Skip to main content
SpringerLink
Log in

Hilfsmittel für die Dosierung von Notfallmedikamenten im Kindesalter

Tools for drug dosing in life-threatening pediatric emergencies

  • Notfallmedizin
  • Published:
Der Anaesthesist Aims and scope Submit manuscript

Zusammenfassung

Kindernotfälle mit akuter Lebensbedrohung, in denen die präzise, korrekte und schnelle Dosierung von Medikamenten notwendig ist, sind seltene Ereignisse. Medikamente zur i.v.-Applikation werden in der Regel nach Milligramm pro Kilogramm Körpergewicht (mg/kgKG) dosiert. Um die im Notfall möglicherweise fehlerbehaftete Kopfrechnung zu erleichtern, existieren zahlreiche Arbeitshilfen, von denen keine einzelne sämtliche Anforderungen an eine ideale Arbeitshilfe erfüllt. Neben dem regelmäßigem Training von praktischen Fertigkeiten und einem Problembewusstsein für die Komplexität der korrekten Medikamentendosierung ist es unabdingbar, auf die lokalen Verhältnisse passende Arbeitshilfen vorzuhalten.

Abstract

Life-threatening pediatric emergencies are rare events in which precise, correct and fast drug dosing is essential. Intravenous drugs are most commonly dosed based on the child’s weight in mg/kg. Numerous tools exist for aiding the physician in the error prone calculation, none of which meet all criteria for the perfect tool. Besides frequent training of practical skills and awareness of the problem of calculating the exact drug dose, it seems indispensable to have a localized tool at hand for these critical events.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Agarwal S, Swanson S, Murphy A et al (2005) Comparing the utility of a standard pediatric resuscitation cart with a pediatric resuscitation cart based on the Broselow tape: a randomized, controlled, crossover trial involving simulated resuscitation scenarios. Pediatrics 116:326–333

    Article  Google Scholar 

  2. Barata IA, Benjamin LS, Mace SE et al (2007) Pediatric patient safety in the prehospital/emergency department setting. Pediatr Emerg Care 23:412–418

    Article  PubMed  Google Scholar 

  3. Bernhard M, Helm M, Luiz T et al (2011) Pädiatrische Notfälle in der prähospitalen Notfallmedizin. Implikationen für die Notarztqualifikation. Notfall Rettungsmed 14:554–566

    Article  Google Scholar 

  4. Conroy S, Sweis D, Planner C et al (2007) Interventions to reduce dosing errors in children: a systematic review of the literature. Drug Saf 30:1111–1125

    Article  PubMed  Google Scholar 

  5. Coté CJ, Karl HW, Notterman DA et al (2000) Adverse sedation events in pediatrics: analysis of medications used for sedation. Pediatrics 106:633–644

    Article  PubMed  Google Scholar 

  6. DeBoer S, Seaver M, Broselow J (2005) Do you know your ABCs? Airway, breathing, and colour-coding! Australas Emerg Nurs J 8:35–41

    Article  Google Scholar 

  7. Eich C, Roessler M, Timmermann A et al (2009) Präklinische Kindernotfälle: Notärztliche Wahrnehmung und Einschätzung. Anaesthesist 58:876–883

    Article  PubMed  CAS  Google Scholar 

  8. Erker CG (2011) GNOM – Gewichtsadaptierte Notfall-Medikamente beim Kindernotfall. akaMedica, Münster. ISBN 978-3-9812965-4-9

  9. Fineberg SL, Arendts G (2008) Comparison of two methods of pediatric resuscitation and critical care management. Ann Emerg Med 52:35–40

    Article  PubMed  Google Scholar 

  10. Ghaleb MA, Barber N, Franklin BD et al (2006) Systematic review of medication errors in pediatric patients. Ann Pharmacother 40:1766–1776

    Article  PubMed  Google Scholar 

  11. Hilmas E, Sowan A, Gaffoor M et al (2010) Implementation and evaluation of a comprehensive system to deliver pediatric continuous infusion medications with standardized concentrations. Am J Health Syst Pharm 67:58–69

    Article  PubMed  CAS  Google Scholar 

  12. Jöhr M (2012) Pharmakotherapie in der Kinderanästhesie. Anaesth Intensivmed 53:330–347

    Google Scholar 

  13. Jordi Ritz EM, Eich C, Gisin S et al (2009) Kindersimulation heute und morgen. Perspektiven und Konzepte. Anaesthesist 58:1231–1238

    Article  Google Scholar 

  14. Kaji AH, Gausche-Hill M, Conrad H et al (2006) Emergency medical services system changes reduce pediatric epinephrine dosing errors in the prehospital setting. Pediatrics 118:1493–1500

    Article  PubMed  Google Scholar 

  15. Kaufmann J, Laschat M, Wappler F (2012) Die präklinische Versorgung von Notfällen im Kindesalter. Anaesth Intensivmed 53:254–267

    Google Scholar 

  16. Kaufmann J (o J) Pädiatrisches Notfalllineal. http://www.notfalllineal.de

  17. Koren G, Barzilay Z, Greenwald M (1986) Tenfold errors in administration of drug doses: a neglected iatrogenic disease in pediatrics. Pediatrics 77:848–849

