Stop U Be 4 Errors

"A recent error occurred when a nurse who was taking a patient's history recorded his insulin dose using the letter 'u' instead of the word 'unit' (Figure 1). The physician misread the 'u' as a '4' and wrote orders for doses dramatically different from what the patient had been taking (Figure 2). Although the physician also used the abbreviation 'u,' thankfully it was not misread as yet another 4. The patient received a single overdose of insulin, but fortunately was not harmed. The only safe way to express units is to write it out completely. Incidentally, another safe practice, telling patients the names and doses of drugs being administered, also played a role in helping to prevent additional errors. Further overdoses were averted when the nurse said to the patient, 'Here's your insulin, 44 units.' The patient responded, '44 units? I take 4 units!'"

Errors while writing orders

"An order was written for '1.25 mg of Toradol x 1,' or so it seemed (Figure 1). Despite a spelling error (Tordol), that's the way a pharmacist initially read the transcribed telephone order (see below). Since the dose didn't make sense, the pharmacist checked with the transcribing nurse, who responded by saying she'd numbered the order for 25 mg of TORADOL (ketorolac) IV using the number 1 followed by a period. Errors are possible whenever numbers or extraneous marks precede drug orders. Avoid the temptation to number orders, even on preprinted order forms. We see no reason for it, but if orders must be numbered, each digit should be circled. In the past we've published cases where initials, letters, checkmarks, and other incidental marks used during ordering or transcription of handwritten orders can obscure or change how a medication order appears."

Celecoxib Linked to Increased Cardiovascular Risk

The cyclooxygenase (COX)-2 inhibitor celecoxib (Celebrex) more than doubled the risk of cardiovascular events in subjects enrolled in the Adenoma Prevention with Celecoxib (APC) study, Celebrex maker Pfizer Inc said today. The large randomized, double-blind, placebo-controlled, multicenter study was designed to investigate whether celecoxib could prevent colon cancer in people who had previously had colon polyps. Subjects who took celecoxib had 2.5 times as many fatal and nonfatal heart attacks as those who did not take the drug.

Exercising Before Mealtime May Improve Postprandial...

Exercising before a meal improves postprandial endothelial function, according to the results of a study published in the Dec. 21 issue of the Journal of the American College of Cardiology. 'Free-living humans spend the majority of their lives in the postprandial state, and the changes to metabolism seen during the hours after meal ingestion are likely to play an important role in the atherosclerotic disease process,' write Jason M.R. Gill, PhD, from the University of Glasgow and Glasgow Royal Infirmary in the U.K., and colleagues. 'There is now a large body of evidence indicating that a single session of moderate exercise can reduce subsequent postprandial lipemia by ~20% to 25%.'

AHA Updates Recommendations for BP Measurements

The American Heart Association has updated its 1993 recommendations for blood pressure measurements. The new guidelines that are published in the February issue of Hypertension emphasize out-of-office blood pressure readings, proper cuff size, and more. 'Since the last statement, there have been huge changes in the technology used to measure blood pressure and in our knowledge about the significance of different measurements,' lead author Thomas G. Pickering, MD, DPhil, from Columbia University Medical Center in New York, NY, says in a news release. 'We've found that blood pressure measurements taken by doctors in their offices may actually be unreliable in many patients. For that reason, there is wider acceptance of blood pressure readings taken by patients in their homes, and of 24-hour ambulatory blood pressure monitoring.

Mobile Phone Radiation Harms DNA, New Study Finds

Radio waves from mobile phones harm body cells and damage DNA in laboratory conditions, according to a new study majority-funded by the European Union, researchers said on Monday. The so-called Reflex study, conducted by 12 research groups in seven European countries, did not prove that mobile phones are a risk to health but concluded that more research is needed to see if effects can also be found outside a lab.

Moderate-Fat Diet Better Than Low-Fat at Improving CVD Risks

"A moderate-fat diet is better than a low-fat diet at improving cardiovascular disease risk factors, according to the results of a study published in the February issue of the American Journal of Clinical Nutrition."