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Episode Overview: In this episode of Pre-Hospital Paradigm Podcast, the team dives deep into medication safety in the EMS system. They explore the challenges of managing medications in the field, how to prevent errors, and the best practices for ensuring patient safety. Special guest Derek Frost, a system EMS pharmacist, joins to share insights on how medication errors occur and what processes are in place to mitigate them.

Key Topics Covered:

• Introduction to Medication Errors: The team starts by discussing medication errors, focusing on the fear EMS providers often experience when they realize a mistake has been made. They emphasize the importance of recognizing errors, reporting them immediately, and addressing the situation to ensure patient safety.

• Pharmacy Perspective on Errors: Derek Frost explains the pharmacist’s role in error prevention and the importance of reducing the stigma associated with reporting mistakes. He highlights that while many medication errors don’t result in patient harm, addressing them promptly is critical to refining systems and preventing future mistakes.

• Reporting and Documentation: The crew discusses the importance of clear communication when errors occur, including documenting the incident and notifying the appropriate medical personnel. Ray Pace and Dr. John Hill highlight how reporting can ultimately protect EMS providers by promoting transparency.

• EMS Drug Box Setup: A large portion of the discussion focuses on how EMS drug boxes are organized to prevent errors. Derek and Ray explain how medications are arranged to reduce the risk of grabbing the wrong drug and how color coding, labeling, and safe storage practices help avoid confusion.

• Look-Alike, Sound-Alike Medications: The dangers of look-alike and sound-alike medications are explored, particularly in high-stress environments. Derek shares a real-world example involving Zofran and oxytocin, two medications with similar packaging that were involved in an error.

• Best Practices for Cross-Checking Medications: Cross-checking with a partner before administration is encouraged. The crew discusses protocols that allow for double-checking dosages, medication types, and patient allergies, emphasizing the importance of teamwork in reducing errors.

• Pediatric and Obstetric Considerations: Special considerations for dosing pediatric and pregnant patients are reviewed, including the use of tools like CertiDose to simplify pediatric medication administration. They also touch on how certain medications may affect pregnant patients and how EMS teams should approach these situations.

• Technology and Medication Safety: The team discusses advancements in technology, such as Kit-Check, that help ensure the correct medications are stored in drug boxes and reduce the risk of expiration or recall issues. Derek also touches on how smart pumps in hospital settings prevent errors through automated alerts.

• Security and Compliance: Scott leads a conversation on the importance of medication security in the field. They discuss best practices for locking up medications, ensuring they aren’t accessible to unauthorized personnel, and reporting lost or stolen medications.

Takeaways:

1. Medication Errors Happen: It’s essential to recognize them, report them, and learn from them to improve systems.

2. Clear Communication and Documentation: Always document errors and communicate with medical control to prevent harm and improve patient care.

3. Use Technology and Tools: Tools like CertiDose and Kit-Check are vital in reducing errors and ensuring proper medication management.

4. Cross-Check Medications: Always verify medications and dosages with a partner to reduce the risk of errors.

5. Security Matters: Keep all medications secure in the field to prevent unauthorized access or theft.

Resources Mentioned:

• CertiDose: A tool for simplifying pediatric medication dosing.

• ISMP (Institute for Safe Medication Practices): A leading organization focused on medication safety.

• Ohio State Board of Pharmacy: For reporting lost medications or compliance issues.

• Kit-Check: A tool used to track medication in EMS drug boxes and ensure they are up to date and accurate.

Connect with Us:

• Visit PreHospitalParadigm.com for more information on this episode, resources, and free online CE opportunities.

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CE Credit: Earn free Ohio CE credits for listening to this episode. Visit our website to sign up.

From The Episode