    PubMed  CAS  Google Scholar 

  18. Krieser D, Nguyen K, Kerr D et al (2007) Parental weight estimation of their child’s weight is more accurate than other weight estimation methods for determining children’s weight in an emergency department? Emerg Med J 24:756–759

    Article  PubMed  Google Scholar 

  19. Leape LL, Bates DW, Cullen DJ et al (1995) Systems analysis of adverse drug events. ADE Prevention Study Group. JAMA 274:35–43

    Article  PubMed  CAS  Google Scholar 

  20. Lesar TS (1998) Errors in the use of medication dosage equations. Arch Pediatr Adolesc Med 152:340–344

    Article  PubMed  CAS  Google Scholar 

  21. Luten R, Wears RL, Broselow J et al (2002) Managing the unique size-related issues of pediatric resuscitation: reducing cognitive load with resuscitation aids. Acad Emerg Med 9:840–847

    Article  PubMed  Google Scholar 

  22. Luten R (2002) Error and time delay in pediatric trauma resuscitation: addressing the problem with color-coded resuscitation aids. Surg Clin North Am 82:303–314

    Article  PubMed  Google Scholar 

  23. Luten RC, Wears RL, Broselow J et al (1992) Length-based endotracheal tube and emergency equipment in pediatrics. Ann Emerg Med 21:900–904

    Article  PubMed  CAS  Google Scholar 

  24. Nieman CT, Manacci CF, Super DM et al (2006) Use of the Broselow tape may result in the underresuscitation of children. Acad Emerg Med 13:1011–1019

    Article  PubMed  Google Scholar 

  25. Partridge RL, Abramo TJ, Haggarty KA et al (2009) Analysis of parental and nurse weight estimates of children in the pediatric emergency department. Pediatr Emerg Care 25:816–818

    Article  PubMed  Google Scholar 

  26. Potts MJ, Phelan KW (1996) Deficiencies in calculation and applied mathematics skills in pediatrics among primary care interns. Arch Pediatr Adolesc Med 150:748–752

    Article  PubMed  CAS  Google Scholar 

  27. Prien T (2009) Empfehlung der DGAI zur farbigen Kennzeichnung von Spritzen. Anaesth Intensivmed 50:333–334

    Google Scholar 

  28. Rolfe S, Harper NJ (1995) Ability of hospital doctors to calculate drug doses. BMJ 310:1173–1174

    Article  PubMed  CAS  Google Scholar 

  29. Rowe C, Koren T, Koren G (1998) Errors by paediatric residents in calculating drug doses. Arch Dis Child 79:56–58

    Article  PubMed  CAS  Google Scholar 

  30. Sauberan JB, Dean LM, Fiedelak J et al (2010) Origins of and solutions for neonatal medication-dispensing errors. Am J Health Syst Pharm 67:49–57

    Article  PubMed  Google Scholar 

  31. Schlechtriemen T, Masson R, Burghofer K et al (2006) Pädiatrische Notfälle in der präklinischen Notfallmedizin. Schwerpunkte des Einsatzspektrums im bodengebundenen Rettungsdienst und in der Luftrettung. Anaesthesist 55:255–262

    Article  PubMed  CAS  Google Scholar 

  32. Shah A, Frush K, Luo X et al (2003) Effect of intervention standardization system on pediatric dosing and equipment size determination: a crossover trial involving simulated resuscitation events. Arch Pediatr Adolesc Med 157:229–236

    Article  PubMed  Google Scholar 

  33. Vilke G, Marino A, Fisher R et al (2001) Estimation of pediatric patient weight by EMT-Ps. J Emerg Med 21:125–128

    Article  PubMed  CAS  Google Scholar 

  34. Wong IC, Wong LY, Cranswick NE (2009) Minimising medication errors in children. Arch Dis Child 94:161–164

    Article  PubMed  CAS  Google Scholar 

  35. Yamamoto L, Kanemori J (2010) Comparing errors in ED computer-assisted vs conventional pediatric drug dosing and administration. Am J Emerg Med 28:588–592

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehung hin: C.G. Erker erhält ein Autorenhonorar in üblicher Höhe vom Verkauf der Buchversion GNOM – Gewichtsadaptierte Notfall-Medikamente beim Kindernotfall vom Verlag akaMedica Akademie & Verlag GmbH. Die übrigen Autoren geben an, dass keine Interessenkonflikte bestehen.

Author information

Authors and Affiliations

  1. Klinik für Anästhesie und operative Intensivmedizin, Bereich Kinderanästhesie, St. Franziskus-Hospital Münster, Hohenzollernring 72, 48145, Münster, Deutschland

    C.G. Erker, M. Santamaria & M. Möllmann

Authors
  1. C.G. Erker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Santamaria
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Möllmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C.G. Erker.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Erker, C., Santamaria, M. & Möllmann, M. Hilfsmittel für die Dosierung von Notfallmedikamenten im Kindesalter. Anaesthesist 61, 965–970 (2012). https://doi.org/10.1007/s00101-012-2096-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00101-012-2096-z

Schlüsselwörter

Keywords

Search

Navigation