scholarly journals Non-health Care Facility Medication Errors Associated with Hormones and Hormone Antagonists in the United States

2017 ◽  
Vol 13 (4) ◽  
pp. 293-302
Author(s):  
Pranav Magal ◽  
Henry A. Spiller ◽  
Marcel J. Casavant ◽  
Thitphalak Chounthirath ◽  
Nichole L. Hodges ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Medication Errors ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Hormone Antagonists

Non–Health Care Facility Cardiovascular Medication Errors in the United States

2017 ◽  
Vol 51 (10) ◽  
pp. 825-833 ◽  
Author(s):  
Amrit K. Kamboj ◽  
Henry A. Spiller ◽  
Marcel J. Casavant ◽  
Nichole L. Hodges ◽  
Thiphalak Chounthirath ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Health Care ◽  
Medication Errors ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Cardiovascular Drugs ◽  
Poison Control ◽  
Cardiovascular Medication

Background: Prior studies have not examined national trends and characteristics of unintentional non–health care facility (HCF) medication errors associated with cardiovascular drugs. Objective: To investigate non-HCF medication errors associated with cardiovascular drugs reported to poison control centers in the United States. Methods: A retrospective analysis of non-HCF medication errors associated with cardiovascular drugs from 2000 to 2012 was conducted using the National Poison Data System database. Results: There were 278 444 medication errors associated with cardiovascular drugs reported to US poison control centers during the study period, averaging 21 419 exposures annually. The overall rate of cardiovascular medication errors per 100 000 population increased 104.6% from 2000 to 2012 ( P < 0.001) and the highest rates were among older adults. Most cases (83.6%) did not require treatment at a HCF. Serious medical outcomes were reported in 4.0% of exposures. The cardiovascular drugs most commonly implicated in medication errors were β-blockers (28.2%), calcium antagonists (17.7%), and angiotensin-converting enzyme inhibitors (15.9%). Most of the 114 deaths were associated with cardiac glycosides (47.4%) or calcium antagonists (29.8%). Most medication errors involved taking or being given a medication twice (52.6%). Conclusions: This study describes characteristics and trends of non-HCF cardiovascular medication errors over a 13-year period in the United States. The number and rate of cardiovascular medication errors increased steadily from 2000 to 2012, with the highest error rates among older adults. Further research is needed to identify prevention strategies for these errors, with a particular focus on the older adult population.

Non-health care facility anticonvulsant medication errors in the United States

2017 ◽  
Vol 37 (6) ◽  
pp. 561-570
Author(s):  
Emily A DeDonato ◽  
Henry A Spiller ◽  
Marcel J Casavant ◽  
Thitphalak Chounthirath ◽  
Nichole L Hodges ◽  
...  
Keyword(s):  
Health Care ◽  
Medication Errors ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Anticonvulsant Drugs ◽  
Poison Control ◽  
Medical Outcomes ◽  
Poison Control Centers ◽  
Anticonvulsant Medication

Introduction: This study provides an epidemiological description of non-health care facility medication errors involving anticonvulsant drugs. Methods: A retrospective analysis of National Poison Data System data was conducted on non-health care facility medication errors involving anticonvulsant drugs reported to US Poison Control Centers from 2000 through 2012. Results: During the study period, 108,446 non-health care facility medication errors involving anticonvulsant pharmaceuticals were reported to US Poison Control Centers, averaging 8342 exposures annually. The annual frequency and rate of errors increased significantly over the study period, by 96.6 and 76.7%, respectively. The rate of exposures resulting in health care facility use increased by 83.3% and the rate of exposures resulting in serious medical outcomes increased by 62.3%. In 2012, newer anticonvulsants, including felbamate, gabapentin, lamotrigine, levetiracetam, other anticonvulsants (excluding barbiturates), other types of gamma aminobutyric acid, oxcarbazepine, topiramate, and zonisamide, accounted for 67.1% of all exposures. Conclusions: The rate of non-health care facility anticonvulsant medication errors reported to Poison Control Centers increased during 2000–2012, resulting in more frequent health care facility use and serious medical outcomes. Newer anticonvulsants, although often considered safer and more easily tolerated, were responsible for much of this trend and should still be administered with caution.

