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David Mittleman
David Mittleman
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Seemingly Small Medical Mistakes Result in Big Problems for Children

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Children are our future, if they make it that far. In this country, medical mistakes happen on a daily basis. In adults, many small medical mistakes have slight impact on a person’s health or life. It is when those seemingly small medical mistakes happen to children that lives get ruined.

Medical errors pose a greater threat to children than to adults for a number of reasons. Children are physically small, and their kidneys, liver, and immune system are still developing. If children take a turn for the worse, they can deteriorate much more rapidly than adults. Children also are less able to communicate what they are feeling, making it difficult to diagnose their problem or know when a symptom or complication develops.

There are several areas where small medical mistakes lead to big medical problems for children. Recently the subject of medication overdosing in children has made national news. Dennis Quaid’s newborn twins nearly died last year after receiving 1,000 times the prescribed dose of heparin. According to a Joint Commission report, about 32 percent of medication errors in children in the operating room involve the wrong dose of medication, compared with 14 percent in adults.

The problem is that adult medications are prepackaged and have standardize doses. Pediatric medications vary. Children’s medications vary based on the child’s weight and sometimes height. This variance requires doctors to make calculations as to how much of a certain drug a child is suppose to get. Typically, children’s medication is a diluted from the adult formulation. According to Dr. Rainu Kaushal, director of quality and patient safety at the Komansky Center for Children’s Health, "the amount of medication being diluted is smaller than an air bubble in a syringe." These tiny changes, along with different formulations like drops, liquids or chewable, increase the variables and chance of human error.

Not all errors in children’s medication happen at hospitals. Dr. Kaushal reported that potentially harmful medication errors affected 26 percent of children in outpatient care. Many of those errors involve children receiving more then the recommended dosage; an error that should be caught by the child’s pharmacist.

Other medical mistakes that affect children involve diagnostic errors, incorrect procedures or tests, infections and injuries. The most common misdiagnosis errors involving children that visit emergency departments are meningitis, appendicitis, and broken arms. Children are also susceptible to infections and injuries from catheters.

How can these seemingly small medical mistake be prevented? Experts say that a combination of technology and awareness can help prevent many for these mistakes. Technology has helped to reduce medication errors. There are two methods favored by experts. The first method is an electronic prescribing system known as computerized physician order entry. This system involves entering a patients information in the computer program and allows for tracking of the patients progress, along with information pertaining to the patient’s medication doses. The second method is a bar code system. Each patient is assigned a bar code and that code is swiped against the bar code of the drug the patient is about to receive. But, due to the expense of these methods, only about 10 percent of hospital in the United States use computerized prescribing, and 20 percent use bar coding.

Medical manufacturers are also being called into question. According to the Joint Commission, "there needs to be more medications specifically manufactured for the pediatric population, more standardized dosing regimens and very accurate and clear labeling and packaging of medications." Problems arise when labels of medications look too similar. Also, this adjustment by the manufactures would help eliminate human error from calculating medicine doses for children.

The second part to help prevent medical mistakes is awareness. Parents need to be advocates for their children. Parents know their children the best and are usually the first to know when something is wrong with their child. If a parent believes that there is something wrong with their child they need to speak up. Inform the people who are treating your child. If nothing is done, move up the chain of command. It is important for parents to ask questions, especially of those who are performing any medical procedures on the child. There is nothing wrong with double-checking with doctors and making sure they are know the exact place the surgery is being preformed. Make sure your child wears their identification bracelet at all times, this can avoid your child being subjected to the wrong procedure.

Just like the Boy Scouts, parents should always be prepared. Parents should carry a list of medications that your child is taking and remind doctors about any allergies your child has. Parents should become familiar with their child’s medication so they can recognize if the child is given the wrong pill or liquid. Parents should be especially watchful if their child is taking multiple medications, asking the doctor to about potential complications. Also, remanding the doctor of your child’s weight and height can avoid errors in dose calculations.

Technology and awareness can help reduce the seemingly small medical mistakes that result in big problems for children. But medical mistakes will remain until hospital budgets and active awareness increases. Until then, parents can help their children by being prepared and asking questions of those individuals who treat their children.