Table 3

Trigger rules employed in paediatric adverse drug event (ADE) computerised surveillance

Rule codeRule nameRule type*Total trigger rule alertsTotal ADEsPositive predictive values (%) (95% CI)ADEs per 1000 patient days
(95% CI)
New paediatric-specific trigger rules (patients <18 years old)
P1Calcium ionised >1.5 mg/dlLab only44000
P2Chloride <80 mEq/lLab only19000
P3Magnesium >3.5 mEq/lLab only26000
P4Potassium >7 mEq/lLab only32000
P5Sodium <120 mEq/lLab only9000
P6Sodium >157 mEq/lLab only25000
P7Total bilirubin >20 mg/dlLab only10000
P8Triglycerides >500 mg/dlLab only37000
P9Insulin and BG <50 mg/dlDrug-lab2314
  • 60.8

  • (40.7 to 77.9)

  • 1.51

  • (0.72 to 2.23)

Total22514
  • 6.2

  • (3.0 to 11.9)

  • 1.51

  • (0.72 to 2.23)

Existing adult trigger rules
A1Dextrose 50% and BG <50 mg/dlDrug-lab74
  • 57.1

  • (25.0 to 84.3)

  • 0.43

  • (0.01 to 0.44)

A2Polystyrene useDrug only5000
  • * Example trigger description: lab only: fire if a paediatric patient has magnesium >3.5 mEq/l in the previous 24 h. Drug-lab: fire if a paediatric patient is on insulin and has a blood glucose (BG) <50 mg/dl in the previous 24 h.

  • All four events were discovered by the P9 rule as well.