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Using Order Entry for Alerts of Dose Conversion Between Potassium Salts to Prevent Physician Dosing Errors

机译:使用订单输入来提醒钾盐之间的剂量转换,以防止医师剂量错误

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摘要

Despite the widespread use of the various potassium salts, confusion over appropriate dosing of potassium phosphate persists,~(1,2) coincident with its continued listing as a high-alert drug product.~3 This is due to the routine expression of the product in order-entry systems by its polyvalent phosphate anion [in millimoles (mM)] rather than by its monovalent potassium cation [in milliequivalents (mEq)]. Numerous errors can result because nurses and physicians typically understand potassium dosing only in terms of mEq. Furthermore, there is a tendency toward overdose, given that each milliliter of potassium phosphate contains 4.4 mEq of potassium versus 3 mMol of phosphate, if the physician mistakenly assumes a 1:1 equivalence. However, such dosing errors may not set off a dose alert in most systems because of the subtlety of the mEq-mMol differential.
机译:尽管广泛使用了各种钾盐,但仍然存在对适当剂量的磷酸钾的困惑,〜(1,2)与其持续被列为高警戒性药品一致。〜3这是由于该产品的常规表达在命令输入系统中是通过其多价磷酸根阴离子[以毫摩尔(mM)为单位],而不是通过其单价钾阳离子[以毫当量(mEq)为单位]。由于护士和医生通常仅根据mEq来了解钾的剂量,因此可能会导致许多错误。此外,如果医生错误地假定1:1当量,则每毫升磷酸钾包含4.4 mEq的钾与3 mMol的磷酸盐,存在过量的趋势。但是,由于mEq-mMol差异的微妙之处,在大多数系统中,这种剂量错误可能不会引起剂量警报。

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