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Pediatric Prehospital Medication Dosing Errors: A Mixed-Methods Study

John D Hoyle, Deborah Sleight, Rebecca Henry

    Prehospital Emergency Care
    |September 25, 2015
    PubMed

    Insights

    Prehospital pediatric dosing errors impact many children. Understanding paramedic and medical director perspectives is key to developing effective solutions for safer medication administration in emergencies.

    Area of Science:

    • Emergency Medicine
    • Pediatric Care
    • Health Services Research

    Background:

    • Prehospital dosing errors affect an estimated 56,000 US children annually.
    • Understanding barriers and enablers from healthcare providers is crucial for error reduction.

    Purpose of the Study:

    • To identify barriers, enablers, and solutions for reducing prehospital pediatric drug dosing errors from the perspective of emergency medical technicians-paramedics (EMT-Ps) and medical directors (MDs).

    Main Methods:

    • A mixed-methods study involving focus groups with 35 EMT-Ps and 9 MDs in Michigan.
    • Data collection included pre-focus group surveys on pediatric experience and agency characteristics, followed by thematic coding of focus group responses.

    Main Results:

    • Key barriers identified include difficulty obtaining patient weight, infrequent pediatric encounters, inadequate pediatric training, and issues with drug packaging and calculations.
    • Paramedic comfort levels with pediatric dosing varied significantly by age group, with only 5-10% comfortable with infants and toddlers.
    • Proposed solutions include dose simplification, improved length-based tapes, pediatric checklists, and dose cards in milliliters.

    Conclusions:

    • This study highlights significant challenges in prehospital pediatric medication dosing.
    • Implementing tested and validated solutions is essential for improving medication safety in pediatric emergency care.

    Keywords:
    emergency medical servicesmedical errorsmedication dosingpediatric

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