Accuracy of Prefilled “Code Cart” Epinephrine Syringes for Direct Administration of Small Doses

Abstract

nerability for patients with errant weights is small. However, weight entry errors still pose a significant risk to efforts aimed at reducing medication errors, especially in pediatrics, where medications are frequently written based on weight. Urgent and emergent settings appear to be at highest risk for weight entry errors, although the inpatient population is at highest risk for medication errors secondary to errant weight entries owing to the frequency of medication ordering in the inpatient setting.Conclusions | This study suggests that relatively simple tools can be used to identify weight entry errors before they present safety risks to patients. More sophisticated methods should be investigated to mitigate entry errors that could be harder to detect, such as patients presenting after long absence or lowermagnitude errors.

The accuracy of medication volume delivered using prefilled “Code Cart” epinephrine syringes: A simulation study

“…In contrast, when small volumes are delivered the percentage inaccuracy increases. While perhaps intuitive, these findings address the concerns raised by Hansen et al (2017). It is not known if, in previous studies that called micro-dosages of epinephrine into question, the preload syringe fluid was first depressed to zero.…”

“…Prefilled syringes of epinephrine are popular because they can decrease medication administration delay. While supported by the manufacturer (Hansen, Eriksson, Mah, Meckler, & Guise, 2017), the accuracy of delivering small doses of epinephrine from 10 mL prefilled syringes has been questioned (Hansen, Eriksson, Mah, Meckler & Guise, 2017). We therefore performed a simulation study to assess the actual versus assumed volume of prefilled epinephrine syringes when the goal was to deliver volumes of 0.5 to 3 millilitres (mL), namely 50 ug to 300 ug.…”

Effect of a Mobile App on Prehospital Medication Errors During Simulated Pediatric Resuscitation

“… 36 One solution may be to use prefilled, weight-based, color-coded syringes, but these are not yet commercially manufactured with standardized pediatric volumes. 37 , 38 Another innovative solution may be to use a syringe holder kit as a substitute (eg, Certa Dose 39 ), although this is currently limited to only a few drugs and is not evidence based. To date, no app designed to assist in pediatric drug preparation at the point of care has been validated in the out-of-hospital setting.…”

Retrospective chart review and survey to identify adverse safety events in the emergency medical services care of children with out-of-hospital cardiac arrest in the USA: a study protocol

“…Open access that critically ill and injured children experience high rates of ASEs in the prehospital setting and that children experiencing OHCA had the highest risk for a lifethreatening ASE. [14][15][16][17] While OHCA cases represented only 8% of paediatric transports using lights and sirens, they accounted for 34% of severe ASEs. 14 The purpose of this study is to measure and characterise the prevalence of severe ASEs in the EMS care of children with OHCA and to identify patient and organisational factors associated with severe ASEs.…”