Study: Try Honey for Children's Coughs
By CARLA K. JOHNSON
The Associated Press
Monday, December 3, 2007; 11:06 PM
CHICAGO -- A teaspoon of honey before bed seems to calm children's coughs and help them sleep better, according to a new study that relied on parents' reports of their children's symptoms.
The folk remedy did better than cough medicine or no treatment in a three-way comparison. Honey may work by coating and soothing an irritated throat, the study authors said.
"Many families are going to relate to these findings and say that grandma was right," said lead author Dr. Ian Paul of Pennsylvania State University's College of Medicine.
The research appears in December's Archives of Pediatrics and Adolescent Medicine
Federal health advisers have recently warned that over-the-counter cough and cold medicines shouldn't be used in children younger than 6, and manufacturers are taking some products for babies off the market.
Three pediatricians who read the study said they would tell parents seeking alternative remedies to try honey. They noted that honey should not be given to children under age 1 because of a rare but serious risk of botulism.
For the study, researchers recruited 105 children with upper respiratory infections from a clinic in Pennsylvania. Parents were given a paper bag with a dosing device inside. Some were empty. Some contained an age-appropriate dose of honey-flavored cough medicine containing dextromethorphan. And some contained a similar dose of honey.
The parents were asked about their children's sleep and cough symptoms, once before the bedtime treatment and once after. They rated the symptoms on a seven-point scale.
All of the children got better, but honey consistently scored best in parents' rating of their children's cough symptoms.
"Give them a little time and they'll get better," said Pat Jackson Allen, a professor at Yale University School of Nursing.
The study was funded by a grant from the National Honey Board, an industry-funded agency of the U.S. Department of Agriculture. The agency had no influence over the study design, data or results, Paul said.
Study: Read the entire article at the original source
Sunday, December 16, 2007
Wednesday, November 28, 2007
Alcohol, tobacco among riskiest drugs
Alcohol, tobacco among riskiest drugs
The Associated Press
Updated: 6:43 a.m. ET March 24, 2007
British study rated the substances more dangerous than marijuana, Ecstasy
LONDON - New "landmark" research finds that alcohol and tobacco are more dangerous than some illegal drugs like marijuana or Ecstasy and should be classified as such in legal systems, according to a new British study.
In research published Friday in The Lancet magazine, Professor David Nutt of Britain's Bristol University and colleagues proposed a new framework for the classification of harmful substances, based on the actual risks posed to society. Their ranking listed alcohol and tobacco among the top 10 most dangerous substances.
Nutt and colleagues used three factors to determine the harm associated with any drug: the physical harm to the user, the drug's potential for addiction and the impact on society of drug use. The researchers asked two groups of experts — psychiatrists specializing in addiction and legal or police officials with scientific or medical expertise — to assign scores to 20 different drugs, including heroin, cocaine, Ecstasy, amphetamines and LSD.
Nutt and his colleagues then calculated the drugs' overall rankings. In the end, the experts agreed with each other — but not with the existing British classification of dangerous substances.
Heroin and cocaine were ranked most dangerous, followed by barbiturates and street methadone. Alcohol was the fifth-most harmful drug and tobacco the ninth most harmful. Cannabis came in 11th, and near the bottom of the list was Ecstasy.
‘Current drug system is ill thought-out’According to existing British and U.S. drug policy, alcohol and tobacco are legal, while cannabis and Ecstasy are both illegal. Previous reports, including a study from a parliamentary committee last year, have questioned the scientific rationale for Britain's drug classification system.
"The current drug system is ill thought-out and arbitrary," said Nutt, referring to the United Kingdom's practice of assigning drugs to three distinct divisions, ostensibly based on the drugs' potential for harm. "The exclusion of alcohol and tobacco from the Misuse of Drugs Act is, from a scientific perspective, arbitrary," write Nutt and his colleagues in The Lancet.
