Hazard Alert! Asphyxiation possible
with syringe tip caps. Do not provide hypodermic syringes
to parents for administering oral liquids to children.
From the August 22, 2001 issue MSA Acute Care Edition Newsletter
This month, a 5-month-old child asphyxiated when a cap from
a Becton-Dickinson 3 mL parenteral syringe ejected into his
throat during drug administration. Choking episodes are possible
if the small, translucent caps on hypodermic syringes are
inadvertently left on the syringe during use (see a diagram
on our web site). In fact, medications can actually be drawn
into some hypodermic syringes and administered without removing
the caps. The caps can dislodge easily during drug administration
and eject into a child's trachea. Over the past several years,
we've heard of several cases where children swallowed or choked
on hypodermic syringe caps that were overlooked by parents.
In the most recent case, a pediatrician provided the parents
with a hypodermic syringe to administer VANTIN (cefpodoxime)
suspension. With the cap intact, the father inserted the syringe
into the Vantin, pulled back the plunger, and the medication
flowed into the syringe. To him, the cap appeared to be part
of the syringe. When he placed the medication into the child's
mouth, the cap flew off and became dislodged in the child's
airway. The baby was taken to the hospital where a procedure
was performed to remove the cap, but the child died. Hypodermic
syringes should never be used for oral medication administration.
Practitioners should tell parents to use only measuring cups
or ORAL syringes when giving liquids. Most caps on oral syringes
are very difficult to dislodge with plunger pressure, yet
pull off easily for drug administration. Usually, the caps
are also colored and shaped for visibility, but it's still
a good idea to remind parents to remove them. Please see our
March 10, 1999 issue (available on
our web site) for additional information on this problem.
|A: Standard hypodermic syringe with
||B: Cap inadvertantly ejected into
|plastic cap ejected on right.
Source: Cohen MR. (ed). Medication administration problem
solving in ambulatory care. 1994 American Pharmaceutical Association.