Wheeler Daniel W, Carter Joseph J, Murray Louise J, Degnan Beverley A, Dunling Colin P, Salvador Raymond, Menon David K, Gupta Arun K
Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom.
Ann Intern Med. 2008 Jan 1;148(1):11-4. doi: 10.7326/0003-4819-148-1-200801010-00003.
The expression of drug concentration as a ratio may cause dosing errors.
To examine the effect of ratio expressions on drug administration.
Randomized, blinded, controlled study.
Simulation center in an urban hospital.
28 physicians.
Participants 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).
The amount of epinephrine given and the time taken to administer it.
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).
Performance in simulated scenarios may not reflect clinical practice. In reality, ampule labels provide both expressions of concentration.
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.
将药物浓度表示为比例可能会导致给药错误。
研究比例表示法对药物给药的影响。
随机、盲法、对照研究。
城市医院的模拟中心。
28名医生。
参与者通过使用标有质量浓度（1毫克/1毫升）或比例（1:1000溶液1毫升）的肾上腺素安瓿来处理模拟的小儿急性过敏反应情况。
给予的肾上腺素量和给药所需时间。
与使用质量浓度标签安瓿的医护人员相比，使用比例标签的医护人员给予了更多的肾上腺素（调整后平均剂量，比目标剂量高213微克[95%可信区间，76.4至350.1微克]；P = 0.003），且给药时间更长（调整后平均延迟91秒，[可信区间，61.0至122.1秒]；P≤0.0001）。
模拟场景中的表现可能无法反映临床实践。实际上，安瓿标签提供了两种浓度表示法。
使用比例来表示药物浓度可能是给药错误的一个来源。仅用质量浓度来表示药物浓度可能会提高患者安全性。
