WHAT TO TAKE IN YOUR KIDS MEDICAL KIT WHEN YOU TRAVEL...

First...sorry for a missed week!  Now this can also be a very broad topic to cover but I'm going to give you some of the basics that I take with me when I travel for the kids, in addition to some recommendations.  This will depend on where you're traveling too (within the United States or internationally), remoteness of the area (5-star resort vs 20-mile hike from civilization) and accessibility of medical care. As with any medications and dosing, make sure you check with your doctor.   If your child has existing medical problems definitely double check with your child's doctor to make sure it’s safe. Got to love disclaimers for the lawyers. NEVER GIVE MORE THAN THE RECOMMENDED AMOUNT.

Again, the other important fact is to know the difference between generic medication names vs brand name.  The best example is Tylenol.  Tylenol is the brand name of acetaminophen (the generic name).   I'll use generic names first as in most cases the only difference between generic vs brand name is marketing

KIDS KIT:  

I’d recommend buying the smaller, travel versions of all of the medications listed below.  It will save you on space. Most of the children's medication is available in tablet/pill form as well which makes it much easier to carry.  It also prevents spilling this in your suitcase!

 

Your Child's Prescribed Medications:  This may sound like a silly addition, but forgetting your kids prescribed medications can be a huge problem and end up costing you a bundle. I recommend carrying any of your child's prescribed medications on your person.  Do not check it in your luggage.  You may also not want to take all of your medication, but make sure you have it in the prescription bottle.  I usually recommend bringing a few days’ worth of additional doses in the event that you get delayed.  You can leave the rest at home.

Acetaminophen (Tylenol):  This is a simple choice.  Not only effective for fevers, it can help with pain control for most things (falls, sunburn, scratches, sore throat).  It's cheap, effective and easy to pack with you.  The typical dosing is 15 mg/kg every 6-8 hours.  How do you figure that out?  This can be tough to dose but if you have a calculator (most of you do on your smart phone) you can figure this out.  I've outlined a step by step formula for proper dosing of this for your child below.  If your outside of the USA, acetaminophen (or Tylenol as commonly known in the US) is called Panadol.  If you exceed the recommended level, it can kill you, so always follow the dosing directions as an adult.  Just some food for thought.

 

DOSING ACETAMINOPHEN (TYLENOL) FOR KIDS STEP BY STEP (always check with your doctor)

  1. STEP ONE: Take your child's weight in pounds (lbs.) and divide that number by 2.2 (this is the conversion of pounds to kilograms).  For example, if your child weighs 22 lbs., they are 10kg (22lbs/2.2 = 10 kg).
  2. STEP TWO: Take the number in kilograms (kg) that you just figured out and multiple that by 15 (the dosing is 15mg per kg).  This will give you the child's proper dose of acetaminophen (Tylenol). In our example that will be 150mg of acetaminophen (Tylenol) (10kg kid x 15mg/kg = 150 mg dose).  
  3. STEP THREE:  Figure out the concentration of acetaminophen (Tylenol). Most come in 160mg/5ml bottle.  This means that in each milliliter of liquid acetaminophen there will be 32 milligrams.
  4. STEP FOUR:  Divide the total dose of acetaminophen that you figured out in STEP TWO above, by the concentration of acetaminophen (Tylenol) that you figured out in STEP THREE.  In our case that means dividing 150mg by 32mg/1ml to give us a final dose of 4.68 ml (rounding down to 4.5 ml is fine...never round up!

Ibuprofen (Advil):  Please note that ibuprofen, Motrin and Advil are all the same drug. Also, an easy choice.  It has a lot of the properties of acetaminophen (Tylenol) as listed above.  This one is cleared by your kidneys while acetaminophen (Tylenol) is cleared by the liver.  It's great alternative coverage between doses of acetaminophen (Tylenol) if you're in a bad way.  We often recommend alternating between acetaminophen (Tylenol) and ibuprofen (ADVIL) every 4 hours.  For example, take acetaminophen at 8am, ibuprofen at 12pm, acetaminophen at 4pm…etc. It’s possible to overdose on Ibuprofen, but really, really hard to do so.   

