BACKGROUND:
The expression of drug concentration as a ratio may cause dosing errors.
INTERVENTION:
Twenty eight physicians managed a simulated pediatric acute anaphylaxis scenario by using epinephrine ampules labeled with mass concentration (1 mg in 1 mL) or a ratio (1 mL of a 1:1000 solution).
RESULTS:
Compared with providers using ampules with mass concentration labels, those using ratio labels gave more epinephrine (adjusted mean dose, 213 microg above target [95% CI, 76.4 to 350.1 microg]; P = 0.003), and took longer to do so (adjusted mean delay, 91 seconds, [CI, 61.0 to 122.1 seconds]; P < or = 0.0001).
LIMITATIONS:
Performance in simulated scenarios may not reflect clinical practice. In reality, ampule labels provide both expressions of concentration.
CONCLUSION:
The use of ratios to express drug concentration may be a source of drug administration error. Patient safety might be improved by expressing drug concentrations exclusively as mass concentration.
Pubmed link : 18166759
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