EMS Publications

Medication Errors in Pediatric Patients After Implementation of a Field Guide with Volume-Based Dosing

By Lara D. Rappaport, MD MPH, Geoffrey Markowitz, Steven Hulac and Genie Roosevelt, MD MPH

Prehospital Emergency Care. January 2022

Several studies have demonstrated the high frequency of medication errors in pediatric patients by prehospital providers during both patient care and simulation. In 2015, our hospital-based urban EMS system introduced the HandtevyTM Field Guide that provides precalculated pediatric doses in milliliters (mL) by patient age. We hypothesized that implementation of the Field Guide would increase the percentage of correct pediatric medication doses to greater than 85%.

Methods: We performed a single center retrospective cohort study of medications administered to patients <13 years of age from August 2017 – July 2019 compared to 2014 baseline data through electronic medical record review. We excluded nebulized medications and online medication direction cases. Our primary outcome was the percentage of correct doses defined as a dose within 80-120% of the Field Guide dose recommendation. Each dosing error was reviewed by two investigators.

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WHEN A CHILD DIES: THE PARENTS’ PERSPECTIVE. They’re often forgotten on their worst day—how can EMS help?

By Peter Antevy, MD

EMS World. January 2020 | VOL. 49, NO.1

A 6-year-old boy was playing in the street in front of his house when his father hurriedly put the car in reverse and accidentally ran him over. The scene was awful in every sense, mostly because the child suffered a head injury incompatible with life. The rescue and engine arrived and immediately focused on treating the child, yet quickly recognized the severity of the skull injury and that further care would be futile.

The father watched in horror. He stood there alone, screaming and crying, but what he needed most he did not receive: The crews that arrived on scene were pre-pared to treat the child but did not have the skill set to speak to the dad.

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DISCLAIMER: Pediatric Emergency Standards Inc. does not make clinical or medical decisions.  The Handtevy System is intended to be utilized as a guide only.  Provider's experience and training should be the final determinant of clinical treatment decisions.