Tobacco causes 40 percent of all hospital illnesses, while alcohol is blamed for more than half of all visits to hospital emergency rooms. The substances also harm society in other ways, damaging families and occupying police services.
Nutt hopes that the research will provoke debate within the UK and beyond about how drugs — including socially acceptable drugs such as alcohol — should be regulated. While different countries use different markers to classify dangerous drugs, none use a system like the one proposed by Nutt's study, which he hopes could serve as a framework for international authorities.
"This is a landmark paper," said Dr. Leslie Iversen, professor of pharmacology at Oxford University. Iversen was not connected to the research. "It is the first real step towards an evidence-based classification of drugs." He added that based on the paper's results, alcohol and tobacco could not reasonably be excluded.
"The rankings also suggest the need for better regulation of the more harmful drugs that are currently legal, i.e. tobacco and alcohol," wrote Wayne Hall, of the University of Queensland in Brisbane, Australia, in an accompanying Lancet commentary. Hall was not involved with Nutt's paper.
While experts agreed that criminalizing alcohol and tobacco would be challenging, they said that governments should review the penalties imposed for drug abuse and try to make them more reflective of the actual risks and damages involved.
Nutt called for more education so that people were aware of the risks of various drugs. "All drugs are dangerous," he said. "Even the ones people know and love and use every day."
Read the full story at the original source
The Associated Press
Updated: 6:43 a.m. ET March 24, 2007
British study rated the substances more dangerous than marijuana, Ecstasy
LONDON - New "landmark" research finds that alcohol and tobacco are more dangerous than some illegal drugs like marijuana or Ecstasy and should be classified as such in legal systems, according to a new British study.
In research published Friday in The Lancet magazine, Professor David Nutt of Britain's Bristol University and colleagues proposed a new framework for the classification of harmful substances, based on the actual risks posed to society. Their ranking listed alcohol and tobacco among the top 10 most dangerous substances.
Nutt and colleagues used three factors to determine the harm associated with any drug: the physical harm to the user, the drug's potential for addiction and the impact on society of drug use. The researchers asked two groups of experts — psychiatrists specializing in addiction and legal or police officials with scientific or medical expertise — to assign scores to 20 different drugs, including heroin, cocaine, Ecstasy, amphetamines and LSD.
Nutt and his colleagues then calculated the drugs' overall rankings. In the end, the experts agreed with each other — but not with the existing British classification of dangerous substances.
Heroin and cocaine were ranked most dangerous, followed by barbiturates and street methadone. Alcohol was the fifth-most harmful drug and tobacco the ninth most harmful. Cannabis came in 11th, and near the bottom of the list was Ecstasy.
‘Current drug system is ill thought-out’According to existing British and U.S. drug policy, alcohol and tobacco are legal, while cannabis and Ecstasy are both illegal. Previous reports, including a study from a parliamentary committee last year, have questioned the scientific rationale for Britain's drug classification system.
"The current drug system is ill thought-out and arbitrary," said Nutt, referring to the United Kingdom's practice of assigning drugs to three distinct divisions, ostensibly based on the drugs' potential for harm. "The exclusion of alcohol and tobacco from the Misuse of Drugs Act is, from a scientific perspective, arbitrary," write Nutt and his colleagues in The Lancet.
Tobacco causes 40 percent of all hospital illnesses, while alcohol is blamed for more than half of all visits to hospital emergency rooms. The substances also harm society in other ways, damaging families and occupying police services.
Nutt hopes that the research will provoke debate within the UK and beyond about how drugs — including socially acceptable drugs such as alcohol — should be regulated. While different countries use different markers to classify dangerous drugs, none use a system like the one proposed by Nutt's study, which he hopes could serve as a framework for international authorities.
"This is a landmark paper," said Dr. Leslie Iversen, professor of pharmacology at Oxford University. Iversen was not connected to the research. "It is the first real step towards an evidence-based classification of drugs." He added that based on the paper's results, alcohol and tobacco could not reasonably be excluded.
