The 2001 July issue of a publication known as "Hospital Pharmacist Report" featured the following: "HEADS UP! Editor's Note: Heads Up! provides information to help health-system pharmacists prevent or avoid med errors. If you have a Heads Up! you would like to share, send it to Hospital Pharmacist Report, 5 Paragon Drive, Montvale NJ 07645.E-mail: [EMAIL PROTECTED] Fax: (201)722-2490. How many milliliters are in three-quarters of a teaspoonful of a liquid medication (the package included a 5-ml oral syringe)? A simple calculation, right? Well, not always. According to the Institute for Safe Medication Practices, an experienced pharmacy technician recently used a calculator and was surprised by an answer of 4 ml. She showed a pharmacist, who repeated the calculation and came up with the same answer. The pharmacist told the technician to use 4 ml as the dose. When the technician looked at the calibrated oral syringe, she insisted it should be 3.75 ml. A second pharmacist used the same calculator and realized that the decimal places had been set at "0" and that the calculator was rounding the answer. This decimal point error, according to ISMP, may have caused a serious error if the medication hasd required a more complex calculation or if an infant's medication had a narrow therapeutic index." Well, I never use a calculator with rounding capabilities anyway, but the technician is indeed correct---the volume should be 3.75 ml. Still, that ain't the point!!!The following was my substitute "heads up" for the problem at hand, submitted to the e-mail address above: Rather than legitimize the colloquy between pharmacist and technician over whether or not three quarters of a teaspoonful is 3.75 ml or 4 ml, I wish to move that teaspoonsful and any other non-metric units of measurement be stricken from US healthcare as soon as is practical. Both healthcare professionals and patients should be using milliliters only in ordering and measuring liquid doses. The United States is now the only remaining country not to have adopted the International System of Units as its standard of measurement. But this does not mean that healthcare, almost wholly metric now, can afford to permit the continued use of an archaic measurement system for the measuring of patient doses at the very hour that medication errors are under national scrutiny. In the example in your July issue, it is not the calculator that is the problem. It is the use of teaspoonful measurement that is the problem! The example is especially laughable because the drug product included a metric syringe. Hence there is absolutely no excuse for the use of non-metric units in this prescription. Prescribers can at least order the dose in milligrams, and we pharmacists can do the rest! As it is now our legal duty to do so, let us counsel the patient on the use of the syringe. Sincerely, Paul Trusten,R.Ph. 3609 Caldera Blvd Apt 122 Midland TX 79707-2872 home 915-694-6208 work 915-685-1549
