but it remains a day-to-day struggle.

“Judicious use of medications includes reserving it for those who truly need it,” Deen said. “We give these medications and vitamins we place in IVs to provide these kids with the nutrition that sustain them. To use them for any reason other than to help the patients in need  are a waste of the materials needed to save lives.”

Welcome to today’s drug culture of “code names” and “street terms.” You may not know what those words mean, but more than likely your kids do.

Russell Johnson, a sergeant in the Narcotics Unit for the Fort Worth Police Department, says the world of recreational drug use has changed dramatically from even just a few years ago.

The availability and quantity of drugs has changed. It’s not nearly as hard to obtain drugs today because it’s more accepted and isn’t criticized as much by parts of society.

Johnson says if your child is using drugs, there will be an overall change in behavior and friends. Teens might be more lazy than normal and their grades will drop across the board. “This could be an indicator of something else that’s extremely stressful on a teen’s life too, but when you look at all of them, something is not right,” he said.

Rosanne Thurman, director of Pharmacy at Cook Children’s, believes it’s important for parents to make sure that their kids are aware they shouldn’t take any drug that’s not prescribed by their doctor and to make sure they follow the instructions of the prescription.

“It’s so hard for parents to stay informed on what is happening out there as far as illegal drugs. So, I think you have to talk to your kids a lot from a young age,” Thurman said. “Let them know that just because a friend is doing something, that doesn’t mean you should be doing it too. Along with these drugs that aren’t prescribed, we’ve also seen problems with teens and college-aged kids exchanging prescription medication. So let them know that a prescription is only for the person who has been prescribed the medication from a doctor and should be the only person taking the medication. It’s so important to sit down and talk to your children about these issues and to let them know the dangers that are involved.”

In an effort to help you stay informed, here’s a list of 11 unsafe drugs that are either trending or have been popular recently that parents need to know about:

1. “Beezin”- This most recent trend involves teens rubbing Burt’s Bees lip balm onto their eyelids. The balm contains peppermint oil, which creates a tingling sensation that teens claim enhances the feeling of being drunk or high, helps keep them alert after a long night and increases their attention span. However, this can irritate eyes and even cause an eye infection or swelling. Teens think it’s safe to do this because Burt’s Bees is “natural” and won’t cause any harm, but that is far from the truth.

2. “Sizzurp” – This concoction is made by combining soda, candy and prescription cough medicine with codeine in it. This lethal cocktail is highly addictive because of the sweetness and is supposed to provide the user with a euphoric high. But it is extremely dangerous because it can lead to seizures and possibly cause you to stop breathing. Popular culture, including hit songs and Internet videos highlight this drug and refer to it as “purple drank,” “lean” and “syrup."

3. Caffeine powder – This powdered caffeine is used by teens to enhance their workouts and accelerate the process of weight loss. This substance is extremely easy to overdose on – one serving is a sixteenth of a teaspoon and is difficult for people to measure. According to the FDA, a teaspoon is roughly equal to 25 cups of coffee. Teens assume it’s safe to mix this powder into drinks because caffeine is in sodas, energy drinks and coffee. But high levels of caffeine can lead to rapid heartbeat, seizures and even death. You won’t see this in stores, but it’s cheap and easy to buy online.

4. E-cigarettes – This electronic form of cigarettes are battery-operated devices that produce flavored nicotine that look and feel like tobacco smoke. Even though e-cigarettes do not contain tobacco, they still supply nicotine which is a highly addictive drug. But still, e-cigarettes are legal for adults. Some teenagers have used e-cigarettes to smoke marijuana and replace the nicotine with THC. Synthetic marijuana in liquid form can be ordered from the Internet and the user can get a high that is extremely potent because there is no method of dose control.

5. Club drug: MDMA – This stimulant enchants users because of its euphoric and energetic effect. It can come in a crystallized powder form “Molly” and in pill form “ecstasy.” Teens and young adults take this drug at raves, nightclubs and concerts to dance vigorously and heighten the feelings of emotional closeness. However, taking this substance can lead to dehydration, high blood pressure and severe rises in body temperature. It also can result in complications including heart attacks, heart failure, strokes and kidney failure.

6. Club drug: Rohypnol – This substance is commonly known as the “date rape drug.” At parties, people secretly place the drug in drinks. Due to the strong amnesia produced by the drug, victims have limited or no recollection of the night after taking the substance. This is why it is crucial to never take your eyes away from your drink. This drug also is referred to as “roofies” and “forget-me pill.”

7. Synthetic weed – This fake weed is a popular option for teenagers because it doesn’t show up in drug tests like regular weed. But it is incredibly unsafe and toxic because as chemists synthesize the weed, it becomes stronger and up to 80 times more potent than regular weed. There are several detrimental side effects including extreme agitation, anxiety/paranoia, vomiting, hallucinations and even brain damage. "Spice," "K-2" and "Yucatan Fire" are names associated with it.

8. Bath salts – This substance is not what we put in our bathtubs. People inject it, snort it and mix it with food or drink to receive a euphoric high. But it also can make users hallucinate, execute violent behavior and have suicidal thoughts. Watch out for these street terms: “Ivory Wave," "Purple Wave," Vanilla Sky" and "Bliss.”

9. Prescription drug: Xanax – This pill is prescribed to alleviate anxiety and panic disorders. It is extremely addictive and highly abused. Teenagers mistakenly believe that because it’s a prescription drug, it’s safer than street drugs and is free from harmful side effects. The most common street names are “bars” and “Z-bar."

10. “Huffing” – This term refers to purposefully inhaling chemical vapors to get high. Users will inhale several household items including nail polish remover, glue, felt-tip markers, spray paint, hair-care products and deodorant. This practice is not healthy and initially causes drowsiness, lightheadedness and loss of inhibition.

11. Palcohol – this new product is freeze-dried alcohol in powder form. It is packaged in small packets which makes it easy to prepare a to-go drink. But the risk of abuse and misuse is high because the accessibility of the packets could stimulate over-consumption of alcohol and lead to drunk driving. This powdered substance can be snorted as well and cause an immediate high with other harmful side effects.

*Article written by Amanda Burmeister