"The rankings also suggest the need for better regulation of the more harmful drugs that are currently legal, i.e. tobacco and alcohol," wrote Wayne Hall, of the University of Queensland in Brisbane, Australia, in an accompanying Lancet commentary. Hall was not involved with Nutt's paper.
While experts agreed that criminalizing alcohol and tobacco would be challenging, they said that governments should review the penalties imposed for drug abuse and try to make them more reflective of the actual risks and damages involved.
Nutt called for more education so that people were aware of the risks of various drugs. "All drugs are dangerous," he said. "Even the ones people know and love and use every day."
Read the full story at the original source
Sunday, August 26, 2007
FDA Warns Against Giving Cough Medicine to Toddlers
FDA Warns Against Giving Cough Medicine to Toddlers
The Washington Post
By Rob Stein, Washington Post Staff Writer
Thursday, August 16, 2007; A02
The Food and Drug Administration, concerned about the number of children being accidentally overdosed on over-the-counter cough and cold medicines, yesterday warned parents never to give children younger than age 2 such products without a doctor's approval.
The warning came as the agency announced plans to convene a panel of experts Oct. 18 to review the use of popular cold medicines in children because of mounting concerns about whether the remedies are being used safely.
The FDA began investigating the issue after public health authorities raised questions about the products, citing reports of hundreds of overdoses that resulted in a handful of deaths. Doctors petitioned the FDA in March to review the situation.
"Questions have been raised about the safety of these products and whether the benefits justify any potential risks from the use of these products in children, especially in children under 2 years of age," the agency said in an advisory.
The FDA's decision was welcomed by those concerned about the medications.
"The fact that they are doing this is illustrative that this is a real problem that is on their radar screen," said Baltimore Health Commissioner Joshua M. Sharfstein, who was among those petitioning the agency.
Sharfstein noted that over-the-counter cold and cough medications have never been proven to be effective in children, and parents can easily inadvertently administer the medications in doses that can cause heart problems and other dangerous side effects.
"There's no good evidence of the efficacy of these products, and there are significant safety concerns about their misuse," he said.
Current labels already warn parents not to use the medications on children younger than age 2, indicating that stronger action is needed, such are possibly barring direct marketing of the products for use in young children, Sharfstein said.
Read article at original source
The Washington Post
By Rob Stein, Washington Post Staff Writer
Thursday, August 16, 2007; A02
The Food and Drug Administration, concerned about the number of children being accidentally overdosed on over-the-counter cough and cold medicines, yesterday warned parents never to give children younger than age 2 such products without a doctor's approval.
The warning came as the agency announced plans to convene a panel of experts Oct. 18 to review the use of popular cold medicines in children because of mounting concerns about whether the remedies are being used safely.
The FDA began investigating the issue after public health authorities raised questions about the products, citing reports of hundreds of overdoses that resulted in a handful of deaths. Doctors petitioned the FDA in March to review the situation.
"Questions have been raised about the safety of these products and whether the benefits justify any potential risks from the use of these products in children, especially in children under 2 years of age," the agency said in an advisory.
The FDA's decision was welcomed by those concerned about the medications.
"The fact that they are doing this is illustrative that this is a real problem that is on their radar screen," said Baltimore Health Commissioner Joshua M. Sharfstein, who was among those petitioning the agency.
Sharfstein noted that over-the-counter cold and cough medications have never been proven to be effective in children, and parents can easily inadvertently administer the medications in doses that can cause heart problems and other dangerous side effects.
"There's no good evidence of the efficacy of these products, and there are significant safety concerns about their misuse," he said.
Current labels already warn parents not to use the medications on children younger than age 2, indicating that stronger action is needed, such are possibly barring direct marketing of the products for use in young children, Sharfstein said.
