Zusammenfassung
Dosierungsfehler treten im Kindesalter häufig auf und beruhen beispielsweise auf der häufig notwendigen Verdünnung von Medikamenten, der Fehleinschätzung des Körpergewichts, der Verwechselung von Medikamenten ähnlichen Namens und einer unzureichenden Kommunikation. Verschiedene Hilfsmittel, wie z. B. Maßbänder und Verdünnunsgschemata wurden entwickelt, um Fehler möglichst zu vermeiden. Im klinischen Alltag dienen Bücher und „pocket cards“ weiterhin der schnellen Orientierung. Die Nutzung smartphonebasierter Apps nimmt zu, für ihre Validität ist der Nutzer grundsätzlich selbst verantwortlich. Im klinischen Alltag sollten möglichst einfache Strategien eingesetzt werden. Eine tragfähige Fehlerkultur ist hilfreich, um Prozesse zu optimieren und zukünftige Fehler zu vermeiden.
Abstract
Dosing errors when administering medicine to children occur often and are due, e.g., to the commonly required dilution of the drugs, misjudgment of the patient's weight, confusion between drugs with similar names, and inadequate communication. Various aids (e.g., measuring tapes and dilution tables) have been designed to avoid mistakes to the greatest extent possible. In daily clinical practice, books and pocket cards are still used for rapid orientation. Use of smartphone-based apps continues to increase, whereby the user is ultimately responsible for their validity. In clinical practice, the simplest possible strategies should be used. A culture that encourages disclosure of errors is useful in order to optimize processes and avoid future errors.
Literatur
BfARM (2015) BfArM-Symposium zu Medizin-Apps: 200 Experten aus Wirtschaft, Forschung, Politik und Verwaltung diskutieren Chancen und Risiken. Pressemitteilung 4/15. http://www.bfarm.de/SharedDocs/Pressemitteilungen/DE/mitteil2015/pm4-2015.html. Zugegriffen: 08. April 2015
Breton ER (2011) Weight loss-there is an app for that! But does it adhere to evidence-informed practices? Transl Behav Med 1(4):523–529
Broselow® Pediatric Emergency Tape. https://www.armstrongmedical.com/index.cfm/go/product.detail/sec/3/ssec/14/fam/2371. Zugegriffen: 08. April 2015
Das Pädiatrische Notfalllineal. http://www.notfalllineal.de/pages3/index.html. Zugegriffen: 08. April 2015
Doherty C (2012) Tenfold medication errors: 5 years’ experience at a university-affiliated pediatric hospital. Pediatrics 129(5):916–924
Edlin JC (2013) Caveats of smartphone applications for the cardiothoracic trainee. J Thorac Cardiovasc Surg 146(6):1321–1326
Elashwah M (2015) Medication errors in ambulatory paediatric patient setting ‒ how close, or far, are we from an error free process? Infect Disord Drug Targets (Epub ahead of print)
GNOM-Pocket-Cards. http://www.akamedica.de/produktuebersicht/gnom/. Zugegriffen: 08. April 2015
Greig A, Ryan J, Glucksman E (1997) How good are doctors at estimating children’s weight? J Accid Emerg Med 14(2):101–103
Harris M, Patterson J, Morse J (1999) Doctors, nurses, and parents are equally poor at estimating pediatric weights. Pediatr Emerg Care 15(1):17–18
Heyming T, Bosson N, Kurobe A, Kaji AH, Gausche-Hill M (2012) Accuracy of paramedic Broselow tape use in the prehospital setting. Prehosp Emerg Care 16(3):374–380. doi:10.3109/10903127.2012.664247
Jeffery AN, Voss LD, Metcalf BS et al (2005) Parents’ awareness of overweight in themselves and their children: cross sectional study within a cohort (EarlyBird 21). BMJ 330:23–24
