This discussion is depressing, and is not addressing the problem that
there is variation in the units we are using. Most of the responses
have
not discussed the variation but have concentrated on the old argument
about which is right. There seems to be no more prospect of an
agreement on this than before the consensus statement was issued.
The consensus statement is the product of a group of colleagues who
are
qualified to find deal with this problem. We should support their
pragmatic recommendations and develop plans to comply with them. It
would be nice to have a national changeover day!!
We have agreed to adopt the guidance in Greater Manchester. I believe
our colleagues in Cheshire and Mersey and Cumbria and Lancashire will
do
so as well. We are looking into making the change from April 2007 and
preparing standardised guidance to support it. A better use of time
than
debating whether molar or mass units are correct - both of which are
SI.
Therefore, Julian, I think you can include the North West of England
as
well as Scotland. Hopefully the winds of change will blow further
south!
Best wishes
Jeff Seneviratne
Chair, Clinical Biochemistry Network Advisory Group
Greater Manchester Pathology Network.
>>> Nick Miller <[log in to unmask]> 04/12/2006 11:45 >>>
Tim,
It's absurb to blame the choice of units for the failure of A&E
SHO's
to
familiarise themselves with the reference range for drugs or any other
lab
tests (unless the lab changed the units and reference ranges without
telling
anyone - which is unlikely).
And yes, pharmaceuticals act and interact according to the molarity of
their
active components, so SI units are the appropriate choice for
reporting
their concentrations in body fluids.
Nick Miller
London
On 04/12/06, Reynolds Tim <[log in to unmask]>
wrote:
>
> Having heard of a recent death due to paracetamol in a patient
because
> the lab reported in mmol/L and the A&E dept interpreted in mg/L and
> discharged the patient, I don't think it matters what we report in
provided
> everyone does the same. In this situation we have a proven cause of
death
> that could be prevented if everyone agreed to do the same thing -
the
sort
> of problem that the safety experts always say we should be following
> airline-type procedures to prevent. Since drugs are measured in mg /
liter
> it seems reasonable to report concentration in mg/L but what does it
matter!
>
> Perhaps we should decide to report in ounces/gallon - then at least
> everyone will be united in hating the 'new' units.
>
>
> TIM
>
>
>
>
*************************************************************************************
> Prof. Tim Reynolds,
> Queen's Hospital,
> Belvedere Rd,
> Burton-on-Trent,
> Staffordshire,
> DE13 0RB
>
> work tel: 01283 511511 ext. 4035
> work fax: 01283 593064
> work email: [log in to unmask]
> home email: [log in to unmask]
>
>
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> -----Original Message-----
> *From:* Clinical biochemistry discussion list [mailto:
> [log in to unmask]] *On Behalf Of *Colley, Michael
> *Sent:* 04 December 2006 09:46
> *To:* [log in to unmask]
> *Subject:* Re: Consensus statement on reporting drugs and poisons
>
> As activity is molar, I'd go for molar. It's the American Drug
Companies
> and the Pharmacists who're the main perpetuators of mass measure.
>
> Mrs. X is just as unlikely to understand 5mg. She understands that
she
> needs one tablet of A and another of B.
> After all, a 5mg tablet of A weighs a heck of a lot more than 5mg!
>
> Perhaps, using the arguments for mass we should be going back to
mg/dL for
> glusoce and all other analytes including sodium and potassium.
>
> Michael (it's Monday morning!!)#
>
> -----Original Message-----
> From: Williams David G (RLN) City Hospitals Sunderland - Clinical
> Scientist
[mailto:[log in to unmask]<[log in to unmask]>
> ]
> Sent: 01 December 2006 14:13
> To: [log in to unmask]
> Subject: Re: Consensus statement on reporting drugs and poisons
>
> Good news then. While I appreciate some of the purists among us may
pine
> for
> the mole, I doubt if the likely confusion on the wards and for
patients
> will
> do us any good at all.
>
> (Cut to GP surgery "Right then Mrs X, I'm going to prescribe 22.56
mmol of
> Y
> and 347 umol of Z for you to be taken twice daily after meals")
>
> David G Williams
>
> -----Original Message-----
> From: Julian Barth
[mailto:[log in to unmask]<[log in to unmask]>
> ]
> Sent: 01 December 2006 13:44
> To: [log in to unmask]
> Subject: Consensus statement on reporting drugs and poisons
>
> Dear Colleagues
>
> I have to date had no real responses regading the proprosal that all
> clinical laboratories in the UK report drugs and poisons in MASS SI
> units. I am very pleased to inform you that the Scottish Senior
> Clinical Biochemists Group have recently agreed that all laboratoies
in
> Scotland will be shanging to mass units.
>
> I assume that the total silence means that there are no objections
to
a
> change in England too, so can we have a discussion about time lines
for
> a change over?
>
> Yours hopefully
> Julian
>
> Julian H Barth MD FRCP FRCPath
> Consultant in Chemical Pathology & Metabolic Medicine
> Department of Clinical Biochemistry & Immunology
> Leeds General Infirmary
> Leeds LS1 3EX
>
> tel 0113 392 3416
> fax 0113 392 5174
>
> Editor-in-Chief, Annals of Clinical Biochemistry,
> http://mc.manuscriptcentral.com/acb
>
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