Read article at original source
These Drugs Are for Colds, Not Fidgets
These Drugs Are for Colds, Not Fidgets
By Leslie Berger, The New York Times, August 14, 2007
In a society that savors convenience, parents are sometimes tempted (or pressured) to use over-the-counter cold and allergy drugs to get their children to sleep. In a widely reported incident last month, a Georgia woman and her talkative 19-month-old son were removed from a flight to Oklahoma after the toddler kept repeating, “Bye-bye, plane!” during the safety demonstration, the annoyed flight attendant suggested a dose of Benadryl, and the mother took offense.
Whatever the merits of that confrontation, doctors say there is one lesson to take away: drugs like Benadryl should never be given to sedate a child. For one thing, they can have side effects, including constipation and respiratory problems. And for another, in some children they produce the exact opposite of the desired effect.
“Instead of becoming sleepy they can become very animated and less controllable,” said Dr. Charles J. Coté, a pediatric anesthesiologist at Harvard Medical School.
That paradoxical reaction to the antihistamines contained in many common cold medicines and allergy remedies occurs in as many as 5 percent to 10 percent of children, some experts say. It is not medically dangerous, but it can take a couple of hours to wear off. Indeed, the fine print on these drugs’ labels warns of possible “excitability.”
Nevertheless, the use of such medicines to make children drowsy is widespread. “Inappropriate use clearly is a very common practice,” said Dr. Philip Walson, a professor of pediatrics and pharmacology at Cincinnati Children’s Hospital Medical Center.
Dr. Philippe Similon, a pediatrician in Manhattan, says the question of how to travel with young children, and whether it is safe to give them nonprescription sedatives, has become one of the most common in his practice.
He advises against it, instead suggesting behavioral techniques. “Make sure they are well rested before they get on the plane,” he said, “that they’ve eaten well and that they have something to distract them like a small toy or a book.”
Dr. Coté and other experts say that while children under 2 tend to have the hardest time staying put in a confined space, they are also the most vulnerable to overdoses and respiratory problems. If a sleeping child’s airways become blocked — by a nose pressed against a seat, for example — the sedation can blunt the natural reflex to shift position.
“There are no real safe sedatives to give children just sort of over-the-counter,” Dr. Walson said. “Sedation is a big deal.”
Dr. Walson was an expert witness in the 2005 trial of a Montana day care operator who was convicted of negligent homicide in the death of a 1-year-old in her care. The jury found she had given children an over-the-counter allergy medicine to get them to nap. “It turned out she’d been buying quarts of it, literally, and giving it to all the babies,” Dr. Walson said.
Most popular allergy and cold medicines were not developed as sedatives; the recommended doses on their labels are meant for their intended use.
Moreover, the Food and Drug Administration has begun a long-sought review of popular nonprescription cough and cold medicines marketed for children as young as 2, in response to concerns that they have caused several serious health problems. The drugs, which include Toddler’s Dimetapp, Triaminic Infant and Little Colds, were approved for sale years before the F.D.A. began requiring rigorous premarket testing, and they were never adequately tested in children.
Diphenhydramine, the main compound in Benadryl, also predates current drug agency standards and was never tested in children, but it is lower on the review’s list of priorities, said Dr. Wayne Snodgrass, a professor of pediatrics, pharmacology and toxicology at the University of Texas Medical Branch at Galveston and chairman of the committee on drugs for the American Academy of Pediatrics.
McNeil Consumer Healthcare, which makes Benadryl, said in a statement that the drug was intended to relieve the symptoms of allergies and colds, and added, “We do not recommend nor condone the use of any of our products for purposes other than those indicated on the label.”
Dr. Kenneth R. Cohen, a psychiatrist in New York who specializes in psychopharmacology, suggested another way of looking at the problem: not the restless children, but the adults who have a hard time dealing with them.
For those adults, he said, there are anti-anxiety medications, which should be taken under a doctor’s direction and should be tried out at home first.
“Children absolutely should not be sedated on airplanes for the convenience of other passengers,” Dr. Cohen said.
