High Alert Medications: Effects of Errors and How to…

High Alert Medications: Effects of Errors and How to Document as per NABH What Is a High Alert Medication? Drugs with a high risk of serious harm when used in error. Errors may not be more frequent, but consequences are severe. Each hospital must define and approve its own HAM list, and the list must be known to every prescriber, nurse and pharmacist. Know Your List: Common High Alert Drugs Concentrated electrolytes: KCl, 3% NaCl, MgSO₄, Ca gluconate Insulin (all forms, IV infusions) Anticoagulants: heparin, enoxaparin, warfarin Opioids and sedatives: morphine, fentanyl, midazolam Neuromuscular blockers: succinylcholine, rocuronium Vasoactives: noradrenaline, adrenaline, dopamine What Can Go Wrong? Potassium chloride (concentrated): rapid IV bolus leads to hyperkalaemia, arrhythmia and cardiac arrest. Insulin: overdose or wrong units lead to severe hypoglycaemia, seizures and coma. Heparin / LMWH: wrong dose leads to bleeding and haematoma, and HIT with prolonged use. Magnesium sulphate: toxicit