Joseph D Losek1. 1. Children's Hospitals and Clinics-St. Paul, Emergency Department, 345 North Smith Avenue, St. Paul, MN 55102, USA. joseph.losek@childrenshc.org
Abstract
OBJECTIVE: To describe the demographic and clinical characteristics of children who receive acetaminophen per emergency department standing orders and identify factors associated with supratherapeutic doses (>or=16 mg/kg). METHODS: A cross-sectional retrospective study of consecutive children who received acetaminophen at an urban children's hospital emergency department. RESULTS: Over a 1-week period, 156 (24%) of 661 emergency department children were treated with acetaminophen. Of the children receiving acetaminophen, 64 (41%) were less than 2 years and 92 (59%) were males. The indication for acetaminophen was fever in 140 (90%) children, and 70 (50%) had temperatures >or=39degreesC. The route of administration was oral [133 (85%)] and rectal [23 (15%)]. There were 122 (78%) correct doses (standing order dose range of 10 to 15 mg/kg), 15 (10%) doses of <10 mg/kg, and 19 (12%, 95% CI, 8% to 18%) doses of >or=16 mg/kg. In comparison, children who received acetaminophen at normal or low doses (<16 mg/kg) versus supratherapeutic doses (>or=16 mg/kg) showed a significant difference in route. The rate of rectal route was significantly greater in the supratherapeutic doses (95% CI for changes in proportion, 14% to 48%). CONCLUSIONS: Review of acetaminophen dose accuracy, particularly the rectal route, is recommended for emergency departments with standing orders for acetaminophen.
OBJECTIVE: To describe the demographic and clinical characteristics of children who receive acetaminophen per emergency department standing orders and identify factors associated with supratherapeutic doses (>or=16 mg/kg). METHODS: A cross-sectional retrospective study of consecutive children who received acetaminophen at an urban children's hospital emergency department. RESULTS: Over a 1-week period, 156 (24%) of 661 emergency department children were treated with acetaminophen. Of the children receiving acetaminophen, 64 (41%) were less than 2 years and 92 (59%) were males. The indication for acetaminophen was fever in 140 (90%) children, and 70 (50%) had temperatures >or=39degreesC. The route of administration was oral [133 (85%)] and rectal [23 (15%)]. There were 122 (78%) correct doses (standing order dose range of 10 to 15 mg/kg), 15 (10%) doses of <10 mg/kg, and 19 (12%, 95% CI, 8% to 18%) doses of >or=16 mg/kg. In comparison, children who received acetaminophen at normal or low doses (<16 mg/kg) versus supratherapeutic doses (>or=16 mg/kg) showed a significant difference in route. The rate of rectal route was significantly greater in the supratherapeutic doses (95% CI for changes in proportion, 14% to 48%). CONCLUSIONS: Review of acetaminophen dose accuracy, particularly the rectal route, is recommended for emergency departments with standing orders for acetaminophen.
Authors: Megan E Foster; Donald E Lighter; Ashok V Godambe; Brandon Edgerson; Randy Bradley; Sandip Godambe Journal: J Pediatr Pharmacol Ther Date: 2013-01
Authors: Lisa Hartling; Samina Ali; Donna M Dryden; Pritam Chordiya; David W Johnson; Amy C Plint; Antonia Stang; Patrick J McGrath; Amy L Drendel Journal: Pain Res Manag Date: 2016-12-18 Impact factor: 3.037