Read article at original source
By Leslie Berger, The New York Times, August 14, 2007
In a society that savors convenience, parents are sometimes tempted (or pressured) to use over-the-counter cold and allergy drugs to get their children to sleep. In a widely reported incident last month, a Georgia woman and her talkative 19-month-old son were removed from a flight to Oklahoma after the toddler kept repeating, “Bye-bye, plane!” during the safety demonstration, the annoyed flight attendant suggested a dose of Benadryl, and the mother took offense.
Whatever the merits of that confrontation, doctors say there is one lesson to take away: drugs like Benadryl should never be given to sedate a child. For one thing, they can have side effects, including constipation and respiratory problems. And for another, in some children they produce the exact opposite of the desired effect.
“Instead of becoming sleepy they can become very animated and less controllable,” said Dr. Charles J. Coté, a pediatric anesthesiologist at Harvard Medical School.
That paradoxical reaction to the antihistamines contained in many common cold medicines and allergy remedies occurs in as many as 5 percent to 10 percent of children, some experts say. It is not medically dangerous, but it can take a couple of hours to wear off. Indeed, the fine print on these drugs’ labels warns of possible “excitability.”
Nevertheless, the use of such medicines to make children drowsy is widespread. “Inappropriate use clearly is a very common practice,” said Dr. Philip Walson, a professor of pediatrics and pharmacology at Cincinnati Children’s Hospital Medical Center.
Dr. Philippe Similon, a pediatrician in Manhattan, says the question of how to travel with young children, and whether it is safe to give them nonprescription sedatives, has become one of the most common in his practice.
He advises against it, instead suggesting behavioral techniques. “Make sure they are well rested before they get on the plane,” he said, “that they’ve eaten well and that they have something to distract them like a small toy or a book.”
Dr. Coté and other experts say that while children under 2 tend to have the hardest time staying put in a confined space, they are also the most vulnerable to overdoses and respiratory problems. If a sleeping child’s airways become blocked — by a nose pressed against a seat, for example — the sedation can blunt the natural reflex to shift position.
“There are no real safe sedatives to give children just sort of over-the-counter,” Dr. Walson said. “Sedation is a big deal.”
Dr. Walson was an expert witness in the 2005 trial of a Montana day care operator who was convicted of negligent homicide in the death of a 1-year-old in her care. The jury found she had given children an over-the-counter allergy medicine to get them to nap. “It turned out she’d been buying quarts of it, literally, and giving it to all the babies,” Dr. Walson said.
Most popular allergy and cold medicines were not developed as sedatives; the recommended doses on their labels are meant for their intended use.
Moreover, the Food and Drug Administration has begun a long-sought review of popular nonprescription cough and cold medicines marketed for children as young as 2, in response to concerns that they have caused several serious health problems. The drugs, which include Toddler’s Dimetapp, Triaminic Infant and Little Colds, were approved for sale years before the F.D.A. began requiring rigorous premarket testing, and they were never adequately tested in children.
Diphenhydramine, the main compound in Benadryl, also predates current drug agency standards and was never tested in children, but it is lower on the review’s list of priorities, said Dr. Wayne Snodgrass, a professor of pediatrics, pharmacology and toxicology at the University of Texas Medical Branch at Galveston and chairman of the committee on drugs for the American Academy of Pediatrics.
McNeil Consumer Healthcare, which makes Benadryl, said in a statement that the drug was intended to relieve the symptoms of allergies and colds, and added, “We do not recommend nor condone the use of any of our products for purposes other than those indicated on the label.”
Dr. Kenneth R. Cohen, a psychiatrist in New York who specializes in psychopharmacology, suggested another way of looking at the problem: not the restless children, but the adults who have a hard time dealing with them.
For those adults, he said, there are anti-anxiety medications, which should be taken under a doctor’s direction and should be tried out at home first.
