Pierre, as a hospital pharmacist, I deal with this issue daily. The correct patient mass and height, in kilograms and meters respectively, are crucial parameters for drug dosing. These values MUST be in metric units for calculating doses of certain antibiotics and chemotherapy agents. In those instances, wrong numbers can prove to be harmful, or even fatal.
Before I answer your question, I have some good news. I attended a continuing education conference in Austin, Texas, on 10 and 11 September. One of the presenters was a Dr. Matthew Grissinger, a pharmacist from the Institute for Safe Medication Practices (ISMP). He stated during his presentation that he wanted to see only metric units used for height and weight in hospitals, period! This opinion came from a high authority, one whose job is to minimize medication errors. ISMP is an organization whose findings and statements are published periodically to all state boards of pharmacy. I'm sure this will eventually make its way to the hospital accrediting body, JCAHO. Some hospitals do use metric units only for patient body parameters (let's not forget Celsius body temperature), but, surely, not enough. Now, to your question about how patient height and mass are obtained, and I'm assuming you are asking about how this is done in the U.S. . The answer is that , too often, it is it is done by chaos, plain and simple. In the mostly metric world of healthcare, you would think that these parameters would be taken by using metric measuring devices and recording the results in metric units only. Sadly, this is not so in America. It's a fascinating fact that this is a sore point at which U.S. customary units make their way firmly into the system. It has to do with people. Both nurses and patients still think non-metric when these questions arise. The patient states weight in pounds and height in feet/inches, and that is the way they are recorded in the chart. Only on a whim do I get metric units, and, oddly, only the mass, not the height. "Metrophobia" is alive and well in U.S. healthcare. It would be a very unusual patient who would come along and state his or her mass in kilograms and height in meters. My hospital is only a month away froma adopting a new information system. In the new one, patient height and weight are ENTERED IN U.S. UNITS BUT ARE CONVERTED TO METRIC BY THE COMPUTER, AND POSTED ON THE PATIENT RECORD IN METRIC. Now, this still poses a safety hazard: the person entering the data must NOT obtain metric units first, but obtain U.S. units from the patient and let the computer do the converting. So, at my workplace we're not out of the woods yet. I agree that the best method is to eliminate all conversion and to use kilogram and meter scales to measure the patient, and use software that simply accepts the numbers and posts them with the obvious symbols. We can only continue to hammer away at officialdom to adopt that practice. I assure you that I am doing just that. Paul T. ----- Original Message ----- From: "Pierre Abbat" <[EMAIL PROTECTED]> To: "U.S. Metric Association" <[email protected]> Sent: Tuesday, September 20, 2005 22:34 Subject: [USMA:34578] Patient height and mass > If someone at the hospital asks a patient his height and mass, the form > specifying metric units for these, and he answers in feet and pounds, what > happens? Does she ask him again, specifying meters and kilograms, or does she > convert the figures? > > phma > >
