Medication dosing errors for infants and children

Jan 24, 2011

Preparing small doses of medication from syringes may be inaccurate and can result in crucial dosing errors for infants and children, according to a study published in CMAJ (Canadian Medical Association Journal).

Because babies and young children require small doses of drugs, these are often prepared from stock of less than 0.1 mL which can result in dosing errors and possible adverse events. Medications most commonly requiring small doses include potent narcotics and sedatives such as morphine, lorazepam and fentanyl as well as immunosuppressants.

"The safe administration of medications requires formulations that permit accurate preparation and administration," writes Dr. Christopher Parshuram, Department of Paediatrics, The Hospital for Sick Children (SickKids) and Director of Paediatric Patient Safety Research, University of Toronto Centre for Patient Safety, with coauthors. "Current equipment does not permit the accurate measurement of volumes less than 0.1 mL."

The researchers conducted a theoretical study as well as a clinical study of 1531 patients admitted to the ICU in 2006. Out of 71 218 intravenous doses, 5245 (7.4%) needed preparations of less than 0.1 mL of stock solution and 12 439 (17.5%) needed preparations from 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," write the authors. "Small volumes of stock solution are required because of the relatively low doses needed for infants and young and the relatively high concentrations of commercially available stock solutions. The clinical sequelae 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."

The authors conclude that since this practice occurs in paediatric hospitals across North America, the "re-evaluation of preparation methods, regulatory requirements and manufacturing practices is warranted."

Explore further: Bristol-Myers: FDA blocks hepatitis C drug for now

add to favorites email to friend print save as pdf

Related Stories

Wrong dose of heart meds too frequent in children

Jul 07, 2009

Infants and young children treated with heart drugs get the wrong dose or end up on the wrong end of medication errors more often than older children, according to research led by the Johns Hopkins Children's Center to be ...

Recommended for you

Have a cold? Don't ask your doctor for antibiotics

Nov 26, 2014

Antibiotic resistance is a major threat to public health. Resistance makes it harder for physicians to treat infections and can increase the chance patients will die from an infection. What is more, the treatment ...

Powdered measles vaccine found safe in early clinical trials

Nov 25, 2014

A measles vaccine made of fine dry powder and delivered with a puff of air triggered no adverse side effects in early human testing and it is likely effective, according to a paper to be published November 28 in the journal ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.