Medical errors pose a greater threat to children than to adults for a number of reasons, according to a report in the New York Times. They are physically small, and their kidneys, liver and immune system are still developing. Even a tiny increase in the dose of medication can have serious effects — especially in babies born prematurely. And if children take a turn for the worse, they can deteriorate 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.
Adult medications are prepackaged and have standardized doses, but pediatric medications vary, based on the child’s weight and sometimes height, requiring doctors to make calculations. It is easy to misplace a decimal point, a tenfold error.
Typically, an adult formulation is diluted for children, and sometimes “the amount of medication being diluted is smaller than an air bubble in a syringe,” said Dr. Rainu Kaushal, director of quality and patient safety at the Komansky Center for Children’s Health at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
“The Joint Commission reported that about 32 percent of medication errors in children in the operating room involved the wrong dose, compared with 14 percent in adults.