akroeze Posted July 18, 2008 Posted July 18, 2008 I've never understood what discipline and remedial training achieves in a situation like this. The person realized they made a mistake and reported it, followed all the process. How do you perform remedial education on checking that you have the right ampoule? It is a fact of nature that humans make mistakes sometimes.
Asysin2leads Posted July 19, 2008 Posted July 19, 2008 I'm a person of the "mistakes are preventable" school of thought. Of course, mistakes do happen, even to the most seasoned and skilled provider. Giving the wrong medication isn't like missing a line or missing a tube. There is a reason that someone drew up the wrong medication and gave the medication and while understandable, it still needs to be addressed. Obviously somewhere in the medication administration area, something broke down. Did the person who drew it up not hear the order correctly? Did they reach for the wrong vial? Did they misread the label? Why did the second person confirm the medication correctly? This is where remedial training comes in. I'm sure the provider knows how to identify, draw up, and administer a medication. However, when situations like this occur, reinforcing the procedure is sometimes what is needed to increase the diligence of the provider. If it is simply blown off, you don't learn from the experience, and if nothing else, the pain in the ass of going to remedial training maybe the positive punishment needed to modify the behavior, or at least that's what my friend BF Skinner told me.
Richard B the EMT Posted July 19, 2008 Posted July 19, 2008 How do you perform remedial education on checking that you have the right ampoule? I believe most of us have heard of the actor Dennis Quaid. He nearly lost his baby twins, when they accidently were given an adult dose of medicine, instead of one at strength for pediatrics, and dosage size. The 2 containers looked the same in both strengths, but the manufacturers are going to change label colors, at minimum.
fireflymedic Posted July 19, 2008 Author Posted July 19, 2008 Good input guys - like the fact you all had the answers you did. In my position, I'd tell or want to be told first. Thank God I haven't had to face this bullet. I've kept me and my patients safe so far and hope I continue to. Be vigilant, be safe !
streetsurgeon Posted July 28, 2008 Posted July 28, 2008 valium , morphine.. damn it they look just alike.. but own up to it... i am sure there is more than one person to make a med. error.
Richard B the EMT Posted July 28, 2008 Posted July 28, 2008 I'm going to put in an addendum to my last posting. The drug manufacturers will change the colors of their medical vials, but only as existing stockpiles of the lookalike vials get used up.
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