Comments on: Dual unit weighing scales can be harmful to health – official

By: Michael Glass

Michael Glass — Mon, 09 Mar 2009 01:00:22 +0000

Errors are so easy to make. Any measure that will reduce medical errors must be enforced. This is why a totally metric environment is essential. As a safety issue, the argument is overwhelming.

All medicine and all pharmacy measures must be metric, including measures sold to the public. For example, medicine glasses must be exclusively in metric measures. Once medicine is exclusively metric, patients will be safer.

By: Paul Trusten, R.Ph., Public Relations Director, U.S. Metric Association

Paul Trusten, R.Ph., Public Relations Director, U.S. Metric Association — Wed, 07 Jan 2009 16:36:44 +0000

As both a practicing pharmacist and a USMA officer, I applaud the LACORS decision to enforce metric-only measurement. Drugs are frequently dosed on a milligram-per-kilogram or milligram-per-square meter body surface area basis, and any risk of a mix-up in units for patient weight can result in a significant, possibly disastrous, dosing error. In the U.S., the Joint Commission has recently called for weighing PEDIATRIC patients in kilograms only, but I continue to call for the ending the use of pounds, feet, and inches in patient data in this country.

By: John Frewen-Lord

John Frewen-Lord — Tue, 09 Dec 2008 14:48:09 +0000

“A watchdog has issued a warning to hospital staff after almost 500 patients received the wrong dose of a sedative over the last four years.

Three died and another 48 were moderately harmed after being injected with midazolam, a drug used to sedate patients undergoing minor procedures.

It urged staff vigilance on dosing.

In some cases staff gave the wrong dose in error or experienced difficulty in determining the appropriate dose for individual patients. Patients were being given whole ampoules of the drug instead of a tiny amount.”

This was on the BBC News website today 2008-12-09. I just wonder how much of this wrong dosage was due to errors in measuring individual patients’ mass/BMI, or whether other factors were involved. Unfortunately the article does not say.

By: Ezra Steinberg

Ezra Steinberg — Tue, 11 Nov 2008 03:39:50 +0000

As with anything else, it all comes down to user education and usage. If the media and all agencies (public and private) cooperate in using kilograms only for weight and meters or centimeters for height, over time the younger folks and many older ones will assimilate what numbers mean in those units and the archaic forms of stones and pounds will disappear.

Those who want to be able to convert should have charts available to them in most agencies and online. This would minimize (though not eliminate) the grumbling of those who object while allowing the natural process of evolution to relegate those units to the dustbin of history.

By: Martin Vlietstra

Martin Vlietstra — Mon, 10 Nov 2008 09:47:57 +0000

A few years ago I spent 18 months working in Germany. A British colleague said that he weighed “x stones” (I forget what x was). One of my Spanish colleagues asked “what kind of barbaric measurement is that?” (I do not recall the exact phrase, but she certainly used the word “barbaric”).

By: John

John — Sun, 09 Nov 2008 17:19:16 +0000

When I give my weight in kg (currently 67 kg), people often do then ask “How many stones is that?”. To which I reply “Depends on whether I dig the stones up from my front garden or back garden.” I usually get a laugh – but that is all. I cannot recall anyone pressing the point further. If they actually know weights in kg, then I don’t need to tell them in stones (I actually do not know my weight in stones). If they don’t know kg, then they can remain in ignorance, or take the trouble to find out for themselves.

By: Shaun

Shaun — Sat, 08 Nov 2008 09:52:47 +0000

People still talk of their weight in imperial although the NHS is metric and I don’t see the stone used anywhere except “informal” weighing. If the stone is already “obsolete” I might as well not use it. I think providing metric only equipment in hospitals is a good idea and I agree with David Brown on the weight of newborns!

By: Philip Bladon/ SI Metric-Matters

Philip Bladon/ SI Metric-Matters — Fri, 07 Nov 2008 11:56:09 +0000

To add to the point that Alex Bailey makes about the diet industry; Calories/calories/kilocalories should be phased out as soon as possible. Nowadays a “calorie” is the same as a “kilocalorie” – more confusion!

Historically a thousand “calories” were equal to one “Calorie”.
1000 calories = 1 kilocalorie

On the front of a food packet it may show “114 Cals” (or 114 cal) and on the side “114 kcal”. (In terms of nutrition calories and energy are used to mean the same thing).

Food energy values and Guideline Daily Amounts should only be given in kilojoules (kJ) and megajoules (MJ).

Conversion increases the chance that mistakes will be made. It’s time to archive or shed calories!

http://www.simetricmatters.com / Philip Bladon

By: Martin W

Martin W — Thu, 06 Nov 2008 14:10:32 +0000

The following articles show that even the USA cannot escape the need to use standard metric units for weighing hospital patients.

http://www.mc.vanderbilt.edu/reporter/index.html?ID=6765
http://www.washingtonpost.com/wp-dyn/content/article/2008/04/11/AR2008041102439.html

There was a safety alert issued earlier this year by the Joint Commission, the American-based healthcare accreditation organisation.

http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_39.htm

The alert states:
“Since patient weight is used to calculate most dosing (either as weight-based dosing, body surface area calculation, or other age-appropriate dose determination), all pediatric patients should be weighed in kilograms at the time of admission (including outpatient and ambulatory clinics) or within four hours of admission in an emergency situation. Kilograms should be the standard nomenclature for weight on prescriptions, medical records and staff communications.”

This follows a safety notice issued in 1999, which included a recommendation resulting from the confusion caused by the non-metric labelling of a drug.

http://www.ismp.org/Newsletters/acutecare/articles/A3Q99Action.asp

“Problem: A patient received phenobarbital 0.5 grams (500 mg, obtained from 4 x 130 mg unit dose syringes) IV daily for three days instead of 0.5 grains after the prescriber misread the apothecary dose listed on the patient’s prescription bottle.
Recommendation: Only the metric system should be used when prescribing and labeling drugs.”

Using more than one system of measurement for a given purpose will always have the potential to cause confusion and errors. Such errors can be life-threatening when healthcare is involved.

By: Alex Bailey

Alex Bailey — Thu, 06 Nov 2008 13:20:17 +0000

People have for some time seen metric as an official & scientific tool and imperial as a personal one and this needs to change. In the same way as “jargon” may be used by a particular industry to keep the general public at arms length, differentiating between metric and imperial in this manner does the same thing and is clearly dangerous!

Medical staff are no less likely to make mistakes in conversion from metric to imperial as market stall holders, the main difference is that the latter are only going to deprive people of their money and not their health. Medical staff should be banned from using “supplementary indications” for this reason alone.

The diet industry and the press could also assist… if people started to weigh everything in metric and stop converting they would more easily see mistakes for themselves!