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Measuring Devices for Children’s Medications Inaccurate; May Cause Overdoses

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When it comes to giving over-the-counter medicines to young children, parents should take the time to read warnings and measure very carefully, says a report from the Health Sciences Center at West Virginia University.

Researchers investigated the accuracy levels of the measuring cups that come in children’s medications packages for treating colds or fevers, and the cups did not fare well. Five out of seven analyzed were inaccurate, with measurements skewed by a half to a full milliliter. What would seem like not much of an overdose at first, say researchers, could end up being an amount significantly beyond recommended levels over a period of a few days.

The research was presented at Scientific Assembly, an annual American College of Emergency Physicians gathering. Findings from the West Virginia University Study and another study from Wilford Hall Medical Center at Lackland Air Force Base pointed to two problems – dosage error on the part of the parents, and parental lack of knowledge that over-the-counter medicines to treat a cold are not recommended for children younger than two years old, in accordance with an advisory issued in 2007 by the FDA.

Dosage error is a potentially serious problem. Many caregivers miscalculate the medicine labels or measure incorrectly. In combination with dosage error, parents may be using an inaccurate measuring cup, which increases the risk for overdose.

The Lackland Air Force Base study said that an alarming rate of parents – as many as two-thirds – may not have knowledge of recent FDA recommendations and guidelines for children’s over-the-counter medications to treat cough and colds. Among parents who were aware of the guidelines, only one-third knew that giving cough or cold medications to children younger than the age of two has been linked to fatalities.

Other studies have investigated dosage accuracy among parents who use the traditional kitchen spoon for dispensing children’s medications, stating that these spoons can also be very off in their measurements. In fact, one study reports that teaspoons can vary in measurements anywhere from 2.5 ml on up to 7.3 ml, depending on the type used.

By the same token, researchers of a teaspoon study also analyzing children’s medicine doses, published in the International Journal of clinical Practice, said some larger teaspoons could deliver a medicine dose that is 192 percent higher than a parent using a teaspoon of a smaller size. Parents also run the risk of under-dosing children if teaspoons that are too small are used.

To help prevent inaccurate dosing, parents are recommended to use the syringe included in the medicine package instead of a kitchen spoon, or request a syringe from the pharmacy. Carefully reading product labels can also help, as well as knowing the child’s exact weight.

Parents can go even further by testing the accuracy of the cup that comes with the medication by filling the cup to a marked level, then removing the medication by syringe to see how the numbers compare.

These extra measurement steps are encouraged because young children are more susceptible to side effects from overdoses than are adults. Experts and researchers hope more resources will be placed toward educating parents about safe levels of medications in order to prevent what could become an emergency health situation.

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