Smartphone Apps for Pediatric Resuscitation

Study Overview
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Brief Summary
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Medication errors are common in children. Characteristics of errors during critical situations in the Emergency Department are ill-defined and might be more frequent than previously thought. However, optimal strategies to eliminate the risk of prescribing errors remain unknown. Many smartphone apps have been suggested over the last years with some of them designed to calculate medication dosage for children. The impact of these apps to decrease dosage error has never been evaluated in resuscitation setting. The aim of the study is to evaluate whether the use of a smartphone application designed to calculate medication doses decreases prescribing errors among residents during pediatric simulated resuscitations. This will be a crossover-randomized trial using high fidelity simulation among 40 residents rotating in the pediatric emergency department.

Official Title
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Smartphone Medical Applications to Reduce Treatment Dosage Errors in Pediatric Resuscitation; a Randomized Simulation Trial

Conditions
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Status Epilepticus, Anaphylaxis

Intervention / Treatment
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* Device: Smartphone apps
* Device: Handbook


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Residents (PGY1 to PGY4) Completing a rotation in pediatric emergency Exclusion Criteria: Residents who previously participated in this study
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Smartphone<br>Smartphone application | Device: Smartphone apps<br>* If already own a smartphone application dedicated to calculate medication dosage for children, the participant will be allowed to use his/her own application. Otherwise, the resident will be offered to chose among a list of applications paid by the research team (PediSafe, PediStat, Palm Pedi, Safedose, EZdrip peds). He/she will be instructed to practice with a few time at home before doing the simulations.<br>|
| Experimental: Handbook<br>Resuscitation handbook who provides drug dosages for each weight for children. For example, at the page of 15 kg, it is written that the dosage of epinephrin is 1.5 cc of 1: 10 000. | Device: Handbook<br>* Resuscitation handbook who provides drug dosages for each weight for children. For example, at the page of 15 kg, it is written that the dosage of epinephrin is 1.5 cc of 1: 10 000.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medication error | The primary outcome is the presence of a medication error. An error will be defined as a drug dose varying by more than 20% from the recommended dose or by incorrect route. | During resuscitation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of tenfold error | A tenfold error will be defined as a drug dose varying by a factor of 10 compared to the recommended dose. | During resuscitation | 
| Time for prescribing the first medication | Time from the beginning of the simulation and complete prescription (oral or written) of the first medication. | During the simulation (10 minutes) | 
| Error in bolus medication | An error in bolus medication will be defined as a drug dose varying by more than 20% from the recommended dose or by incorrect route. | during simulation | 
| Error in perfusion medication | An error in perfusion medication will be defined as a drug dose varying by more than 20% from the recommended dose. This can be related to a preparation error or a flow error. | during simulation | 
| User satisfaction | Satisfaction of the resident with both tools using a Visual analog scale | 2 weeks | 
| User confidence | Confidence of the resident while using both tools using a Visual analog scale | 2 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Children, resuscitation, smartphone