ERDoc Posted May 18, 2009 Posted May 18, 2009 I wasn't sure what category to put this in so I'll put it here. Mods, feel free to put it somewhere else if you think it would be more appropriate. With the talk of evidence based medicine I figured we could start a journal club type discussion of an article published in the recent literature. I'd like to try to have a civilized discussion about the article. Let's discuss the strengths and weaknesses of the study, the relevance of the results and other appropriate issues. Let's start with the following article: http://pediatrics.aappublications.org/cgi/...full/118/4/1493
WelshMedic Posted May 18, 2009 Posted May 18, 2009 Doc, I'll kick off then, shall I? Firstly, an interesting article on a subject that is important but that does not get discussed as often as it should do. However, I did miss one vital aspect in the study. How did the dosage errors affect mortality and morbidity. It's OK to tell us that we got it wrong, but I'd like to know what the consequences were too. I suspect that the epinephrine dosage errors did not contribute significantly to mortality rates as pediatric arrest outcomes are generally appalling anyway. Still, it would have been nice to know how much difference it makes. One statement did stick out though, and I will certainly be mindfull of it the next time I give pediatric drugs: Although overall error rates in the treatment of adult and pediatric patients are similar, it is estimated that errors with potential to cause harm are 3 times more likely to occur among pediatric patients. WM
AnthonyM83 Posted May 18, 2009 Posted May 18, 2009 Damn, Doc. I almost did my paper study on this...until I realized I could educate more LA medics on non-traditional AMI's. I had all my research on the first topic done, too. I'll read it when I'm sober and get back to you.
Kiwiology Posted May 18, 2009 Posted May 18, 2009 Ah, perfect idea, I mean who has anything better to do but sit up at 1am reading the journals? What, don't look at me like that ... we all need hobbies
CBEMT Posted May 18, 2009 Posted May 18, 2009 I should be surprised that LA didn't use Broselow tapes until 03-04, and that despite using them they're still effing it up, but...... I'm not.
ERDoc Posted May 18, 2009 Author Posted May 18, 2009 CB, don't think it is confined to LA. One of my colleauges did a local study based on these studies. Even with the Braslow tapes he found a greater than 50% error rate. He is looking at a follow up study to see if he can determine the cause. Welsh, I agree that ir does not look at the affect on morbidity/mortality but I think in this population it will be difficult to tell. But, I think it should make us ask if ped pts are being incorrectly dosed with other drugs that may be causing harm.
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