Prehospital medication administration for pediatric patients is complicated by the need to obtain an accurate weight for correct dosing. This retrospective analysis examined prehospital medication dosing in children 12 years of age and younger after implementation of a statewide emergency medical services (EMS) pediatric dosing reference. Despite implementation of written guidelines, researchers found that 35% of prehospital medication administrations involved a dosing error. Dosing errors were most common for hyperglycemia reversal medications, opioids, and one type of bronchodilator (Ipratropium bromide).

… dosing errors. Systems-based solutions are presented. … Hoyle JD, Jr., Ekblad G, Woodwyk A, et al. Methods used to obtain pediatric …

This position statement shares 11 recommendations drawn from a review of the evidence to improve the safety of pediatric dosing in pre-hospital emergent situations. Suggestions for improvement include use of kilograms as the standard unit of weight, pre-calculated weight-based dosing, and dose-derivation strategies to minimize use of calculations in real time.   

Emergency medical technicians (EMTs) often make dosing errors when administering medication to pediatric patients. This study found that in simulations, Michigan's state-wide pediatric dosing reference system reduced but did not eliminate prehospital provider medication mistakes. A PSNet perspective further explores prehospital patient safety.

… pediatric medication safety in the prehospital setting. … Hoyle JD Jr, Crowe RP, Bentley MA, Beltran G, Fales W. Pediatric Prehospital Medication Dosing Errors: A …

Medication errors are common in pediatric patients who require care from emergency medical services. This study found that most paramedics had limited experience and comfort in administering medications to children. Investigators identified several remediable barriers to improving medication safety in this setting.

This study used a simulation exercise to uncover error types (e.g., cognitive, procedural, and teamwork) that impact the prehospital care of ill and injured children. The findings generated a series of recommendations to emergency medical services agencies to improve the safety of care delivery.