Medication errors in sick children may be higher than previously thought

December 02, 2004

The level of medication errors in sick children might be substantially higher than previously estimated, according to a study in this week's BMJ.

Medication errors are common in paediatric emergency departments, but the incidence of errors during paediatric resuscitation has not been fully investigated.

Eight mock resuscitations were conducted in the emergency department of a children's hospital. The exercises were videotaped and drugs ordered and administered during the resuscitation were recorded. Syringes and drugs prepared during the resuscitation were collected and analysed for concentrations and actual amounts.

Medication errors were identified in seven of the eight mock resuscitations. Frequent and potentially serious errors occurred at all stages of resuscitation, and both physicians and nurses made errors.

Many errors could be detected only by analysis of syringe content, suggesting that the incidence of medication errors during resuscitations is substantially higher than previously estimated.

Resuscitation is an extremely stressful and uncontrolled situation for medical staff and calculating drug doses under these conditions is challenging. Yet improved communication within the team could reduce errors, they add say the authors.

They suggest that every paediatric emergency department should have regular team training of physicians and nurses.
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BMJ

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