Spoons are for Soup – Not for Medicines©

"Content below from: “Don’t leave parents to their own measuring devices,” Pharmacy Today, APhA, November 2016, Volume 22, Issue 11, Page 31)

Some 40% of parents make dosing errors when administering liquid medications to their children. The majority of these errors are overdoses. The mistakes contribute to more than 10,000 calls to poison control centers annually. Parents shouldn’t be left to their own devices—such as using the various-sized spoons in their silverware drawers—when it comes to dosing medications for their children. Two recent studies suggest that access to appropriate measuring devices and consistent prescription labeling would greatly reduce parental error.“This is a problem that we need to work on. Parents, grandparents, and other caregivers are often confused about measuring medications,” said Robert Kuhn, PharmD, professor of pharmacy practice and science at the University of Kentucky College of Pharmacy and a pediatrics pharmacy specialist at the Children’s Hospital of Kentucky, both in Lexington.

Don’t ‘take a teaspoon’

The problem can start with the label on the bottle. Inconsistencies on prescription labels instruct patients to dose in teaspoons, milliliters, or both. Instructions to measure doses in teaspoons only are more likely to lead to errors, says a five-arm randomized controlled experiment published in the September issue of Pediatrics. The study assessed parents’ ability to accurately measure medications based on instructions that listed the dose in “mL,” “mL and tsp,” “mL and teaspoon,” and “teaspoon.”

“‘Take a teaspoon’ should be a phrase we just don’t use anymore,” said Kuhn. “Even though doctors write it that way, we try to convert it to let parents know exactly how much that is. A teaspoon is 5 milliliters.” Kuhn urges other pharmacists to do the same. Dosing instructions in spoon units can only increase the likelihood that parents reach for household spoons when administering medication. The American Academy of Pediatrics formally spoke out against dosing with household teaspoons in 1975. Still, a 2000 study found that they continued to be the most common pediatric dosing instrument. According to the Journal of the American Pharmacists Association (JAPhA), the size of a household teaspoon can range from 1.5 mL to 10 mL. Depending on the person measuring, the same spoon can deliver a dose difference of 4 mL.

© National Council on Patient Information and Education, NCPIE, Nov. 2016.