title: Pediatric Prehospital Medication Dosing Errors: A National Survey of Paramedics.
abstract: Pediatric drug dosing errors occur at a high rate in the prehospital environment.
  
  
  
  To describe paramedic training and practice regarding pediatric drug administration, exposure to pediatric drug dose errors and safety culture among paramedics and EMS agencies in a national sample.
  
  
  
  An electronic questionnaire was sent to a random sample of 10,530 nationally certified paramedics. Descriptive statistics were calculated.
  
  
  
  There were 1,043 (9.9%) responses and 1,014 paramedics met inclusion criteria. Nearly half (43.0%) were familiar with a case where EMS personnel delivered an incorrect pediatric drug dose. Over half (58.5%) believed their initial paramedic program did not include enough pediatric training. Two-thirds (66.0%) administered a pediatric drug dose within the past year. When estimating the weight of a pediatric patient, 54.2% used a length-based tape, while 35.8% asked the parent or guardian, and 2.5% relied on a smart phone application. Only 19.8% said their agency had an anonymous error-reporting system and 50.7% believed they could report an error without fear of disciplinary action. For solutions, 89.0% believed an EMS-specific Broselow-Luten Tape would be helpful, followed by drug dosing cards in milliliters (83.0%) and changing content of standardized pediatric courses to be more relevant (77.7%).
  
  
  
  This national survey demonstrated a significant number of paramedics are aware of a pediatric dosing error, safety systems specific to pediatric patients are lacking, and that paramedics view pediatric drug cards and eliminating drug calculations as helpful. Pediatric drug-dosing safety in the prehospital environment can be improved.
authors.forename: John D
authors.initials: JD
authors.lastname: Hoyle
authors.forename: Remle P
authors.initials: RP
authors.lastname: Crowe
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Bentley
authors.forename: Gerald
authors.initials: G
authors.lastname: Beltran
authors.forename: William
authors.initials: W
authors.lastname: Fales
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000592:standards*; D004634:Emergency Medical Technicians / Q000592:standards*; D019538:Health Care Surveys; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D061214:Patient Safety; D011795:Surveys and Questionnaires; D014481:United States
keywords: Key words; emergency medical services; medication errors; patient safety; pediatric; prehospital; safety culture