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Cases & Commentaries
- Web M&M
Nicole M. Acquisto, PharmD, and Daniel J. Cobaugh, PharmD; March 2019
Seen in the emergency department, a man with insulin-dependent diabetes mellitus had not taken insulin for 3 days. His blood glucose levels were in the 800s with an anion-gap acidosis and positive beta hydroxybutyrate. While awaiting an ICU bed for treatment of diabetic ketoacidosis, the patient received fluids, an insulin drip was started, and blood glucose levels were monitored hourly. When lab results showed he was improving, the team decided to convert his insulin drip to subcutaneous long-acting insulin. However, both the intern and the resident ordered 50 units of insulin, and the patient received both doses—causing his blood glucose level to dip into the 30s.
Journal Article > Study
Rothschild JM, Churchill W, Erickson A, et al. Ann Emerg Med. 2010;55:513-521.
In this direct observation study, emergency department pharmacists identified approximately one actual or potential medication error per 13 patients.
PA-PSRS Patient Saf Advis. March 2011;8:1-7.
This piece reports on the prevalence of medication errors in the emergency department and suggests expanding pharmacy involvement as a strategy to reduce risks.
Silverman L. Morning Edition. National Public Radio. June 9, 2014.
This radio segment discusses the experience of a pediatric medical center that hired pharmacists for its emergency department to review medication orders before the medicine is dispensed and administered in an effort to prevent medication errors.
Journal Article > Review
Jacknin G, Nakamura T, Smally AJ, Ratzan RM. Am J Emerg Med. 2014;32:673-677.
Exploring factors that increase risk of medication-related errors in the emergency department, this review describes the benefits of incorporating clinical pharmacists in the frontline care team, including real-time monitoring, discussion, and education about medication prescribing and use of substitute drugs.