Each year, about 7,000 children die and 140,000 are injured due to dosing errors performed by medical personnel.
According to a study published in 2018 in the American Academy of Pediatrics magazine, children treated in an emergency setting are at a particularly high risk, due in part to a lack of standard pediatric drug dosing and formulations.
Medical personnel have to convert adult dosing guidelines to a child’s weight in extremely high-stress situations such treating a child for anaphylaxis, a life-threatening allergic reaction that can be fatal within minutes. Overall, pre-hospital epinephrine administration error rates can exceed 60%.
To help prevent such errors, 65 members of Franklin County Public Safety recently received training in a new medication delivery system called Certa Dose that offers a simpler way to determine pediatric dosages.
“What the Certa Dose product does is it has a color-coded syringe that matches up with what the EMS personnel already use, called the Broslow Tape,” explained Terry Grooters, who handles Certa Dose distribution for North Carolina based Sovereign Medical.
The Broslow Tape is used worldwide for pediatric emergencies as it relates a child’s height to his or her weight.
The provider can adjust for children who visually appear over or under the 50th percentile of height-weight ratios for their ages.
Rather than weigh the child at a point when every second counts and parents are often panicked, EMS personnel can match the color of the Broslow tape to the syringe to administer the correct dose of a medication such as epinephrine, used to reverse anaphylaxis.
“It saves time, it saves money and it saves lives,” Grooters continued.
On May 21, Franklin County High School’s Claude Moore Scholars (a dual enrollment EMT program with Virginia Western Community College) joined EMS staff from each county squad for training in the Certa Dose Epinephrine Convenience Kit under pharmacist Chris Lowry and Grooters.
Certa Dose is also significantly less expensive than epinephrine auto-injectors such as the EpiPen, which runs $300 to $600 compared to Certa Dose’s $90. Certa Dose can be used for epinephrine, lidocane and atropine. Additionally, Certa Dose can last up to 20 months where the recommended EpiPen shelf-life is 12 months.
Franklin County EMS and EMS students were the first in the region and one of the first in the state to receive Certa Dose training. All squads are slated to receive Certa Dose kits within two weeks.
Dr. Charles Lane, medical director for Franklin County Public Safety and regional director for 12 counties, began advocating for Certa Dose in February. It may eventually be used in the emergency room at Carilion Franklin Memorial Hospital.
The delivery system was developed by Dr. Caleb Hernandez who was working in an emergency room on a 6-year-old girl under cardiac arrest when he stopped a nurse from administering a fatal medication overdose. He realized that the current approach to administering medication to children didn’t make sense, as it required medical personnel to do complex math equations under incredible stress.
“Once everyone learns what it is, it will spread like wildfire because it takes all the stress and anxiety out of that situation,” Grooters explained. “You’ve got parents yelling at you and other people yelling. It’s super stressful.”