Dating of multidose vials in hospitals 1000 online dating sites in wales
For example, the U-100 designation on insulin vials has been misunderstood to represent 100 units per vial, leading to 10-fold overdoses.
Taking into consideration that the label of virtually every other injectable drug notes both the “per m L” and “per total volume” amounts, one can understand how this inconsistency might contribute to such an error with insulin.
For example, a patient recently received 1,000 units of LANTUS (insulin glargine) IV instead of PROTONIX (pantoprazole).
A nurse had removed the vial cap and reconstituted Protonix with 0.9% sodium chloride as directed.
Given reports of ongoing misuse of insulin pens—in particular, the sharing of insulin pens with multiple patients after only changing the needle, as well as needlestick injuries, user technique errors, and pen design flaws as first described in 2008 ()—we believe the risk associated with cross-contamination is best mitigated by removing insulin pens from use in hospitals.
While we stand firmly behind our recommendation on this issue, we want to take this opportunity to point out that simply replacing insulin pens with insulin vials may result in unintended vulnerabilities that can result in errors. A physician had ordered a “stat” dose of insulin aspart 10 units IV along with a dextrose infusion to treat a patient with hyperkalemia.
She withdrew and administered all 10 m L of Lantus.
The concentration and total dose was not readily apparent on the vial label.
She showed the vial to another nurse, who confirmed it was the right medication.
First, for staff who have been using insulin pens for any length of time, transitioning back to insulin vials may uncover knowledge deficits that may lead to errors and patient harm. Several years before, the hospital began using insulin pens.
Since graduation, the nurse who needed to give the insulin had only used the pens and had forgotten that only insulin syringes should be used when measuring an insulin dose from a vial.