LAUSR

Purpose: To evaluate the frequency of concurrent drug administration and drug‐drug incompatibility of concurrently administered drugs in critically ill children based on available references. Materials and methods: We retrospectively evaluated concurrent intravenous drug administration in children admitted to a single centre. Eligible patients included those admitted to the critical care unit for at least 6‐hours in the ten‐year period ending 30 July 2015 and received two or more IV drug administrations. Compatibilities were classified using local reference documents. Results: The 16,863 eligible patients were admitted to ICU for 2,212,326 h and received 3,664,667 concurrent administrations. Concurrent infusions ran for 6,263,600 h. There were 2,284,066 (62%) concurrent administrations; 334,144 (9%) were compatible, 293,856 (8%) were incompatible, 293,856 (8%) required pharmacist consultation, and 752,601 (21%) had ‘unknown’ compatibility. Individual patients received a median (IQR) of 33 (10 − 132) concurrent administrations, comprised of 7 (1 − 30) concurrent injections 1 (0–5) concurrent infusions and 13 (0–74) concurrently administered injections and infusions. Conclusions: Concurrent IV‐drug administration is frequent in critically ill children. Known incompatible concurrent administration occurs, however the compatibilities of many drug‐drug pairs were unknown ‐ adding complexity to routine bedside management and identifying information gaps for future research. HIGHLIGHTSIntravenous‐drug administration and concurrent administration are frequent in critically ill children.Important knowledge gaps that affect more than a third of concurrent drug administration in critically ill children exist.Drug administration is complex, and has significant clinical implications on line, lumen and patient complications.