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Drug dosing errors in simulated paediatric emergencies – Comprehensive dosing guides outperform length-based tapes with precalculated drug doses
BACKGROUND: The accuracy of drug dosing calculations during medical emergencies in children has not been evaluated extensively. The objectives of this study were to evaluate the accuracy of drug dose calculations using the Broselow tape, the PAWPER XL tape plus its companion drug-dosing guide, a cus...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
African Federation for Emergency Medicine
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320197/ https://www.ncbi.nlm.nih.gov/pubmed/32612912 http://dx.doi.org/10.1016/j.afjem.2020.01.005 |
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author | Wells, Mike Goldstein, Lara |
author_facet | Wells, Mike Goldstein, Lara |
author_sort | Wells, Mike |
collection | PubMed |
description | BACKGROUND: The accuracy of drug dosing calculations during medical emergencies in children has not been evaluated extensively. The objectives of this study were to evaluate the accuracy of drug dose calculations using the Broselow tape, the PAWPER XL tape plus its companion drug-dosing guide, a custom-designed mobile phone app and no drug-dosing aid (control group). METHODS: This was a prospective study in which 32 emergency medicine volunteers participated in eight simulations of common paediatric emergency conditions, using children models. The participants used the three methods to estimate the children's weight and calculate drug doses. The accuracy of and time taken for the drug dose determinations were then evaluated for each of the methods. RESULTS: The overall accuracy of drug dose determinations was extremely and potentially dangerously low in the control group in which no dosing guide was used as well as in the Broselow tape group (<20% of doses were correct). The accuracy was significantly higher with the PAWPER XL tape group and the mobile app group (47% and 31% respectively). The times taken to obtain the required information did not differ in a clinically meaningful magnitude. CONCLUSIONS: Both an accurate weight estimation and a dosing guide with comprehensive information were necessary to produce an accurate prescription. The information on the Broselow tape was not sufficient for this purpose. The current guidelines recommending the use of tapes with limited information should be revised. The results from the comprehensive dosing guides were substantially better, but still had a lower proportion of accurate prescriptions than desirable. The role of training in every aspect of the emergency paediatric weight estimation and drug dosing procedure cannot be underestimated and should be routine in any environment where emergency care may be needed. |
format | Online Article Text |
id | pubmed-7320197 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | African Federation for Emergency Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-73201972020-06-30 Drug dosing errors in simulated paediatric emergencies – Comprehensive dosing guides outperform length-based tapes with precalculated drug doses Wells, Mike Goldstein, Lara Afr J Emerg Med Original Article BACKGROUND: The accuracy of drug dosing calculations during medical emergencies in children has not been evaluated extensively. The objectives of this study were to evaluate the accuracy of drug dose calculations using the Broselow tape, the PAWPER XL tape plus its companion drug-dosing guide, a custom-designed mobile phone app and no drug-dosing aid (control group). METHODS: This was a prospective study in which 32 emergency medicine volunteers participated in eight simulations of common paediatric emergency conditions, using children models. The participants used the three methods to estimate the children's weight and calculate drug doses. The accuracy of and time taken for the drug dose determinations were then evaluated for each of the methods. RESULTS: The overall accuracy of drug dose determinations was extremely and potentially dangerously low in the control group in which no dosing guide was used as well as in the Broselow tape group (<20% of doses were correct). The accuracy was significantly higher with the PAWPER XL tape group and the mobile app group (47% and 31% respectively). The times taken to obtain the required information did not differ in a clinically meaningful magnitude. CONCLUSIONS: Both an accurate weight estimation and a dosing guide with comprehensive information were necessary to produce an accurate prescription. The information on the Broselow tape was not sufficient for this purpose. The current guidelines recommending the use of tapes with limited information should be revised. The results from the comprehensive dosing guides were substantially better, but still had a lower proportion of accurate prescriptions than desirable. The role of training in every aspect of the emergency paediatric weight estimation and drug dosing procedure cannot be underestimated and should be routine in any environment where emergency care may be needed. African Federation for Emergency Medicine 2020-06 2020-02-07 /pmc/articles/PMC7320197/ /pubmed/32612912 http://dx.doi.org/10.1016/j.afjem.2020.01.005 Text en © 2020 African Federation for Emergency Medicine. Publishing services provided by Elsevier. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Wells, Mike Goldstein, Lara Drug dosing errors in simulated paediatric emergencies – Comprehensive dosing guides outperform length-based tapes with precalculated drug doses |
title | Drug dosing errors in simulated paediatric emergencies – Comprehensive dosing guides outperform length-based tapes with precalculated drug doses |
title_full | Drug dosing errors in simulated paediatric emergencies – Comprehensive dosing guides outperform length-based tapes with precalculated drug doses |
title_fullStr | Drug dosing errors in simulated paediatric emergencies – Comprehensive dosing guides outperform length-based tapes with precalculated drug doses |
title_full_unstemmed | Drug dosing errors in simulated paediatric emergencies – Comprehensive dosing guides outperform length-based tapes with precalculated drug doses |
title_short | Drug dosing errors in simulated paediatric emergencies – Comprehensive dosing guides outperform length-based tapes with precalculated drug doses |
title_sort | drug dosing errors in simulated paediatric emergencies – comprehensive dosing guides outperform length-based tapes with precalculated drug doses |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320197/ https://www.ncbi.nlm.nih.gov/pubmed/32612912 http://dx.doi.org/10.1016/j.afjem.2020.01.005 |
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