Design, evaluation, and dissemination of a plastic syringe clip to improve dosing accuracy of liquid medications

Garrett J. Spiegel, Cindy Dinh, Amanda Gutierrez, Julia Lukomnik, Benjamin Lu, Kamal Shah, Tara Slough, Ping Teresa Yeh, Yvette Mirabal, Lauren Vestewig Gray, Stephanie Marton, Michelle Adler, Gordon E. Schutze, Hadley Wickham, Maria Oden, Rebecca Richards-Kortum

    Research output: Contribution to journalArticlepeer-review


    Pediatricians in Africa requested a tool to improve caregiver dosing of liquid antiretroviral medication. We developed, evaluated and disseminated a clip to control the amount of medication drawn into an oral syringe. In a laboratory, a user tested clips of different lengths, corresponding to different volumes, by drawing water into a syringe with a clip. In Texas and Malawi, 149 adults attempted to measure Pepto-Bismol™ using a syringe with a clip, a syringe without a clip, and a dosing cup, in a randomly assigned order. In the laboratory, the volume of liquid, ranging from 1 to 4.5 mL, drawn into the syringe was always within at least 5 μL of the intended dose. In Texas, 84% of doses were accurate within ±10%, vs. 63% using the syringe alone, and 21% with the dosing cup. In Malawi, 98% of doses were accurate to within ±10%, vs. 90% using the syringe alone, and 27% with the dosing cup. For target accuracy values within ±45% (±21%), a significantly higher fraction of Houston (Kamangira) participants delivered an accurate dose using the syringe with the clip than with the syringe alone (p < 0.05). The clip enables a greater proportion of users to accurately measure liquid medication.

    Original languageEnglish (US)
    Pages (from-to)1860-1868
    Number of pages9
    JournalAnnals of Biomedical Engineering
    Issue number9
    StatePublished - Sep 2013


    • Dosing error
    • Global health
    • Low-resource settings
    • Measuring devices
    • Medication administration
    • Medication errors

    ASJC Scopus subject areas

    • Biomedical Engineering


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