How an Ariz. fire department reduced medication errors

Training, including pediatric-specific training, reduced self-reported medication errors in a major fire-based EMS system

DALLAS — Medication error prevention training, with a specific focus on reducing pediatric drug dosage errors helped a major fire-based EMS system significantly reduce drug administration errors.

The results of an eight year project, started in 2008 and conducted at the Phoenix Fire Department, were presented by John Gallagher, MD at the 2016 Gathering of Eagles XVIII EMS State of the Science program. The project showed the effectiveness of reporting and training to reduce medication errors.

A medication error is defined as any preventable error involving medication that may cause injury or harm to the patient. At the start of the project, 10 percent of paramedics anonymously, self-reported a medication error.

Decline in paramedic self-reported medication errors after the start of a training program.
Decline in paramedic self-reported medication errors after the start of a training program. (Photo by Greg Friese)

By 2014, the rate of reported errors declined to 2 percent. General education about medication administration and error prevention cut the error rate in half. Many studies, cited by Gallagher, have shown higher rates of errors in pediatric patients and the need for training specific to pediatric medication error prevention. Additional pediatric specific training in 2011 halved the error rate.

Memorable quotes regarding prevention of EMS medication errors

"All of the 2015 errors involved wrong drug dosages. We have eliminated wrong drug errors."
 — John Gallagher, MD

"Why would you want to be in a hurry to give the patient the wrong medication? Slow down, talk to your partner."
 — John Gallagher, MD

Key takeaways to prevent EMS medication errors
Here are key takeaways for medical directors and EMS field providers from Gallagher's presentation.

  • Medication administration and error prevention training programs reduce error rates.
  • Pediatric specific medication error prevention, especially avoiding epinephrine dosage errors, is also needed.
  • Job aids, charts, apps or cards such as the PFD Peds Code Card for epinephrine administration dosing can help prevent drug errors.
  • Regular, online and face-to-face, training is important for all drugs and even more important for new drugs.
  • Allow, encourage and facilitate non-punitive error reporting in your EMS system.

Visit to view the presenter's slides.

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