title: Anesthesiologists' ability in calculating weight-based concentrations for pediatric drug infusions: an observational study.
abstract: OBJECTIVE
  To assess the ability of anesthesiologists to calculate weight-specific drug concentrations for continuous drug administration in children, and to evaluate the acceptance of an inhouse-developed, computer-based application for calculating drug infusions for pediatric cardiac surgery.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Anesthesiology department of a tertiary-care medical center in Israel.
  
  
  METHODS
  45 anesthesiology department staff members (attendings and residents).
  
  
  METHODS
  Anesthesiologists were asked to calculate the weight-based amount of drug and the corresponding amount in mL to be drawn from a standard vial and added to a 50-mL syringe in order to reach an infusion rate, where 1 mL/hr corresponds to 1 μg x kg(-1) x min(-1). The time it took to reach the result was measured. Staff members were also asked to rate the user-friendliness and usability of the program.
  
  
  RESULTS
  41 of the original 42 participants returned the completed questionnaire. Only 6 (15%) of 41 anesthesiologists provided all the correct answers. The mean calculation time required was 205 (±53) seconds. There was no difference in success rate between attendings and residents. Incorrect calculations ranged from a drug concentration 50 times too low up to 56 times too high. Most staff members believed that the computer-based application to perform these calculations reduced errors (65%) and workload (81%), and improved patient treatment (71%). This application was rated as very user-friendly.
  
  
  CONCLUSIONS
  Anesthesiologists have difficulty calculating pediatric drug concentrations for continuous drug infusions. The correct calculations are time-consuming. Incorrect calculations may lead to dangerously high or low doses. A computer-based application to calculate drug concentrations was rated as very useful and user-friendly.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hadassah - Hebrew University Medical Center, Jerusalem 91120, Israel. Electronic address: alex@avidan.co.il.
authors.forename: Alexander
authors.initials: A
authors.lastname: Avidan
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hadassah - Hebrew University Medical Center, Jerusalem 91120, Israel.
authors.forename: Phillip D
authors.initials: PD
authors.lastname: Levin
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hadassah - Hebrew University Medical Center, Jerusalem 91120, Israel.
authors.forename: Charles
authors.initials: C
authors.lastname: Weissman
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hadassah - Hebrew University Medical Center, Jerusalem 91120, Israel.
authors.forename: Yaacov
authors.initials: Y
authors.lastname: Gozal
mesh_terms: D000758:Anesthesia / Q000379:methods*; D000776:Anesthesiology / Q000592:standards*; D000777:Anesthetics / Q000008:administration & dosage*; D001291:Attitude of Health Personnel; D001835:Body Weight; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D054796:Drug Dosage Calculations; D004360:Drug Therapy, Computer-Assisted; D006801:Humans; D007262:Infusions, Intravenous; D007557:Israel; D008508:Medication Errors / Q000517:prevention & control*; D010372:Pediatrics; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D013997:Time Factors
chemical_list: D000777:Anesthetics
keywords: Anesthesia; Computer software tools; Drug dosage calculation; Intravenous infusions; Medical errors