The Medical Minute: Getting Safe Doses of Medicine for Children

By Ian Paul

Every year, more than 70,000 children end up in hospital emergency rooms across the United States as the result of unintentional medication overdoses. Many of these cases are caused by dosing devices that are either ambiguous, confusing or the wrong device altogether. There are steps that physicians and parents can take to ensure that children are receiving the right amount of medication.

One of those steps centers on how liquid medications are measured. In testimony presented last year to an FDA committee, the American Academy of Pediatrics acknowledged that dosages should be in metric units (milliliters) and should not use teaspoon or tablespoon measures. It’s been demonstrated that inconsistent volumes are administered when medications are given using teaspoons as the unit of measurement. This is especially the case when household spoons are the delivery device – a practice that is unfortunately quite commonplace. Experiences from other countries show that only minimal education is needed to ensure the safe use of metric-based dosing. As for the actual dosing device, studies have shown that syringes lead to the delivery of more precise volumes than dosing cups.

These dosing guidelines are among several strategies put forth by the Prevention of Overdoses and Treatment Errors in Children Taskforce (or PROTECT) Initiative, a collaboration of public health agencies, private sector companies, professional organizations, patient advocates and academic experts. The PROTECT Initiative was launched in 2008 by the Centers for Disease Control and Prevention to develop strategies to prevent unintentional medication overdoses. Other strategies from the initiative that are already moving forward include industry-led efforts to improve child-resistant packaging and the Up and Away and Out of Sight educational program to promote safe storage of medication.

For tips on avoiding medication mistakes in children, visit the PROTECT Initiative website.

Ian Paul is a pediatrician at Penn State Hershey Children’s Hospital and professor of pediatrics and public health sciences at Penn State College of Medicine. Paul also serves on the Prevention of Overdoses and Treatment Errors in Children Taskforce (PROTECT).

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