title: Accurately administering oral medication to children isn't child's play.
abstract: OBJECTIVE
  Parents administer oral medications with various measuring devices including metal teaspoons, calibrated spoons and oral syringes. We aimed to determine which was the most accurate.
  
  
  METHODS
  Self-controlled, non-randomised, experimental study.
  
  
  METHODS
  Caregivers attending paediatric outpatient clinics.
  
  
  METHODS
  Caregivers measured 5 ml of 120 mg/5 ml paracetamol suspension using a 5.0 ml metal teaspoon, 5.0 ml calibrated spoon and 5.0 ml oral syringe. Samples were weighed and converted to mls.
  
  
  METHODS
  The mean volume and variance of volumes were measured for each device.
  
  
  RESULTS
  We recruited 277 caregivers (98% parents). Volumes measured ranged from 0.83-6.52 ml. Accuracy did not vary with caregivers' age, gender, instrument preference, number and age of children. The mean volumes measured with the oral syringe (95% CI 5.09 to 5.17 ml) and metal spoon (95% CI 3.90 to 4.08 ml) were significantly different to the desired 5 ml volume (p<0.0001), dissimilar to the mean volume measured using the calibrated spoon (95% CI 4.91 to 5.09 ml, p=0.99). The variance of volumes measured with the oral syringe (SD 0.348 ml) was significantly smaller (p<0.0001) than that measured using a calibrated spoon (SD 0.762 ml) or metal spoon (SD 0.749 ml).
  
  
  CONCLUSIONS
  The calibrated spoon was the most accurate producing a mean volume of 5 ml, while the oral syringe had the smallest variance. The increased variability of calibrated or metal spoons may result in under or overdosing especially when administering drugs with a narrow therapeutic window. Health care professionals must make a case-by-case decision regarding which device is preferable depending on the medication in question. Parental education could improve measuring accuracy.
authors.affiliation: School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge, UK. victoria.beckett@cantab.net
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Beckett
authors.forename: Luke D
authors.initials: LD
authors.lastname: Tyson
authors.forename: Daniel
authors.initials: D
authors.lastname: Carroll
authors.forename: Nigel M
authors.initials: NM
authors.lastname: Gooding
authors.forename: A W
authors.initials: AW
authors.lastname: Kelsall
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D004864:Equipment and Supplies / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control; D008875:Middle Aged; D010290:Parents; D019999:Pharmaceutical Solutions / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D019999:Pharmaceutical Solutions