“Children absolutely should not be sedated on airplanes for the convenience of other passengers,” Dr. Cohen said.
Read article at original source
Sunday, March 11, 2007
Medication Errors During Surgeries Particularly Dangerous
Medication Errors During Surgeries Particularly Dangerous
By Amanda Gardner, HealthDay Reporter
Washington Post, Tuesday, March 6, 2007
Medication errors that occur during the course of a surgical procedure are three times more likely to harm a patient than errors committed during other types of hospital care, a new report shows.
Some 5 percent of such errors resulted in harm, said Diane Cousins, vice president of the department of Healthcare Quality and Information at the United States Pharmacopeia (USP), which conducted the survey. The nonprofit group sets safety standards for pharmaceutical care that are used worldwide.
The report analyzed 11,000 errors reported by 500 hospitals between 1998 and 2005. This is the largest known analysis of medical errors related to surgery, according to the USP.
Overall, there were about 500 harmful errors, including four fatalities, one of which involved a child.
Errors were most common in the operating room and were most likely to affect children. Almost 13 percent of pediatric errors resulted in harm, proportionately higher than any other group studied.
The most common medication errors in the surgery setting were receiving the wrong drug, the wrong amount of a drug, receiving the drug at the wrong time or not receiving the drug at all. Antibiotics and painkillers were most frequently found to be involved in errors.
The report focused on four parts of the "surgical continuum" -- outpatient surgery, the preoperative holding area, the operating room, and the post-anesthesia care unit.
There were 2,437 reported errors in outpatient surgery, 3.3 percent of them resulting in harm. In the pediatric population, 3.6 percent of errors resulted in harm, vs. 5.1 percent in adults and 5.1 percent in geriatric patients. Problems most commonly involved central nervous system medications and antimicrobials, with central nervous system drugs most likely to result in harm.
In the preoperative holding area, there were 779 errors, with 2.8 percent resulting in harm. For children, 4.2 percent of errors resulted in harm, compared to 7.1 percent for adults and 2.6 percent for elderly patients.
In the operating room, 3,773 errors were reported, 7.3 percent of which resulted in harm. Almost 17 percent of errors resulted in harm in children, 11.3 percent in adults and 10 percent in geriatric patients. Two of the errors caused or contributed to patient deaths.
Finally, in the post-anesthesia care unit, 3,260 errors occurred, of which 5.8 percent resulted in harm. Here, more than 20 percent of errors in children resulted in harm, compared with 8.7 percent in adults and 8.8 percent in elderly patients. Morphine drips and other patient-controlled analgesia machines were often involved in the most harmful errors. Tubing misconnections were also involved, as was an absence of reliable allergy information. Medication errors caused or contributed to two deaths.
Overall, Cousins said, the so-called "surgical continuum" was really a fragmented system in which numerous hand-offs of patients resulted in lack of coordination and errors.
The report included 47 recommendations, more than any other year. These included implementing strategies to improve communication among team members, designating a pharmacist to coordinate medication safety on behalf of a patient, working to ensure that medications are administered on time (particularly antibiotics) and issuing a call to manufacturers to provide ready-to-use sterile packaging, especially for drugs administered to children.
More information
Find out more about the report at USP.
SOURCES: March 6, 2007, teleconference with Diane D. Cousins, R.Ph., vice president, Department of Healthcare Quality and Information, USP;MEDMARX Data Report: A Chartbook of Medication Error Findings from the Perioperative Settings from 1998-2005.
Read article at original source
By Amanda Gardner, HealthDay Reporter
Washington Post, Tuesday, March 6, 2007
Medication errors that occur during the course of a surgical procedure are three times more likely to harm a patient than errors committed during other types of hospital care, a new report shows.
Some 5 percent of such errors resulted in harm, said Diane Cousins, vice president of the department of Healthcare Quality and Information at the United States Pharmacopeia (USP), which conducted the survey. The nonprofit group sets safety standards for pharmaceutical care that are used worldwide.