Non-health care facility medication errors resulting in serious medical outcomes

2017 ◽  
Vol 56 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Nichole L. Hodges ◽  
Henry A. Spiller ◽  
Marcel J. Casavant ◽  
Thiphalak Chounthirath ◽  
Gary A. Smith
Keyword(s):  
Health Care ◽  
Medication Errors ◽  
Care Facility ◽  
Health Care Facility ◽  
Medical Outcomes

An 11-year retrospective review of venlafaxine ingestion in children from the California Poison Control System

2015 ◽  
Vol 35 (7) ◽  
pp. 767-774 ◽  
Author(s):  
S Doroudgar ◽  
PJ Perry ◽  
GD Lackey ◽  
NG Veselova ◽  
HM Chuang ◽  
...  
Keyword(s):  
Health Care ◽  
Control System ◽  
Care Facility ◽  
Health Care Facility ◽  
Altered Mental Status ◽  
The United States ◽  
Poison Control ◽  
Minor Effect ◽  
Clinical Effects ◽  
Phone Calls

Venlafaxine is commonly used in the United States for approved and non-Food and Drug Administration–approved indications in adults. It is used off-label to treat children for psychiatric diagnoses. The aim of the study was to describe venlafaxine toxicities in children and to identify the venlafaxine dose per weight that correlates with toxicities. An 11-year retrospective study of venlafaxine ingestion in children was performed using the California Poison Control System (CPCS) database. Data was extracted from phone calls received by CPCS clinicians and follow-up phone calls made to assess the patient’s progress in a health-care setting. Inclusion criteria were venlafaxine ingestion cases reported to CPCS between January 2001 and December 2011, children aged 20 years and under, venlafaxine as the only ingested substance, managed in a health-care facility, and followed to a known outcome. Two hundred sixty-two cases met the study criteria. Common presentations included gastrointestinal (14.9%), altered mental status (13.7%), and tachycardia (13.4%). The majority of the cases resulted in no effect (51.5%) or minor effect (19.9%). The average estimated dose per weight was 18.3 mg/kg in all patients and 64.5 mg/kg in those experiencing moderate-to-severe adverse effects. Seizures occurred in only 4 of the 262 cases at doses ranging from 1500 to 7500 mg. Although the estimated dose per weight exceeded 10 mg/kg for the majority of the cases, only 12 cases resulted in moderate or severe outcomes. The majority of venlafaxine ingestion cases in children resulted in either no clinical effects or minor clinical effects.

Redotex ingestions reported to Texas poison centers

2010 ◽  
Vol 29 (9) ◽  
pp. 789-791
Author(s):  
Mathias B Forrester
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Minor Effect ◽  
Poison Center ◽  
Clinical Effects ◽  
Clinical Factors ◽  
Poison Centers ◽  
Moderate Effect

Although the multi-component weight loss supplement Redotex is banned in the United States, the supplement can be obtained in Mexico. The intent of this report was to describe the pattern of Redotex calls received by a statewide poison center system. Cases were all Redotex calls received by Texas poison centers during 2000—2008. The distribution of total calls and those involving ingestion of the supplement were determined for selected demographic and clinical factors. Of 34 total Redotex calls received, 55.9% came from the 14 Texas counties that border Mexico. Of the 22 reported Redotex ingestions, 77.3% of the patients were female and 45.5% 20 years or more. Of the 17 ingestions involving no coingestants, 52.9% were already at or en route to a health care facility, 41.2% were managed on site, and 5.9% was referred to a health care facility. The final medical outcome was no effect in 23.5% cases, minor effect in 5.9%, moderate effect in 11.8%, not followed but minimal clinical effects possible in 47.1%, and unable to follow but judged to be potentially toxic in 11.8%. Most Redotex calls to the Texas poison center system originated from counties bordering Mexico.

Prescription Opioid Exposures Among Children and Adolescents in the United States: 2000–2015

2018 ◽  
pp. 5-15
Author(s):  
Jakob D. Allen ◽  
Marcel J. Casavant ◽  
Henry A. Spiller ◽  
Thiphalak Chounthirath ◽  
Nichole L. Hodges ◽  
...  
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Annual Number ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
Medical Outcomes ◽  
National Poison Data System

