Universität zu Köln

Kaufmann, Jost ORCID: 0000-0002-5289-6465, Uhl, Stefanie, Singer, Eva, Eifinger, Frank ORCID: 0000-0003-1758-6039, Klein, Tobias, Lechleuthner, Alex, Engelhardt, Thomas, Wappler, Frank and Boehmer, Andreas (2021). Improving Pediatric Drug Safety in Prehospital Emergency Care-10 Years on. J. Patient Saf., 17 (8). S. E1241 - 6. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1549-8425

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Abstract

Objectives The Pediatric Emergency Ruler (PaedER) is a height-based drug dose recommendation tool that was reported to reduce life-threatening medication errors by 90%. The PaedER was introduced into the Cologne Emergency Medical Service (EMS) in 2008 along with educational measures, publications, and lectures for pediatric drug safety. We reviewed the impact of these continuously ongoing measures on medication errors after 10 years. Methods The PaedER was introduced and distributed to all 14 emergency ambulances and 2 helicopters staffed with emergency physicians in the city of Cologne in November 2008. Electronic records and medical protocols of the Cologne EMS over two 20-month periods from March 2007 to October 2008 and March 2018 to October 2019 data sets were retrieved. The administered doses of either intravenous, intraosseous, intranasal, or buccal fentanyl, midazolam, ketamine, or epinephrine were recorded. Primary outcome measure was the rate of severe drug dosing errors with a deviation from the recommended dose of greater than 300%. Results A total of 59 and 443 drug administrations were analyzed for 2007/08 and 2018/19, respectively. The overall rate of drug dosing errors decreased from 22.0% to 9.9% (P = 0.014; relative risk reduction, 55%). Four of 5 severe dosing errors for epinephrine were avoided (P < 0.021; relative risk reduction, 78%). Documentation of patient's weight increased from 3.2% in 2007/08 to 30.5% in 2018/19 (P < 0.001). Conclusions The distribution of the PaedER combined by educational measures significantly reduced the rates of life-threatening medication errors in a large EMS. Those results should motivate further initiatives on pediatric drug safety in prehospital emergency care.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kaufmann, Jost UNSPECIFIED orcid.org/0000-0002-5289-6465 UNSPECIFIED Uhl, Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Singer, Eva UNSPECIFIED UNSPECIFIED UNSPECIFIED Eifinger, Frank UNSPECIFIED orcid.org/0000-0003-1758-6039 UNSPECIFIED Klein, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Lechleuthner, Alex UNSPECIFIED UNSPECIFIED UNSPECIFIED Engelhardt, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Wappler, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Boehmer, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-586368
DOI:	10.1097/PTS.0000000000000915
Journal or Publication Title:	J. Patient Saf.
Volume:	17
Number:	8
Page Range:	S. E1241 - 6
Date:	2021
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1549-8425
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RESUSCITATION COUNCIL GUIDELINES; MEDICATION DOSING ERRORS Multiple languages Health Care Sciences & Services; Health Policy & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58636