There are so many different ways to give liquid medicine to young children, and we know that many of these methods can result in unintentional inaccuracies due to how a medication might be measured for a device or how a child accepts that device as the vehicle for delivery. In addition, there are problems with instructions for administration given on the bottle labels and the lack of direction for using a dosing tool that may be unfamiliar to a parent due to the measuring units required for its use. Add in the issues of health literacy and English proficiency, and you can understand why errors occur.
This is why Yin et al. (10.1542/peds.2016-0357) decided to conduct a randomized controlled study involving over 2000 English and Spanish-speaking parents from three urban clinics who were randomized into 5 different study arms involving dosing liquid medications with various labels and dosing tools. Parents were asked to measure 9 doses in various amounts using either a cup or a 0.2 or 0.5 ml dosing syringe in random order and dosing errors were then recorded.
Without spoiling what you can learn by reading this study yourself, perhaps an incentive to do so is the fact that 84% of parents made a least two dosing errors and more than 20% of parents made at least two substantive errors while measuring out medications in this study. So what do you think caused the most problems--the cup or the syringes? Do you think it helps or hurts to put the number of milliliters needed per teaspoon on the label or just list milliliters?
The good news is that as a result of reading this study, a strategy emerges that should result in fewer dosing errors for your patients—but you have to swallow the information contained in this article to find the “big reveal”—and decide if a spoonful or a syringe full of liquid (not sugar as Mary Poppins would recommend) will be best for making the medicine go down.