DOSING FOR IBUPROFEN (ADVIL) STEP BY STEP (always check with your doctor)

  1. STEP ONE: Take your child's weight in pounds (lbs.) and divide that number by 2.2 (this is the conversion of pounds to kilograms).  For example, if your child weighs 22 lbs., they are 10kg (22lbs/2.2 = 10 kg).
  2. STEP TWO: Take the number in kilograms (kg) that you just figured out and multiple that by 10 (the dosing is 10mg per kg).  This will give you the child's proper dose of Ibuprofen (Advil). In our example that will be 100mg of ibuprofen (10kg kid x 10mg/kg = 100 mg dose).  
  3. STEP THREE:  Figure out the concentration of ibuprofen (Advil). Most come in 100mg/5ml bottle.  This means that in each milliliter of liquid ibuprofen there will be 20 milligrams.
  4. STEP FOUR:  Divide the total dose of ibuprofen that you figured out in STEP TWO above, by the concentration of ibuprofen (Advil) that you figured out in STEP THREE.  In our case that means dividing 100mg by 20mg/1ml to give us a final dose of 5 ml.

Diphenhydramine (Benadryl): This is great stuff.  It’s great for allergic reactions of most kinds.  They make it in a 12.5mg tablet that is grape flavored for kids.  The age cut off that we typically recommend is 2 years of age.  If a child is less than 2 you should really check with your doctor.   It can help with the itch after a sunburn or seasonal allergies.  The standard dose for kids is 1-2 mg/kg.  Now, some people will have the opposite reaction to (Benadryl) when they take it and become very awake.  If this is the case for your child, I would proceed with caution.  Dosing of Diphenhydramine 1-2mg/kg

  1. STEP ONE: Take your child's weight in pounds (lbs.) and divide that number by 2.2 (this is the conversion of pounds to kilograms).  For example, if your child weighs 22 lbs., they are 10kg (22lbs/2.2 = 10 kg).
  2. STEP TWO: Take the number in kilograms (kg) that you just figured out and multiple that by 1 or 2 (the dosing is 1-2mg/kg).  This will give you the child's proper dose of diphenhydramine (Benadryl). In our example that will be 10-20 mg of diphenhydramine (Benadryl) 10kg kid x 1-2 mg/kg = 10-20mg of a final dose.  In these cases, I usually will go with the easiest dosing and give my child a 12.5mg tablet as it's between the normal range of the recommended dose.  NEVER give more than the recommended dose. The max dose is usually age based.  <6 years never exceed 37.5 mg/day; 6-11 years never more than 150 mg/day; and ≥12 years never more than 300 mg/day.

Hydro-cortisone cream 1%:  I usually feel that it’s a good idea to have a topical steroid.  It can be used for most minor rashes.  It’s small, easy to carry and relatively inexpensive.   The cut off for using this is also 2 years of age.   It is not recommended to use this on children less than 2 unless you check with your doctor. 

Pedialite Packets:  This is relatively inexpensive packet that you can mix with water.  If you’re traveling in a foreign country where the chances of travelers’ diarrhea are high, this can literally be a life saver.  I’d recommend ordering some online (relatively inexpensive) and if needed, mix it with bottled water.  It's also easy to pack because it's powder form. 


Neosporin:  Or some other form of topical antibiotic cream to use over minor scrapes or cuts.  This can be useful to help prevent infection and to decrease the length of time to heal.  

 

Non-medical additions:  A small pack of Band-Aids and a pair of tweezers for removing splinters are the other two additions I would add to your kit. These can come in handy yet take up minimal space.

 

Other things to consider:  If you’re going somewhere warm, sunscreen is a simple one to forget.  The sun sticks are handy as they can serve as a lite weight alternative to liquid or cream.  Kids tend to like these better.  If you’re going to a foreign country where water or sanitation is a consideration, a discussion with your primary care physician about prescribing a short course or nausea medication like ondansetron (Zofran) or an antibiotic for traveler’s diarrhea is not a bad idea depending on your child's age and existence of any medical problems. 

 

Next week we based on a few requests we will tackle Lyme disease…

 

Dr. Paul  

Neosporin:  Or some other form of topical antibiotic cream to use over minor scrapes or cuts.  This can be useful to help prevent infection and to decrease the length of time to heal.  

 

Non-medical additions:  A small pack of Band-Aids and a pair of tweezers for removing splinters are the other two additions I would add to your kit. These can come in handy yet take up minimal space.

 

Other things to consider:  If you’re going somewhere warm, sunscreen is a simple one to forget.  The sun sticks are handy as they can serve as a lite weight alternative to liquid or cream.  Kids tend to like these better.  If you’re going to a foreign country where water or sanitation is a consideration, a discussion with your primary care physician about prescribing a short course or nausea medication like ondansetron (Zofran) or an antibiotic for traveler’s diarrhea is not a bad idea depending on your child's age and existence of any medical problems. 

 

Next week we based on a few requests we will tackle Lyme disease…

 

Dr. Paul