Development and Prospective Federal State-Wide Evaluation of a Device for Height-Based Dose Recommendations in Prehospital Pediatric Emergencies: A Simple Tool to Prevent Most Severe Drug Errors

Kaufmann, Jost; Roth, Bernhard; Engelhardt, Thomas; Lechleuthner, A.; Laschat, Michael; Hadamitzky, Christoph; Wappler, Frank; Hellmich, Martin

doi:10.1080/10903127.2016.1248257

Cited by 30 publications

(34 citation statements)

References 26 publications

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“…On a global scale, it is widely believed that the 'range and depth' of paediatric-focused training and education provided for EMS personnel is insufficient to support the complex functions required for these healthcare professionals (Guise et al 2017;Hansen et al 2016;Lim et al 2013;Kaufmann et al 2018;Reynolds et al 2017). The local condition is similar with various local studies identifying the significant knowledge and competency gaps present in EMS personnel; specifically pertaining to paediatric emergency care, leading to recommendations of improved training and education in this domain (Calvello et al 2013;Hanewinckel et al 2010;Saggie 2013;Manchev et al 2015;Ballot et al 2016;Butler & Adefuye 2019).…”

Section: Category 3: Need For Paediatric-specific Trainingmentioning

confidence: 89%

South African pre-hospital emergency care personnel’s lived experiences of managing paediatric emergencies: A qualitative research design utilising one-on-one interviews

Mosca

Stein

Lawrence

2021

Health SA Gesondheid

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Background: The phenomenon of managing paediatric emergencies in the pre-hospital environment within the South African setting is poorly understood with specific regard to what emergency care personnel are experiencing when managing paediatric emergencies.Aim: The aim of this study was to explore and describe the lived experiences of emergency care personnel in managing paediatric patients in the pre-hospital environment and to understand the meaning and the significance of these experiences.Setting: All participants were purposively sampled from emergency medical services agencies operating within the Johannesburg metropolitan city area.Methods: This study followed a qualitative, exploratory, descriptive, phenomenological design, whereby participants purposively sampled within the Johannesburg metropolitan city voluntarily consented to one-on-one interviews (n = 10).Results: Three main themes, with 11 contributing categories, were identified and contextualised with available literature. Emerging from the main themes was an overall sense that managing paediatric emergencies is a negative experience, coloured with feelings of inadequacy, stress, anxiety and even fear.Conclusions: The findings of this study provided new insights into what South African EMS are experiencing when managing paediatric emergencies, which enables future research efforts to identify research and practice gaps that are relevant to paediatric pre-hospital emergency care, and that are specific to the South African environment.Contribution: This research provides preliminary insight into the lived experiences of prehospital personnel managing paediatric emergencies as well as emerging recommendations for the improvement of the prehospital care of paediatric patients.

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Section: Category 3: Need For Paediatric-specific Trainingmentioning

confidence: 89%

South African pre-hospital emergency care personnel’s lived experiences of managing paediatric emergencies: A qualitative research design utilising one-on-one interviews

Mosca

Stein

Lawrence

2021

Health SA Gesondheid

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“…During the years 2010–2015, a prospective federal statewide evaluation was conducted and published in 2016. 8 …”

Section: Methodsmentioning

confidence: 99%

“…We conducted a pre-post interventional study in real-life prehospital pediatric emergencies to assess the impact of the PaedER on the correct administration of drug doses with emphasis on life-threatening medication errors. 8 When the PaedER was used in the postinterventional group with federal statewide prospective recruitment between 2010 and 2015, 9 of 10 cases with deviations of the recommended dose (DRD) of greater than 300% (<33% or >300% of the recommended dose) of all observed medications (midazolam, fentanyl, ketamine, and epinephrine) were prevented. Subsequently, a prospective randomized controlled trial was considered unethical because of the expected positive impact of the PaedER necessitating a retrospective control group of all electronic data sets and medical protocols of all children (<18 years) who were treated by Cologne Emergency Medical Service (EMS) during a 20-month period from March 2007 to October 2008.…”

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confidence: 99%

Improving Pediatric Drug Safety in Prehospital Emergency Care—10 Years on

et al. 2021

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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.

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“…Internationale Leitlinien empfehlen 10 µg/kg und warnen explizit davor, diese Dosis zu steigern [8]. Verwendung der darauf angebotenen Dosierungsempfehlungen werden 9 von 10 schwerwiegenden Medikamentenfehlern bei der präklinischen Versorgung von Kindernotfällen vermieden [9]. Aber auch einfachste tabellarische Dosierungshilfen waren in simulierten Situationen mit einer vergleichbaren Effektgröße dazu in der Lage, Fehler zu verhindern [10].…”

Section: Caveunclassified

Kinderanästhesie mit Sicherheit: Update Medikamentensicherheit

Kaufmann¹,

Laschat²,

Wappler³

2018

Anästhesiol Intensivmed Notfallmed Schmerzther

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ZusammenfassungMedikamentenfehler kommen in allen Versorgungsbereichen vor. Bei Kindern steigt die Fehlerwahrscheinlichkeit im Vergleich zu Erwachsenen aufgrund altersgruppenspezifischer Besonderheiten und der erforderlichen Dosisberechnung. Wesentliche Aspekte sind: die Erkenntnis, dass jeder Versorger fehlbar ist, und die Akzeptanz von Sicherheitsstrukturen. Dieser Beitrag beschreibt einen Katalog alltagstauglicher Maßnahmen zur Medikamentensicherheit.

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Development and Prospective Federal State-Wide Evaluation of a Device for Height-Based Dose Recommendations in Prehospital Pediatric Emergencies: A Simple Tool to Prevent Most Severe Drug Errors

Cited by 30 publications

References 26 publications

South African pre-hospital emergency care personnel’s lived experiences of managing paediatric emergencies: A qualitative research design utilising one-on-one interviews

South African pre-hospital emergency care personnel’s lived experiences of managing paediatric emergencies: A qualitative research design utilising one-on-one interviews

Improving Pediatric Drug Safety in Prehospital Emergency Care—10 Years on

Kinderanästhesie mit Sicherheit: Update Medikamentensicherheit

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