Labelling syringe plungers to reduce medication errors

Preventing medication errors in anesthesia and critical care (abbreviated version)

Drug medication errors remain a major safety issue in anaesthesia and intensive care, and prevention measures need to be strengthened. This is why the French Society of Anaesthesia and Intensive Care and the French Society of Clinical Pharmacy have profoundly reviewed their previous recommendations published in 2007. The 2017 recommendations are based on the literature but also on feedback from field professionals targeting patient safety. They share many similarities with recommendations issued from other countries (European countries, North America and Australia in particular) on this subject. Specific measures to prevent preparation, reconstitution and administration errors are detailed. Medical products using small bore connectors specified in the ISO 80369 series allow the prevention of administrtion errors. Specific labeling should be used according to an international color-coding of syringes, routes of administration, preparation bags, PCAs and PCEAs, trolleys or drug storage devices. A risk mapping must be established a priori and medication errors reporting is imperative in order to analyze them a posteriori in departmental meetings (REMED). Self-assessment, or external assessment, must be conducted. All of the proposed recommendations reinforce the culture of safety, which is essential to the practice of anaesthesia and intensive care.