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).

Inaccurate assessment of pediatric patient weight can lead to medication dosing errors. In simulated pediatric scenarios, pre-hospital emergency medical services (EMS) crews obtained patient weight using one or more of three methods: asking parent, using patient age, and Broselow-Luten Tape (BLT). BLT was the most frequent method used and patient age resulted in the most frequent dosing errors. Systems-based solutions are presented.

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.

… setting. … Hoyle JD Jr, Crowe RP, Bentley MA, Beltran G, Fales W. Pediatric Prehospital Medication Dosing Errors: A …

Simulations of prehospital pediatric cardiopulmonary arrest uncovered many potential errors. Most notably, medication errors related to the correct weight-based dosing of epinephrine were common. This mistake can have serious consequences and warrants further efforts to mitigate this risk.

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.

This case analysis explains how crew resource management training provides an opportunity to identify latent failures and delineate resolution strategies.

The authors share the recommendations of an expert task force on areas of research needed to advance simulation use in medical education.