October 6, 2026

This month’s continuing education lecture reviews the drug box medications for all ALS-level departments.

We'll start by covering the “Six Rights of Medication Administration," a topic covered in the Pharmacy Phriday series in December 2025: Right Patient, Right Medication, Right Dose, Right Route, Right Time, Right Documentation.1 Medication errors are the leading cause of preventable patient harm according to the World Health Organization. One out of 30 patients is harmed by medication errors, with 25% deemed severe or life-threatening.2 Errors may result from the wrong medication, the wrong patient, the wrong dose, a misreview of allergies, an inappropriate route, extravasation, or unintended side effects, among many other causes. In the U.S., medication errors are the third most common cause of death.3 Interestingly, the highest rate of preventable medication error is seen in the elderly population given multiple comorbidities, polypharmacy, and increased likelihood for adverse reactions to medications.3 Many emergency department organizations across the country have attempted to address this at the physician level.  

What tool do we have in today’s technology that can help us reduce the risk of medication error? OneDose®! OneDose provides easy access to UH protocols with links to medications, dosing, and administration. If you input the patient’s age and weight (specifically for pediatrics), the output becomes even more specific. For example, inputting a 7-year-old patient will not allow review of aspirin dosing, as it is not indicated for children. It also helps decrease errors with med math and dosing calculations, especially after waking up at 2 AM for a critical patient. Scanning and verification of the medications also decreases the risk of accidentally drawing and giving a different medication than you were intending; OneDose can help with these potential errors. You will be alerted if you scan the incorrect medication, given appropriate mixing and administration instructions, as well as notified of warnings, contraindications, and the need for online medical control, all on the same screen. Nursing must scan all medications before administration across the hospital to increase safety and accuracy. The exception is time-critical medications, such as anaphylactic epinephrine, ACLS meds, etc.  

Documentation is just as important. Good documentation shows the medication being administered, which the ePCR will often do automatically with the patient, dose, route, and time. Great documentation includes the rationale for why (or why not) a medication was used per protocol. This is equally important when protocol recommends a medication, but circumstances recommended against, such as “nitroglycerin was considered for this patient; however, given borderline blood pressures, medication was withheld.” This will also provide protection in the event of adverse outcomes. In the event of an error or adverse response, be honest, document well, and learn from the incident.  

You deal with enough stress, critical decision-making, and quick thinking on a daily basis. Use OneDose to take some of the burden off to help decrease the risk of harm to the patient and yourself. As always, reach out to online medical control, your medical director, and each other for help, questions, and guidance.  

Stay safe out there,

Erin Fenoff, DO, MPH

Sources:

1. ”The Six Rights of Medication.” December 5, 2025. Accessed October 5, 2026. https://www.prehospitalparadigm.org/pharmacy/the-six-rights. 

2. Patient safety. World Health Organization. September 11, 2023. Accessed October 5, 2026. https://www.who.int/news-room/fact-sheets/detail/patient-safety. 

3. Hodkinson A, Tyler N, Ashcroft DM, et al. Preventable medication harm across health care settings: A systematic review and meta-analysis. BMC Medicine. 2020;18(1). doi:10.1186/s12916-020-01774-9