OBJECTIVES This study analyzes and compares exposures to prescription opioids among children and adolescents younger than 20 years old in the United States. METHODS Data from the National Poison Data System for 2000 through 2015 were analyzed. RESULTS Poison control centers received reports of 188 468 prescription opioid exposures among children aged &lt;20 years old from 2000 through 2015. The annual number and rate of exposures increased early in the study period, but declined after 2009, except for buprenorphine exposures, which increased during the last 3 study years. Hydrocodone accounted for the largest proportion of exposures (28.7%), and 47.1% of children exposed to buprenorphine were admitted to a health care facility (HCF). The odds of being admitted to an HCF were higher for teenagers than for children aged 0 to 5 years (odds ratio [OR]: 2.86; 95% confidence interval [CI]: 2.78–2.94) or children aged 6 to 12 years (OR: 6.62; 95% CI: 6.06–7.02). Teenagers also had greater odds of serious medical outcomes than did children aged 0 to 5 years (OR: 3.03; 95% CI: 2.92–3.15) or children aged 6 to 12 years (OR: 4.59; 95% CI: 4.21–5.00). The rate of prescription opioid–related suspected suicides among teenagers increased by 52.7% during the study period. CONCLUSIONS Prescription opioid–related HCF admissions and serious medical outcomes were higher among teenagers. Contrary to trends for other prescription opioids, exposures to buprenorphine have increased in recent years; children aged 0 to 5 years accounted for almost 90% of buprenorphine exposures. These findings indicate that additional prevention efforts are needed.

Pediatric Exposure to E-Cigarettes, Nicotine, and Tobacco Products in the United States

2017 ◽  
pp. 50-59
Author(s):  
Alisha Kamboj ◽  
Henry A. Spiller ◽  
Marcel J. Casavant ◽  
Thiphalak Chounthirath ◽  
Gary A. Smith
Keyword(s):  
United States ◽  
Young Children ◽  
Electronic Cigarettes ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Data System ◽  
Tobacco Products ◽  
National Poison ◽  
National Poison Data System

OBJECTIVES To investigate the epidemiologic characteristics and outcomes of exposures to electronic cigarettes (e-cigarettes), nicotine, and tobacco products among young children in the United States. METHODS A retrospective analysis of exposures associated with nicotine and tobacco products among children younger than 6 years old was conducted by using National Poison Data System data. RESULTS From January 2012 through April 2015, the National Poison Data System received 29 141 calls for nicotine and tobacco product exposures among children younger than 6 years, averaging 729 child exposures per month. Cigarettes accounted for 60.1% of exposures, followed by other tobacco products (16.4%) and e-cigarettes (14.2%). The monthly number of exposures associated with e-cigarettes increased by 1492.9% during the study period. Children &lt;2 years old accounted for 44.1% of e-cigarette exposures, 91.6% of cigarette exposures, and 75.4% of other tobacco exposures. Children exposed to e-cigarettes had 5.2 times higher odds of a health care facility admission and 2.6 times higher odds of having a severe outcome than children exposed to cigarettes. One death occurred in association with a nicotine liquid exposure. CONCLUSIONS The frequency of exposures to e-cigarettes and nicotine liquid among young children is increasing rapidly and severe outcomes are being reported. Swift government action is needed to regulate these products to help prevent child poisoning. Prevention strategies include public education; appropriate product storage and use away from children; warning labels; and modifications of e-cigarette devices, e-liquid, and e-liquid containers and packaging to make them less appealing and less accessible to children.

scholarly journals The Emergency Medical Service Microbiome

2017 ◽  
Vol 84 (5) ◽  
Author(s):  
Andrew J. Hudson ◽  
Graeme D. Glaister ◽  
Hans-Joachim Wieden
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Pathogen Transmission ◽  
Health Care Facilities ◽  
Content Type ◽  
Sequencing Technologies ◽  
Emergency Medical ◽  
Care Facilities

ABSTRACTEmergency medical services (EMS) personnel are an integral component of the health care framework and function to transport patients from various locations to and between care facilities. In addition to physical injury, EMS personnel are expected to be at high risk to acquire and transmit health care-associated infections (HAIs) in the workplace. However, currently, little is known about EMS biosafety risk factors and the epidemiological contribution of EMS to pathogen transmission within and outside the health care sector. Health care facility microbiomes contain diverse bacterial, fungal, and viral pathogens that cause over 1.7 million HAIs each year in the United States alone. While hospital microbiomes have been relatively well studied, there is scant information about EMS infrastructure and equipment microbiomes or the role(s) they play in HAI transmission between health care facilities. We review recent literature investigating the microbiome of ambulances and other EMS service facilities which consistently identify antibiotic-resistant pathogens causing HAIs, including methicillin-resistantStaphylococcus aureus(MRSA), vancomycin-resistantEnterococcus, andKlebsiella pneumoniae. Our review provides evidence that EMS microbiomes are dynamic and important pathogen reservoirs, and it underscores the need for more widespread and in-depth microbiome studies to elucidate patterns of pathogen transmission. We discuss emerging DNA sequencing technologies and other methods that can be applied to characterize and mitigate EMS biosafety risks in the future. Understanding the complex interplay between EMS and hospital microbiomes will provide key insights into pathogen transmission mechanisms and identify strategies to minimize HAIs and community infection.

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