@article{2154, keywords = {Key words, emergency medical services, medication errors, patient safety, pediatric, prehospital, safety culture}, author = {John D. Hoyle and Remle P. Crowe and Melissa A. Bentley and Gerald Beltran and William Fales}, title = {Pediatric prehospital medication dosing errors: a national survey of paramedics}, abstract = {

BACKGROUND: Pediatric drug dosing errors occur at a high rate in the prehospital environment.

OBJECTIVE: To describe paramedic training and practice regarding pediatric drug administration, exposure to pediatric drug dose errors and safety culture among paramedics and EMS agencies in a national sample.

METHODS: An electronic questionnaire was sent to a random sample of 10,530 nationally certified paramedics. Descriptive statistics were calculated.

RESULTS: There were 1,043 (9.9%) responses and 1,014 paramedics met inclusion criteria. Nearly half (43.0%) were familiar with a case where EMS personnel delivered an incorrect pediatric drug dose. Over half (58.5%) believed their initial paramedic program did not include enough pediatric training. Two-thirds (66.0%) administered a pediatric drug dose within the past year. When estimating the weight of a pediatric patient, 54.2% used a length-based tape, while 35.8% asked the parent or guardian, and 2.5% relied on a smart phone application. Only 19.8% said their agency had an anonymous error-reporting system and 50.7% believed they could report an error without fear of disciplinary action. For solutions, 89.0% believed an EMS-specific Broselow-Luten Tape would be helpful, followed by drug dosing cards in milliliters (83.0%) and changing content of standardized pediatric courses to be more relevant (77.7%).

CONCLUSION: This national survey demonstrated a significant number of paramedics are aware of a pediatric dosing error, safety systems specific to pediatric patients are lacking, and that paramedics view pediatric drug cards and eliminating drug calculations as helpful. Pediatric drug-dosing safety in the prehospital environment can be improved.

}, year = {2017}, journal = {Prehosp Emerg Care}, volume = {21}, pages = {185-191}, month = {12/2017}, issn = {1545-0066}, doi = {10.1080/10903127.2016.1227001}, language = {eng}, }