STATEMENTS OF POLICY
Title 55--PUBLIC WELFARE
DEPARTMENT OF PUBLIC WELFARE
[55 PA. CODE CHS. 3270, 3280 AND 3290]
Syrup of Ipecac
[35 Pa.B. 6662] Scope
This statement of policy applies to child day care centers, group child day care homes and family child day care homes.
Purpose
The purpose of this statement of policy is to clarify the Department of Public Welfare's (Department) regulations for child care facilities regarding Syrup of Ipecac in §§ 3270.75(c), 3280.75(c) and 3290.73(c) (relating to first-aid kit). Based on the recommendations of the American Academy of Pediatrics (AAP), the Department will not enforce the requirement for Syrup of Ipecac in a first-aid kit.
Discussion
Syrup of Ipecac is a substance that induces vomiting when consumed. If a child has consumed a poisonous substance, taking Syrup of Ipecac causes vomiting that can often remove some of the poisonous substance from the child's body.
The Department's regulations requiring Syrup of Ipecac in a first-aid kit at a child care facility were promulgated in 1992. At that time, health care organizations, including the AAP, recommended that parents and caregivers in child care facilities keep a 1-ounce bottle of Syrup of Ipecac available in case a poisoning emergency occurred. Based on new scientific evidence, the AAP has changed its recommendation regarding Syrup of Ipecac.
In November 2003, the AAP issued new recommendations on poison treatment in the home. The AAP now recommends that parents and caregivers should not keep Syrup of Ipecac in their homes or child care facilities. According to the AAP's Committee on Injury, Violence, and Poison Prevention, there has never been any scientific evidence that administering Syrup of Ipecac to induce vomiting reduces death rates from poisoning. Studies of children who had ingested a potentially toxic amount of a drug and then took ipecac showed that on average, only 28% of the poison was eliminated from their bodies after vomiting.
Activated charcoal has replaced Syrup of Ipecac as the preferred treatment for poisoning in hospital emergency departments. Activated charcoal binds to the poison in a person's stomach and prevents the poison from entering the bloodstream. Using Syrup of Ipecac first may actually reduce the effectiveness of activated charcoal treatments, another reason cited by the AAP for the change in policy.
The AAP also stated that Syrup of Ipecac may be misused by people with eating disorders, such as anorexia nervosa and bulimia nervosa, who want to induce vomiting in an attempt to lose weight or purge stomach contents. In very rare cases, the substance may be abused by adults with a mental disorder called Munchausen syndrome by proxy, in which they purposely make a child ill to gain attention for themselves.
Based on the AAP recommendations, the Department will not enforce the requirement that a first-aid kit in a child care facility must include Syrup of Ipecac.
Effective Date
This statement of policy is effective immediately upon publication in the Pennsylvania Bulletin.
Contact Person
Comments and questions regarding this statement of policy should be directed to Jennifer Lau, Division of Regulatory Administration, Bureau of Certification Services, Office of Child Development, Bertolino Building 4th Floor, Harrisburg, PA 17105, (717) 787-8691.
(Editor's Note: The regulations of the Department, 55 Pa. Code Chapters 3270, 3280 and 3290, are amended by adding a statement of policy in §§ 3270.75a, 3280.75a and 3290.73a to read as set forth in Annex A.)
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-BUL-067. No fiscal impact; (8) recommends adoption.
Annex A
TITLE 55. PUBLIC WELFARE
PART V. CHILDREN, YOUTH AND FAMILIES MANUAL
Subpart D. NONRESIDENTIAL AGENCIES, FACILITIES AND SERVICES
ARTICLE I. LICENSING/APPROVAL
CHAPTER 3270. CHILD DAY CARE CENTERS
PHYSICAL SITE § 3270.75a. Syrup of Ipecac--statement of policy.
The Department will not cite a facility for noncompliance with § 3270.75(c) (relating to first-aid kits) if the first-aid kit does not include Syrup of Ipecac.
CHAPTER 3280. GROUP CHILD DAY CARE HOMES
PHYSICAL SITE§ 3280.75a. Syrup of Ipecac--statement of policy.
The Department will not cite a facility for noncompliance with § 3280.75(c) (relating to first-aid kits) if the first-aid kit does not include Syrup of Ipecac.
CHAPTER 3290. FAMILY CHILD DAY CARE HOMES
PHYSICAL SITE§ 3290.73a. Syrup of Ipecac--statement of policy.
The Department will not cite a facility for noncompliance with § 3290.73(c) (relating to first-aid kits) if the first-aid kit does not include Syrup of Ipecac.
[Pa.B. Doc. No. 05-2271. Filed for public inspection December 9, 2005, 9:00 a.m.]
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