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What is the easier and more reliable dose calculation for iv Phenytoin in children at risk of developing convulsive status epilepticus, 18 mg/kg or 20 mg/kg?

Prasad, Manish; Shenton, Priya; Dietz, Sanne; Saroha, Vivek; Whitehouse, William P.

Authors

Manish Prasad

Priya Shenton

Sanne Dietz

Vivek Saroha

William P. Whitehouse



Abstract

Background: With the Convulsive Status Guidelines due for renewal, we wondered if a phenytoin dose of ‘20 mg/kg’
would be easier to calculate correctly and therefore safer than the current ‘18 mg/kg’. An educational exercise in dose
calculation was therefore undertaken to assess ease of calculation.
Method: A standard question paper was prepared, comprising five clinical scenarios with children of varying ages and
estimated body weights. Medical students, trainee doctors at registrar and senior house officer level, and consultant
paediatricians were asked to complete the exercise, in private, by one of two medical students (SD, PS). Calculations were done with and without a calculator, for 18 mg/kg and for 20 mg/kg in randomised order. Speed and errors (greater than 10%) were determined. The data analysis was performed using SPSS version 18.
Results: All answered all 20 scenarios, giving a total of 300 answers per doctor/student group, and 300 answers per
type of calculation. When comparing the 2 doses, the numbers of errors more than 10% were significantly less in
20 mg/kg dose (0.33%) as compared to the 18 mg/kg dose (9.3%) (p

Journal Article Type Article
Publication Date Apr 21, 2013
Journal BMC Pediatrics
Electronic ISSN 1471-2431
Publisher Humana Press
Peer Reviewed Peer Reviewed
Volume 13
Issue 60
Institution Citation Prasad, M., Shenton, P., Dietz, S., Saroha, V., & Whitehouse, W. P. (2013). What is the easier and more reliable dose calculation for iv Phenytoin in children at risk of developing convulsive status epilepticus, 18 mg/kg or 20 mg/kg?. BMC Pediatrics, 13(60), doi:10.1186/1471-2431-13-60
DOI https://doi.org/10.1186/1471-2431-13-60
Publisher URL http://www.biomedcentral.com/1471-2431/13/60
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0
Additional Information Copy of License must accompany any deposit

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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