More children, 1 out of 15 hospitalized kids, are harmed by accidental overdoses, medicine mix-ups and adverse reactions to drugs than originally believed. This finding is contained in the first scientific test of a new procedure to detect errors.

This estimate means about 540,000 children are affected each year by these errors.

The study was conducted by the National Initiative for Children’s Healthcare Quality. Researchers detected an incidence of 11 drug-related harmful events for every 100 children in hospitals using the new method. In the traditional detection procedure, the estimate was only 2 such events per 100 hospitalized children. The new estimate also accounts for situations where a child went through drug-treatment errors more than once.

The new procedure devised in the study follows a list of 15 indicators or “triggers” on the medical charts of child patients, which point to possible drug-related harm. This list includes administration of certain antidotes to counter drug overdoses, particular side effects and specific lab tests.

The traditional procedures cover only non-specific reviews of patient charts and voluntary reporting of errors by hospitals.

Some of the triggers are:

• Use of the drug naloxone, an antidote to counteract overdose of morphine and related painkillers. Over half of the problems found by the researchers involved these powerful drugs.

• Use of vitamin K, which counteracts an overdose of the blood thinner Coumadin.

• Use of a blood test that detects insulin overdoses.

• Use of a lab test that detects blood-clotting problems that can arise from an overdose of the blood thinner heparin and related drugs.

A random selection of 960 medical charts for child patients was reviewed by the research team. The children were treated at children’s hospitals across the U.S. in 2002.

The likelihood exists that the problem may be bigger than the 1:15 ratio suggested in the study, because the study did not cover general community hospitals where the majority of children needing hospitalization are admitted.

Safety Tips:

• Log each medication and every treatment (whether at home or in the hospital).

• Remember pediatric medication is based on body weight. Doctors calculated dosages based on kilograms; parents often think in terms of pounds (1 pound = 454 grams; 1 kg = 2.203 pounds).

• Don’t be afraid or embarrassed to ask the caregiver what medication is being given to your child and for what purpose.

• When going to the hospital, bring all medications in labeled bottles. This will give doctors and nurses an exact idea of the drugs and doses being given to your child.

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