IntroductionVery few studies have assessed drug preparation and administration errors during paediatric resuscitation. Current evidence suggests that medication errors in paediatrics are a serious problem. The aim of this study was to evaluate drug preparation and administration errors incurred during the simulated resuscitation of paediatric patients.MethodsThis was a prospective observational study performed in the emergency department of a tertiary-level hospital. Teams consisting of two emergency doctors were tasked with preparing and delivering medication during simulated emergency scenarios. Preparation processes were video recorded. All phials, syringes and administered volumes were collected and analysed to determine the accuracy of drug preparation and delivery. Deviations from intended volumes were calculated.Main resultsA total of 96 dosages were recorded from 24 participants. Most errors were identified in the withdrawal of drug phase (prior to dilution) (13 of 96 doses had a >20% error), and the administration of medication phase (20 of 96 doses had a >20% error). Overall the median time taken to deliver each drug was 79 s (IQR 59, 100 s). The largest percentage errors were seen when a large syringe was used to withdraw or administer a small volume of medication.ConclusionThe study clearly demonstrated that there were significant errors in the preparation and administration of medication. Training in the preparation and administration of paediatric medications should be available for all emergency nurses and doctors. Correct syringe choice may reduce these errors—smaller syringes should be used for withdrawing or administering smaller volumes.

Background: Cannabis has been decriminalised for private use in South Africa in September 2018. This act may potentially lead to an increase of undesirable effects from cannabis exposures. Objectives: To describe the demographics and characteristics of reported cannabis exposure cases from June 2015 to June 2019. Methods: This was a retrospective, observational, cross-sectional study of reported cannabis exposures reported to the Poisons Information Helpline of the Western Cape (PIHWC). Data included: demographics; circumstances of exposure; route of exposure; symptom profile and changes in the number of reports made to the PIHWC from June 2015 to June 2019. Results: A total of 106 database entries were identified. The most common age groups were 20–59 years old (52.8%) followed by under 12 years old (27.3%). There was a threefold increase in cases reported during the period 06/2018 – 06/2019, compared the period 06/2015 – 06/2016. Accidental overuse (40.6%), substance abuse (26.4%) and intentional self-harm (19.8%) were the most reported circumstances of exposure. The most common route of exposure was oral (66.0%) followed by inhalation (26.4%). Central nervous system (75.5%) and gastrointestinal (20.8%) symptoms were commonly reported. Central nervous system symptoms were more commonly reported in children 12 years and younger (p=0.001) compared to those over 12 years. Conclusion: During the study period undesired effects of cannabis were commonly reported after accidental exposures and oral ingestions. Children 12 years and younger are more likely to report neurological symptoms.