The report analyzed 11,000 errors reported by 500 hospitals between 1998 and 2005. This is the largest known analysis of medical errors related to surgery, according to the USP.
Overall, there were about 500 harmful errors, including four fatalities, one of which involved a child.
Errors were most common in the operating room and were most likely to affect children. Almost 13 percent of pediatric errors resulted in harm, proportionately higher than any other group studied.
The most common medication errors in the surgery setting were receiving the wrong drug, the wrong amount of a drug, receiving the drug at the wrong time or not receiving the drug at all. Antibiotics and painkillers were most frequently found to be involved in errors.
The report focused on four parts of the "surgical continuum" -- outpatient surgery, the preoperative holding area, the operating room, and the post-anesthesia care unit.
There were 2,437 reported errors in outpatient surgery, 3.3 percent of them resulting in harm. In the pediatric population, 3.6 percent of errors resulted in harm, vs. 5.1 percent in adults and 5.1 percent in geriatric patients. Problems most commonly involved central nervous system medications and antimicrobials, with central nervous system drugs most likely to result in harm.
In the preoperative holding area, there were 779 errors, with 2.8 percent resulting in harm. For children, 4.2 percent of errors resulted in harm, compared to 7.1 percent for adults and 2.6 percent for elderly patients.
In the operating room, 3,773 errors were reported, 7.3 percent of which resulted in harm. Almost 17 percent of errors resulted in harm in children, 11.3 percent in adults and 10 percent in geriatric patients. Two of the errors caused or contributed to patient deaths.
Finally, in the post-anesthesia care unit, 3,260 errors occurred, of which 5.8 percent resulted in harm. Here, more than 20 percent of errors in children resulted in harm, compared with 8.7 percent in adults and 8.8 percent in elderly patients. Morphine drips and other patient-controlled analgesia machines were often involved in the most harmful errors. Tubing misconnections were also involved, as was an absence of reliable allergy information. Medication errors caused or contributed to two deaths.
Overall, Cousins said, the so-called "surgical continuum" was really a fragmented system in which numerous hand-offs of patients resulted in lack of coordination and errors.
The report included 47 recommendations, more than any other year. These included implementing strategies to improve communication among team members, designating a pharmacist to coordinate medication safety on behalf of a patient, working to ensure that medications are administered on time (particularly antibiotics) and issuing a call to manufacturers to provide ready-to-use sterile packaging, especially for drugs administered to children.
More information
Find out more about the report at USP.
SOURCES: March 6, 2007, teleconference with Diane D. Cousins, R.Ph., vice president, Department of Healthcare Quality and Information, USP;MEDMARX Data Report: A Chartbook of Medication Error Findings from the Perioperative Settings from 1998-2005.
Read article at original source
Medication Errors Are Studied
Medication Errors Are Studied
Medication Errors Are Studied
By DONALD G. McNEIL Jr., New York Times, March 7, 2007
Young children are the most likely victims of surgery-related medication mistakes, a new study has found, and poor communication as the patient moves from the operating room to recovery is the most likely culprit.
The study, released yesterday, was done by the United States Pharmacopeia, which sets standards for the pharmaceutical industry, and by the Uniformed Services University of the Health Sciences in Bethesda, Md., and two nurses’ associations.
Medical error has been a charged topic ever since a 1999 report by the Institute of Medicine, “To Err Is Human,” estimated that such mistakes led to as many as 98,000 deaths a year — more than highway accidents and breast cancer combined.
The current study did not try to estimate total error rates. Instead, it analyzed 11,000 mistakes that had been voluntarily and anonymously reported to the pharmacopeia by hundreds of hospitals since 1998.
The study was confined to errors made on patients undergoing surgery, and the rate of harm, 5 percent, was much higher than is typical for medication errors. Among children it was 12 percent.
Most of the errors involved painkillers and antibiotics. Four resulted in deaths, and one death was of a child.
