RESUMO
Context: Children undergoing MRI often require sedation to avoid motion artifacts and anxiety attacks. Dexmedetomidine is a highly selective α2 adrenoceptor agonist that has sedative and analgesic effects. Aim: This study was conducted to determine whether intranasal Dexmedetomidine 2 µg/kg offered effective sedation in children posted for diagnostic MRI studies. Methods: This prospective pilot study was conducted on 30 ASAI/II patients aged upto 12 years posted for Magnetic Resonance Imaging Studies. In this study all patients were administered with intranasal dexmedetomidine 2 µg/kg in the presence of parents, 30 minutes before scheduled MRI scan. The time of administration and reaction of children were noted. Children were observed in holding area with standard monitors applied. The degree of sedation was assessed at 15 and 30 minutes by using University of Michigan Sedation Scale (UMSS). Recovery time and recovery score were noted according to Modified Aldrete recovery score and quality of MRI is also observed. Statistical analysis:The data was entered in MS EXCELspreadsheet and analysis was represented as mean plus standard deviation. Results: Mean sedation scores after 15 minutes and after 30 minutes were 1.20±1.8 and 2.80±0.7 respectively. Mean discharge time according to modified Aldrete score was 82.42±32.68 minutes. There were no adverse events. No sneezing or coughing episodes were observed during drug administration. Conclusion: Dexmedetomidine is a useful agent for sedation of children undergoing MRI studies.
RESUMO
The importance of drug labels can not be overlooked. Many a times drug labels are missing which may lead to toxicological effects catastrophic accident and medico -legal implication. The objective of the present study was to learn and highlight the problems faced by the medical practitioner, pharmacist and the patients as regards to drug label it’s, medico- legal problems and suggest remedial measures. 55 medical practitioner of Government Medical College, Haldwani and 40 pharmacist of Haldwani town were surveyed through a questionnaire. The 90% of medical practitioners and 80% of pharmacist had faced problem with label related errors. None had been charged for malpraxis and negligence. Remedial measures suggested were barcoding (96%, 60%) colour coding, prefilled syringes (90%, 30%), increasing font sizes and more awareness about medico-legal liability, ethical issue and punishment. Drug label errors are an important cause of patient morbidity, mortality and medico-legal liabilities of medical practitioners. Improved and correct labeling understanding medico-legal importance and communication is the key element in minimising errors. Bar code generated labels, embossing, waterproof labels, improving quality of stickers, increasing font sizes, overcoming language barriers and sense of responsibility will readdress these deficiencies in services.