Dear Paul, John and All,
I think John is being a little harsh in condemning the pharmacists in these
transactions - the medical staff (health professionals) also play a major
role here.
Naturally I can't speak for the USA, but my experience here is that doctors
and nurses are almost universally ignorant of SI in Australia. The battle
through their numerical days with a mishmash of units from old imperial
sources muddled together with cgs, mksA, and other specialist medical units
of their own devising.
Leave the pharmacists alone John, they are probably the best of a bad lot.
But having said that I am reminded of an old Bushies' (Australian rural)
line: 'Just because it's the best, doesn't mean it's any good!'
Cheers,
Pat Naughtin CAMS
Geelong, Australia
on 07.01.2001 11.22, Paul Trusten at [EMAIL PROTECTED] wrote:
> Sounds simple enough, but it's not in the cards. We do take a
> calculations quiz as part of our initial licensure exam, but there are
> no mandatory continuing education requirements for an annual or even
> period repeat of a pharmaceutical calculations exam. Some states require
> pharmacists to take a continuing education program in pharmacy law as
> part of their annual continuing education requirements for relicensure,
> but I have never seen a mandate for a closed-book periodic
> re-examination of calculations skills.
>
> What had happened in the instance that I once mentioned here was that
> the technician was mixing a chemotherapy product, which is done so
> carefully that even a different unit of measurement causes a tiny bit of
> confusion. She wanted to see 600 mg, not 0.6 g, on the label, and I had
> labeled it just the way the doctor ordered it: 0.6 g. We customarily
> label the product with the same name and the same units ordered by the
> physician. I was a bit surprised that she could not accept 0.6 g as a
> unit to work with.
>
> kilopascal wrote:
>>
>> 2001-01-06
>>
>> Maybe the only way to solve this problem is to revoke the licenses of
>> pharmacists or pharmacy techs that do not show a working knowledge in SI.
>> Those who are in training must show both written and oral knowledge of the
>> workings of SI in order to get a license and those already licensed must be
>> tested yearly to show they can function in proper units, symbols and
>> inter-conversions. Those that can't are OUT!
>>
>> This lack of knowledge may be a source of pride to those opposed to metric,
>> but it is a danger to those who could die from the wrong dosage. Why
>> doesn't anyone see the seriousness of this? Why isn't someone at the top
>> seeing a crisis situation here? It seems we as a nation are priding
>> ourselves in our freedom to be stupid, and we get angry when someone tries
>> to educate us and make us smarter.
>>
>> And to think if medicines were in the old system, the situation would be
>> worse. Maybe there isn't enough lawsuits to force the issue.
>>
>> Glückliches Neues Jahr!
>> Happy New Year!
>>
>> John
>>
>> Keiner ist hoffnungsloser versklavt als derjenige, der irrtümlich glaubt
>> frei zu sein.
>>
>> There are none more hopelessly enslaved then those who falsely believe they
>> are free!
>>
>> Johann Wolfgang von Goethe (1749-1832)
>>
>> -----Original Message-----
>> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]On
>> Behalf Of Paul Trusten
>> Sent: Saturday, 2001-01-06 15:22
>> To: U.S. Metric Association
>> Subject: [USMA:10296] leading decimal
>>
>> I can state from experience that a leading decimal point can be harmful
>> of even fatal in healthcare. But, there is a general decimal illiteracy
>> in US society, one that affects doctors and nurses. In fact, as I
>> mentioned on this list in the recent past, a co-worker of mine, in
>> pharmacy, could not easily convert grams to milligrams and vice versa.
>> The decimal illiteracy usually shows up in the dosing of levothyroxine,
>> a thyroid hormone supplement, which is often ordered in both milligram
>> and microgram doses. Often, the dose 0.025 mg gets mis-transcribed as
>> 0.25 mg, or the drug is ordered as 250 milligrams instead of 250
>> micrograms. Despite being the innovators in decimalizing currency, we
>> Americans have a clear lack of facility in thinking decimally.
>>
>> But, I think I was lucky in attending the Boston Public Schools when I
>> did (1956-64). We received an extensive arithmetical education, both in
>> decimal numeration and in the use of expressed fractions (i.e., the
>> WOMBAT system of numeration). I don't know if schools are as tough today
>> as they were then, but my elementary-school contemporaries were made to
>> run the mathematical gauntlet of the times.
>>
>> Another poor prescription writing practice is the use of a trailing zero
>> when it is not a significant digit. If the decimal point is not clearly
>> legible, and there is a ten-fold strength of the drug available, 2.0 mg
>> can become 20 mg. There is NO reason to write "2.0 mg"!!! "2 mg" is all
>> that is required.
>>
>> A few (VERY few) prescribers write ALL of their prescriptions in grams,
>> i.e., if there is a 1 mg dose, the order is written as 0|001, and 25 mcg
>> is written as 0|000|025. This would be a good safeguard if everybody did
>> it as a standard notation, but few do it, and it probably raises more
>> questions than it answers when it appears.
>>
>> The best solution to this communication problem is mathematical facility
>> in using decimals and in using SI, so the writer writes either 0.025 mg
>> OR 25 mcg (sorry, I don't have a "mu" handy) and the reader can
>> understand either notation.
>>
>> I must also confess that use of the SI "mu" prefix for "micro" can cause
>> confusion in medication orders, since a careless writer will make the
>> "mu" look like "m", so we have to read between the lines and/or call the
>> prescriber to verify (time for electronic order entry in all medication
>> orders!).
>>
>> --
>> Paul Trusten, R.Ph.
>> 3609 Caldera Boulevard, Apt. 122
>> Midland TX 79707-2872 USA
>> [EMAIL PROTECTED]