Problems typically arose when a patient was handed off from the preoperative team to the operating room to the recovery room to the regular ward nurses, said Diane Cousins, a health care specialist at the pharmacopeia and one of the authors. “The system is often very fragmented,” Ms. Cousins said.
Typical dangerous mistakes were failures to administer antibiotics before surgery, failures to note allergies, errors in setting pumps that dispense blood thinners or painkillers, and giving overdoses to infants.
In several cases described in the report, poor penmanship, careless listening or bad arithmetic caused patients to get doses 10 or even 50 times as high as they should.
“It’s beyond troubling that the smallest, youngest patients are the ones most at risk,” Ms. Cousins said.
There are 10,000 drugs in the marketplace, she said, and many have never been tested on children in clinical trials, so doses are often made by guesswork based on weight, involving conversion of pounds to kilograms, sometimes by nurses who are not pediatric specialists.
“These may be back-of-the-envelope calculations not checked by anyone,” she said, “and they are often in very tiny amounts — milliliters — and that in itself breeds errors.”
The report made 42 recommendations, among them that hospitals improve communication and designate a pharmacist to be consulted for each patient.
Since 1999, committees investigating medical mistakes have routinely recommended that hospitals install computerized systems for prescribing drugs, which can sound alarms when a toxic combination is ordered for a patient. But fewer than 10 percent of all hospitals have them.
Read article at the original source
Medication Errors Are Studied
By DONALD G. McNEIL Jr., New York Times, March 7, 2007
Young children are the most likely victims of surgery-related medication mistakes, a new study has found, and poor communication as the patient moves from the operating room to recovery is the most likely culprit.
The study, released yesterday, was done by the United States Pharmacopeia, which sets standards for the pharmaceutical industry, and by the Uniformed Services University of the Health Sciences in Bethesda, Md., and two nurses’ associations.
Medical error has been a charged topic ever since a 1999 report by the Institute of Medicine, “To Err Is Human,” estimated that such mistakes led to as many as 98,000 deaths a year — more than highway accidents and breast cancer combined.
The current study did not try to estimate total error rates. Instead, it analyzed 11,000 mistakes that had been voluntarily and anonymously reported to the pharmacopeia by hundreds of hospitals since 1998.
The study was confined to errors made on patients undergoing surgery, and the rate of harm, 5 percent, was much higher than is typical for medication errors. Among children it was 12 percent.
Most of the errors involved painkillers and antibiotics. Four resulted in deaths, and one death was of a child.
Problems typically arose when a patient was handed off from the preoperative team to the operating room to the recovery room to the regular ward nurses, said Diane Cousins, a health care specialist at the pharmacopeia and one of the authors. “The system is often very fragmented,” Ms. Cousins said.
Typical dangerous mistakes were failures to administer antibiotics before surgery, failures to note allergies, errors in setting pumps that dispense blood thinners or painkillers, and giving overdoses to infants.
In several cases described in the report, poor penmanship, careless listening or bad arithmetic caused patients to get doses 10 or even 50 times as high as they should.
“It’s beyond troubling that the smallest, youngest patients are the ones most at risk,” Ms. Cousins said.
There are 10,000 drugs in the marketplace, she said, and many have never been tested on children in clinical trials, so doses are often made by guesswork based on weight, involving conversion of pounds to kilograms, sometimes by nurses who are not pediatric specialists.
“These may be back-of-the-envelope calculations not checked by anyone,” she said, “and they are often in very tiny amounts — milliliters — and that in itself breeds errors.”
The report made 42 recommendations, among them that hospitals improve communication and designate a pharmacist to be consulted for each patient.
Since 1999, committees investigating medical mistakes have routinely recommended that hospitals install computerized systems for prescribing drugs, which can sound alarms when a toxic combination is ordered for a patient. But fewer than 10 percent of all hospitals have them.
Read article at the original source
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