Post by Tony Held on Sept 2, 2017 9:36:52 GMT -6
I know, I know. We all hate labeling our medications after mixing a concentration for drip or for push. We are also terrible at math under stress and frequently avoid protocols that require mixing, math'ing, and labeling.
There's a better way
EMS has the luxury of operating in protocolized medicine. In-hospital procedure can be largely the same as long as physicians agree on concentrations for ER and critical care. Check out the following label sheets made on Avery 8160 label sheets (1" x 2 5/8"):
Don't look at these as pre-printed drug labels. The real magic in these is the ability to cognitively offload the mixing procedure, the dosage checking, and the calculation for drop rate. The bonus is that your meds are labeled for you. Feel free to make them your own for whatever purpose, but I encourage you to keep these components. That's the real strength.
References
Podcast 103 – Avoiding Resuscitation Medication Errors – Part II
Scott Weingart.
EMCrit Blog. Published on July 21, 2013
EMCrit Podcast 205 – Push-Dose Pressors Update
Scott Weingart.
EMCrit Blog. Published on August 7, 2017
Reducing Errors with Injectable Medications: Unlabeled Syringes Are Surprisingly Common.
Grissinger, Matthew.
Pharmacy and Therapeutics 35.8 (2010): 428–451.
Prescription Drug Labeling Medication Errors: A Big Deal for Pharmacists.
Jeetu, G, and T Girish.
Journal of Young Pharmacists : JYP 2.1 (2010): 107–111.
There's a better way
EMS has the luxury of operating in protocolized medicine. In-hospital procedure can be largely the same as long as physicians agree on concentrations for ER and critical care. Check out the following label sheets made on Avery 8160 label sheets (1" x 2 5/8"):
- Mixed Medications for Gravity Infusion
- Ketamine (500mg/5mL) for Induction
- Ketamine (500mg/10mL) for Induction
- Morphine (10mg/1mL) - Diluted
- Epinephrine - Push-dose Pressor
- Phenylephrine - Push-dose Pressor
Don't look at these as pre-printed drug labels. The real magic in these is the ability to cognitively offload the mixing procedure, the dosage checking, and the calculation for drop rate. The bonus is that your meds are labeled for you. Feel free to make them your own for whatever purpose, but I encourage you to keep these components. That's the real strength.
References
Podcast 103 – Avoiding Resuscitation Medication Errors – Part II
Scott Weingart.
EMCrit Blog. Published on July 21, 2013
EMCrit Podcast 205 – Push-Dose Pressors Update
Scott Weingart.
EMCrit Blog. Published on August 7, 2017
Reducing Errors with Injectable Medications: Unlabeled Syringes Are Surprisingly Common.
Grissinger, Matthew.
Pharmacy and Therapeutics 35.8 (2010): 428–451.
Prescription Drug Labeling Medication Errors: A Big Deal for Pharmacists.
Jeetu, G, and T Girish.
Journal of Young Pharmacists : JYP 2.1 (2010): 107–111.