This study was performed to evaluate the clinical characteristics of, consequences of, and factors associated with medication errors (MEs) that cause harm to pediatric patients (<15 years of age) treated in the hospital setting. Patients and Methods: We performed a 10-year retrospective study (January 2011-December 2020) by analyzing data from the Ramathibodi Poison Center. MEs were classified into categories A to I according to the severity of the outcome. Results: In total, 121 patients were included in the study. Most (51.24%) patients were male. Their median age was 1 year (range, 1 hour-14 years). Infants, newborns, and toddlers were the three most common age groups in which MEs were reported. Most MEs occurred during the afternoon shift [n = 60 (49.59%)] and in the inpatient department (66.12%). The most common type of MEs was a dose error (64.46%). Antibiotics, sedative agents, and bronchodilators were the three most common classes of ME drugs. Four patients died. Three deaths occurred because of a dose error. One patient was a 1-year-old girl who received an iatrogenic intravenous phenytoin overdose of 10 times the normal dose, resulting in a phenytoin level of 72.4 mcg/mL. She died 22 hours after the ME occurred. The work shift was the only factor that significantly differed between patients with category C and D MEs and those with category E to I MEs. Conclusion: Small children were at highest risk for MEs. MEs induced harm and deaths in some patients. A preventive and safety system, including appropriate shift work administration, should be emphasized and implemented to prevent and/or decrease the occurrence of MEs.
Background: This study was to study the prehospital time among suspected stroke patients who were transported by emergency medical service (EMS) system using national database. Methods: National EMS database across 77 provinces of Thailand among suspected stroke patients who were treated by EMS system between January 1, 2015 to December 31, 2018 was retrospectively analyzed. Demographic data (i.e., regions, shifts, levels of ambulance and distance to scene) and prehospital time (i.e., dispatch, activation, response, scene and transportation times) were extracted. Time parameters were also categorized according to guideline. Results: In total 53,536 subjects were included in analysis. Most of the subjects were transported during 06.00-18.00 and were in 10 kilometers from ambulance parking. Half of the subjects were treated by advanced life support (ALS) ambulance. Median total time was 29 minutes (IQR: 21, 39) which was mainly occupied for transporting patient from scene to hospital. Although most of subjects had dispatch and activation times ≤ 2 minutes, but only 48.3% had RT ≤ 8 minutes. However, 95% of service were at scene ≤ 15 minutes. ALS ambulance had the longer total time, compared to first responder and basic level (30 minutes versus 28 and 27 minutes). Conclusions: Prehospital time from EMS call to hospital was approximately 30 minutes among suspected stroke patients. This was mainly utilized for travelling from ambulance parking to scene and transporting patient from scene to hospital. Although only 48% of services had RT ≤ 8 minutes, but 95% of them had scene time ≤ 15 minutes.
Background This work was to study the prehospital time among suspected stroke patients who were transported by an emergency medical service (EMS) system using a national database. Methods National EMS database of suspected stroke patients who were treated by EMS system across 77 provinces of Thailand between January 1, 2015, and December 31, 2018, was retrospectively analyzed. Demographic data (i.e., regions, shifts, levels of ambulance, and distance to the scene) and prehospital time (i.e., dispatch, activation, response, scene, and transportation time) were extracted. Time parameters were also categorized according to the guidelines. Results Total 53,536 subjects were included in the analysis. Most of the subjects were transported during 06.00-18.00 (77.5%) and were 10 km from the ambulance parking (80.2%). Half of the subjects (50.1%) were served by advanced life support (ALS) ambulance. Median total time was 29 min (IQR 21, 39). There was a significant difference of median total time among ALS (30 min), basic (27 min), and first responder (28 min) ambulances, Holm P = 0.009. Although 91.7% and 88.3% of the subjects had dispatch time ≤ 1 min and activation time ≤ 2 min, only 48.3% had RT ≤ 8 min. However, 95% of the services were at the scene ≤ 15 min. Conclusion Prehospital time from EMS call to hospital was approximately 30 min which was mainly utilized for traveling from the ambulance parking to the scene and transporting patients from the scene to hospitals. Even though only 48% of the services had RT ≤ 8 min, 95% of them had the scene time ≤ 15 min.
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