Thursday, September 6, 2012
You may or may not be familiar with warfarin, a drug that patients sometimes refer to as "rat poison" because it is used to poison rats. Like most drugs, it was discovered when someone's cows died after eating mouldy clover, using a scientific process that is opaque to me, but undoubtedly involved much glassware. The dose is often tweaked up or down each day depending on the results of that day's blood tests because otherwise the after hours cover intern would have nothing to do on the weekend. Getting it wrong might mean that your patient bleeds to death internally or perhaps has a massive stroke. No pressure.
So when I was called to the ward one day to clarify the daily dose of warfarin, I thought, yeah - fair enough - nobody wants to stuff this up, and doctors' handwriting is actually even worse than it is reputed to be. But when I get there, the nurse points at the drug chart and asks, and I am not making this up, "Is that a '6' or a 'b'?"
I mean - like, totally, huh? How could you prescribe someone 'b' milligrams of warfarin?
Not even I am nerdy enough to prescribe in hexadecimal. Although if I was, I'd make sure that I did paediatric prescriptions in octal and neonates in binary...