My guess is that it is a direct result of the country's "dual is beautiful" 
policy.  These nurses probably weigh themselves and their kids at home in 
pounds, and don't have much of a sense of weight in kilograms.  If they used SI 
in their personal lives, they would develop such a sense.

I draw particular attention to Recommendation 3 in the report.  Computized 
record keeping should automatically check for likely out-of-bound conditions 
and 
throw an alert.  No guarentee the nurse would act on it, but it would probably 
catch a large portion of the errors.

As long as people are estimating weights in both pounds and kilograms, they 
will 
do both badly, to varying degrees.  Why did the system give her a choice of 
units?  How did she obtain the 25 pound weight, by weighing or from the 
parents.  No scale weighing in pounds should be present, and weight provided by 
the parents should probably not be relied on and converted.

Using SI on the job and Customary at home is the norm for a lot of people in 
this country but it is poor practice.  We need to have ONE system of measure, 
SI.




________________________________
From: Team Metric Info <[email protected]>
To: U.S. Metric Association <[email protected]>
Sent: Fri, March 29, 2013 2:38:48 PM
Subject: [USMA:52574] Question about number sense- is this the correct term?


I am writing up a case study about a  triage nurse who incorrectly recorded a 
toddler's weight as 25 kg, instead of 25 lbs (11.3kg). The weight error caused 
the toddler to receive 225 mg of clindamycin orally three times a day, instead 
of the correct dosage of 113 mg orally three times a day.  Dosage was 
calculated 
for a toddler weighing 25kg instead of their actual weight of 11.3kg. Read the 
full case study at  http://webmm.ahrq.gov/case.aspx?caseID=293.
 
None of the other ER staff (who were different from the triage nurse) caught 
the 
error. To me this is an example of another issue most American’s have with SI 
units- a lack of number sense!  At least that is what I have been calling it. I 
am trying to clearly state that most Americans even in the healthcare field do 
not intuitively understand metric units. So even looking directly at the same 
toddler none of the other ER staff thought no way this kid is 25kg. 

 
A related thing happened to my son recently, during an allergy appointment at 
children’s hospital here, he got on the scale and it said 10kg. My son is over 
3 
ft tall and weighs about 45lbs. My husband told the nurse, there is no way he 
weighs 10kg. The nurse replied, “that is what the scale said”- so he reminded 
her of the 2.2 conversion and she agreed. Turns out the digital scale was 
broken, but my point and how this story relates to the other story is that the 
nurse did not have a “number sense” of what 10kg would look like. She was 
looking directly at my son. 

 
Group- do you think the term “number sense” is correct in this context?  
Because 
it is not really the number but the unit attached to it which they do not 
intuitively understand. 

 
Any thoughts would be appreciated

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