Gene and Pat et al.,
The debate over grams and kilograms is evocative of the problem we have with the poorly related units of ounces and pounds. Why disown the gram from the kilogram? Aren't they "family"(grin)?
I believe that all of us in a metric America---standards setters, butchers, bakers, and healthcare professionals--should be able to deal with grams OR kilograms, and be able to change between them by mere inspection. As I mentioned, newborns' body masses are measured in grams, but thereafter, we tend to mentally move that decimal point so we can calculate milligram-per-kilogram or milligram per square meter of body surface area doses. For example, if I happen to have to calculate a milligram-per-kilogram dose of the antibiotic gentamicin for a newborn that weighs 2470 g, I would use the value 2.5 kg. The power and the beauty of the decimal SI is that, with the correct symbols, and also with the knowledge of what (or who) is being measured (i.e., generally, no newborn weighs 2.5 g; so the number must represent kilograms). Also, in making these dose calculations, one place beyond the decimal marker is usually sufficient.
Concerning electronic data entry and storage, I can only use my hospital's system as an example. All body masses are stated in kilograms in the heading of the medical record, and all heights are stated there in centimeters (I think meters would be better, in order to facilitate body mass index and body surface area calculation; better yet, the system should calculate and post both values--BSA and BMI-- at the top of the record). The notation in grams for neonates is usually found in the supporting documents, i.e., nurses' and physicians' notes.
----- Original Message ----- From: <[email protected]>
To: <[email protected]>; <[email protected]> Sent: 20 January, 2009 14:21Subject: Re: [USMA:42373] Re: Is there any literature on metrication in the US aimed at immigrants?
Paul,Do you have contacts in the Joint Commission who might be persuaded to adopt "body mass in grams (up to 20 kg) and body mass in kilograms at 20 kg and more than 20 kilograms?Could there be an electronic data entry and storage problem for lifetime medical records containing both grams and kilograms?Gene. ---- Original message ----Date: Mon, 19 Jan 2009 15:46:40 -0600 From: "Paul Trusten, R.Ph." <[email protected]>Subject: [USMA:42373] Re: Is there any literature on metrication in the US aimed at immigrants?To: "U.S. Metric Association" <[email protected]> Cc: "U.S. Metric Association" <[email protected]> Gene et al, your answer. Yes, I think you're right, but they wrote:"Since patient weight is used to calculate most dosing (either as weight-baseddosing, body surface area calculation, or other age-appropriate dosedetermination), all pediatric patients should be weighed in kilograms at the time of admission (including outpatient and ambulatory clinics) or within four hours of admission in an emergency situation. Kilograms should be the standardnomenclature for weight on prescriptions, medical records and staff communications." Paul Quoting [email protected]:Better: "body mass in kilograms" as in Body Mass Index (BMI). What is the precise quotation from the Joint Commission? ---- Original message ---- >Date: Sun, 18 Jan 2009 19:50:39 -0600 >From: "Paul Trusten, R.Ph." <[email protected]>>Subject: [USMA:42359] Re: Is there any literature on metrication in the >USaimed at immigrants? >To: "U.S. Metric Association" <[email protected]> >Cc: "U.S. Metric Association" <[email protected]> > >... > >Yes--in the U.S., the Joint Commission (national healthcare accrediting body)>has issued a guideline stating that all pediatric patients should be >weighedin>kilograms only and their weights stated in kilograms only. (I have >urgedthe JC>to suggest that ALL patient weights be measured and stated in kilograms >onlyand >their heights measured and stated in meters only.) > >Paul T.-- Paul Trusten, R.Ph. Public Relations Director U.S. Metric Association (USMA), Inc. www.metric.org 3609 Caldera Boulevard, Apartment 122 Midland TX 79707-2872 US +1(432)528-7724 mailto:[email protected]
