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J Clin Anesth. 2014 Jun;26(4):276-80. doi: 10.1016/j.jclinane.2013.11.021. Epub 2014 May 22.

Anesthesiologists' ability in calculating weight-based concentrations for pediatric drug infusions: an observational study.

Author information

1
Department of Anesthesiology and Critical Care Medicine, Hadassah - Hebrew University Medical Center, Jerusalem 91120, Israel. Electronic address: alex@avidan.co.il.
2
Department of Anesthesiology and Critical Care Medicine, Hadassah - Hebrew University Medical Center, Jerusalem 91120, Israel.

Abstract

STUDY OBJECTIVES:

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.

DESIGN:

Observational study.

SETTING:

Anesthesiology department of a tertiary-care medical center in Israel.

PARTICIPANTS:

45 anesthesiology department staff members (attendings and residents).

MEASUREMENTS:

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.

MAIN 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.

KEYWORDS:

Anesthesia; Computer software tools; Drug dosage calculation; Intravenous infusions; Medical errors

PMID:
24856861
DOI:
10.1016/j.jclinane.2013.11.021
[Indexed for MEDLINE]

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