-- Robert Preidt
MONDAY, Jan. 24 (HealthDay News) -- Preparing small doses of
medications from syringes can be inaccurate and lead to dangerous
dosing errors for infants and small children, warns a new
The problem is that small doses of potent drugs for young
patients are often prepared from stock of less than 0.1 millileter
(mL) in size, but the equipment does not permit the accurate
measurement of volumes that small, explained study author Dr.
Christopher Parshuram, of the University of Toronto.
And medications that most often require small doses include
powerful narcotics and sedatives such as morphine, lorazepam and
fentanyl, as well as immunosuppressants, noted Parshuram, who works
in the Department of Pediatrics at The Hospital for Sick Children
and directs Pediatric Patient Safety Research at the University of
Toronto Center for Patient Safety.
It's a Catch-22, he and his colleagues acknowledge. "The safe
administration of medications requires formulations that permit
accurate preparation and administration, but current equipment does
not permit the accurate measurement of volumes less than 0.1 mL,"
said Parshuram in a Canadian Medical Association Journal news
In both hypothetical and clinical studies, he and his colleagues
looked at 71,218 intravenous doses given to 1,531 infants and
children admitted to an intensive care unit in 2006. Of those
doses, 7.4 percent of the children and babies needed preparations
of less than 0.1 mL of stock solution, and 17.5 percent needed
preparations of less than 0.2 mL.
"Our findings indicate a substantial source of dosing error that involved potent medications and affected more than a quarter of the children studied," the researchers wrote.
"Small volumes of stock solution are required because of the relatively low doses needed for infants and young children and the relatively high concentrations of commercially available stock solutions," they added. "The clinical [consequences] of errors occurring as a result of preparing doses from small volumes will be compounded by incomplete safety data, errors in medication orders, and errors in preparation or administration."
Since the preparation of small doses of medication is common in
pediatric hospitals across North America, there is a need to review
preparation methods, regulatory requirements and manufacturing
processes, the researchers concluded.
The study appears in the current issue of the
Canadian Medical Association Journal.
The U.S. Food and Drug Administration has more about
giving medications to children.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.