We give medications all of the time and most of the time, things go really well. But in EMS, all the things that can go wrong sometimes do and you need to make sure that you follow the same checks and balances before administering medications every time to prevent one of the most common medical errors—-medication mistakes. A medication error has been defined as any error occurring in the medication use process. This includes selection, labeling, administration, monitoring or use. Since 2000, the FDA has received more than 95,000 reports of medication errors. That number is believed to be much higher as it relies on self-reporting.
The Medication Rights are a way to help ensure proper administration. The Six Rights are Person, Time, Medication, Dose, Route and Documentation. The Right Person is usually not an issue for EMS. Right Time may seem obvious since we typically give medications now but time includes redosing which can be very important and som
e medications need to be given shortly before a procedure or the effectiveness is lost.
Right Medication is very important. After you determine the proper medication to resolve the problem, you have to locate the proper med and they can come packaged differently from box to box. In addition, crews often work together and one person may draw up the medication while another administers. It is imperative that the medication is checked carefully before drawing it up, after drawing it up and before administration. Right Dose should be verified three times as well. Right Route must also be verified. Can the medication be given that way? Is there too much for that route or not enough? Ensure you know your landmarks and administra
tion techniques for injections. Right Documentation includes who gave the med, the proper time, dose and route.
What else can you do to prevent a medication error?
- Ask to see the vial if someone else drew up the medication
- Have someone verify your med math before administering
- Double check the protocols if you aren’t sure (or contact med control)
- Label syringes if using multiple medications
- Know the medications you are able to administer
- Take a calm moment (or make one) while calculating and drawing up medications
- Have someone verify the medication name with you
- Know brand and generic names of medications
- Never assume…..
If you find that a medication error did occur, self-report it to the receiving physician and staff immediately, Next, contact an EMS supervisor and document as it was actually administered. Notify the CQI Coordinator via email or telephone as soon as feasible.