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Int. J. Pediatr. Otorhinolaryngol. · Oct 2014
Review Case ReportsIatrogenic phenol injury: a case report and review of medication safety and labeling practices with flexible laryngoscopy.
- Valerie Cote and Jeremy D Prager.
- University of Colorado School of Medicine, Department of Otolaryngology, United States; Children's Hospital Colorado, Division of Pediatric Otolaryngology, Aurora, CO, United States.
- Int. J. Pediatr. Otorhinolaryngol. 2014 Oct 1;78(10):1769-73.
AbstractMedication errors can be reduced by following standards in patient identification and medication labeling. We present an investigation of a life-threatening event from medication error: A newborn that received intranasal phenol instead of topical anesthetic prior to flexible laryngoscopy. The patient required urgent intubation for respiratory distress and suffered chemical burns of the face, neck, and upper aerodigestive tract. The hospital course was prolonged and included intensive care, delayed oral feeding with enteral support, and the need for several endoscopies. Current standards of medication labeling are reviewed as well as evidence for and against using topical agents for flexible laryngoscopy.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
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