On behalf of the inpatient pharmacy department at Hershey Medical Center, I am reaching out about guidelines institutions may have in place for pediatric dosing. Specifically, I would like to know if you have weight and/or age cutoffs for sterile IV preparations for pediatric doses.

Currently, our institution does not differentiate between a 16-year-old pediatric patient versus a 5-year-old pediatric patient or a 22 kg versus 94 kg pediatric patient when it comes to preparation of sterile IV medications. For example, if a 16-year-old is ordered Ketorolac 15mg IV q6h prn moderate pain, the product is drawn up by the IV room into a syringe to be readily available for administration by nursing. This is irrespective of the dose being a vial of Ketorolac 15mg that is available in Pyxis and would be able to be drawn up into a syringe on the floor same as what occurs for adult patients. Due to the sheer volume of sterile IV preparations needing to be made, our IV room staff are consistently behind and overworked which leads to errors.

Therefore, do your institutions have sterile IV preparation guidelines approved through the P&T committee that enable pediatric patients to be considered adults based on weight and/or age? If so, would you be willing to share the information in the hopes that we would be able to change our practices here at Hershey Medical Center?