Johner C Strenge Regeln für medizinische Apps. http://www.medizin-und-technik.de/markt/-/article/33568401/39414574/Strenge-Regeln-für-medizinische-Apps/art_co_INSTANCE_0000/maximized/. Zugegriffen: 08. April 2015
Kaji AH (2006) Emergency medical services system changes reduce pediatric epinephrine dosing errors in the prehospital setting. Pediatrics 118:1493–1500
Keers RN, Williams SD, Cooke J, Ashcroft DM (2015) Understanding the causes of intravenous medication administration errors in hospitals: a qualitative critical incident study. BMJ Open 5(3):e005948. doi:10.1136/bmjopen-2014-005948
Khouli M, Ortiz MI, Romo-Hernández G, Martínez-Licona D, Stelzner SM (2015) Use of the broselow tape in a mexican emergency department. J Emerg Med pii:S0736-4679(15)00056-6. doi:10.1016/j.jemermed.2014.12.082
Lammers R (2012) Root causes of errors in a simulated prehospital pediatric emergency. Acad Emerg Med 19(1):37–47
Lammers R (2014) Errors and error-producing conditions during a simulated, prehospital, pediatric cardiopulmonary arrest. Simul Healthc 9(3):174–183
Lammers R (2014) Medication errors in prehospital management of simulated pediatric anaphylaxis. Prehosp Emerg Care 18(2):295–304
Leffler S, Hayes M (1997) Analysis of parental estimates of children’s weights in the ED. Ann Emerg Med 30(2):167–170
Maaskant JM, Vermeulen H, Apampa B, Fernando B, Ghaleb MA, Neubert A, Thayyil S, Soe A (2015) Interventions for reducing medication errors in children in hospital. Cochrane Database Syst Rev 3:CD006208. (Epub ahead of print)
Miller MR, Robinson KA, Lubomski LH, Rinke ML, Pronovost PJ (2007) Medication errors in paediatric care: a systematic review of epidemiology and an evaluation of evidence supporting reduction strategy recommendations. Qual Saf Health Care 16(2):116–126
Milne WK (2012) Ontario children have outgrown the Broselow tape. CJEM 14(1):25–30
Mobile Medical Applications. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ConnectedHealth/MobileMedicalApplications/ucm255978.htm. Zugegriffen: 08. April 2015
Mobile Medical Applications. Guidance for Industry and Food and Drug Administration Staff. Document issued on February 9, 2015. http://www.fda.gov/downloads/MedicalDevices/…/UCM263366.pdf. Zugegriffen: 08. April 2015
O’Neill S (2012) Colorectal smartphone apps: opportunities and risks. Colorectal Dis 14(9):e530–e534
Paulino-System für die medizinische Notfallversorgung von Kindern. http://www.paulino-system.de. Zugegriffen: 08. April 2015
Partridge RL, Abramo TJ, Haggarty KA, Hearn R, Sutton KL, An AQ, Givens TG (2009) Analysis of parental and nurse weight estimates of children in the pediatric emergency department. Pediatr Emerg Care 25(12):816–818
Selbst S (1999) Medication errors in a pediatric emergency department. Pediatr Emerg Care 15(1):1–4
Smart N (2012) Haemorrhoids? There’s an App for that!. Colorectal Dis. 14(9):e509
Woo Y, Kim HE, Chung S, Park BJ (2015) Pediatric medication error reports in Korea adverse event reporting system database, 1989–2012: comparing with adult reports. J Korean Med Sci 30(4):371–377. doi:10.3346/jkms.2015.30.4.371
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
J.M. Strauß gibt an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
Additional information
Redaktion
O. Heinzel, Tübingen
F. Hoffmann, München
Rights and permissions
About this article
Cite this article
Strauß, J. Neue Hilfsmittel zur Dosierung von Medikamenten im Kindesalter. Med Klin Intensivmed Notfmed 111, 118–123 (2016). https://doi.org/10.1007/s00063-015-0094-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00063-015-0094-z