Cubic Centimetre (cc) completely phased out?

[DylanAsdale]

In your experience, do some more classical hospitals use the term "cc" instead of "mL"?

I was at Indiana University hospital 2 days ago, and on one of the office computer screensavers read "USE ML, NOT CC!"

I know its use is deprecated, but is its use punished?

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[Winged Scapula]

It's not a function of "classical" hospitals (although I'm not sure what that even means) but rather JCAHO recommends not using cc as
as an abbreviation.

 

[SLUser11]

It's not a function of "classical" hospitals (although I'm not sure what that even means) but rather JCAHO recommends not using cc as
as an abbreviation.

Agreed. "cc" is not an acceptable abbreviation for orders....I wonder if some of it has to do with handwriting and the likelihood of medication errors, but I'm not sure.

 

[Winged Scapula]

Agreed. "cc" is not an acceptable abbreviation for orders....I wonder if some of it has to do with handwriting and the likelihood of medication errors, but I'm not sure.

If you check the JCAHO page it notes that cc might be confused with units. So most likely a function of handwriting but given the coming requirements for EMR, it doesn't make sense to me.

 

[DylanAsdale]

If you check the JCAHO page it notes that cc might be confused with units.

Then that would make sense for its deprecation, but I'd think that professionals who administer medications in syringes would have a decent knowledge of the measurements used. (eg. that 100 Units = 1cc)

Why not just increase the importance of measurement training?

 

[gro2001]

If you check the JCAHO page it notes that cc might be confused with units. So most likely a function of handwriting but given the coming requirements for EMR, it doesn't make sense to me.

At our hospital we recently had a JCI audit (like JCAHO, but for international hospitals). At the peak of the insanity we were being made to write out the sign > as "more than" (such as for PRN medication, if the Visual Analog Scale (another of the brilliant bureaucratic innovations) is more than 50 %). Supposedly can be confused with 7. Yeah. If Pain is 750 on the VAS.

 

[SocialistMD]

Then that would make sense for its deprecation, but I'd think that professionals who administer medications in syringes would have a decent knowledge of the measurements used. (eg. that 100 Units = 1cc)

Why not just increase the importance of measurement training?

You'd like to think so, but it isn't that simple.

1. There aren't a specific number of units of anything per mL. See the Dennis Quaid ordeal for one example.

2. The problem is that, when sloppily written, "cc" can appear like an undercase "u," which is what can cause the confusion. One hospital where I work has a poster with actual handwritten orders that are convincingly confusing and illegible. This is the best I could find online:

One could argue that if someone were dosing something by "cc's" and the order was interpreted as "u's," it would make no sense in the context in 99% of the cases, as anything that was dosed in units shouldn't be dosed by volume and vice versa, but the JCAHO recommendations are usually based on actual errors that have occurred. One has to safety-proof the system for the lowest common denominator, be it physician, nurse, tech or pharmacist. It is easier to limit the number of abbreviations used than it is to ensure every person in the hospital can read and comprehend an order.

 

[Winged Scapula]

At our hospital we recently had a JCI audit (like JCAHO, but for international hospitals). At the peak of the insanity we were being made to write out the sign > as "more than" (such as for PRN medication, if the Visual Analog Scale (another of the brilliant bureaucratic innovations) is more than 50 %). Supposedly can be confused with 7. Yeah. If Pain is 750 on the VAS.

Oh, that insanity exists here too.

JCAHO also does not like > or < and wants you to write it out, along with Enteric Coated Aspirin (instead of ECASA), Morphine Sulfate (instead of MS04), etc.

 

[Buzz Me]

JCAHO also does not like > or < and wants you to write it out, along with Enteric Coated Aspirin (instead of ECASA), Morphine Sulfate (instead of MS04), etc.

Did you just use the "0" symbol ("zero") instead of the "O" (letter "O") symbol for oxygen? Oh, one of my pet peeves!... 🙁

 

[Winged Scapula]

Did you just use the "0" symbol ("zero") instead of the "O" (letter "O") symbol for oxygen? Oh, one of my pet peeves!... 🙁

Didn't mean to...but it does look like it. 😛

 

[gro2001]

Oh, that insanity exists here too.

JCAHO also does not like > or < and wants you to write it out, along with Enteric Coated Aspirin (instead of ECASA), Morphine Sulfate (instead of MS04), etc.

Any day now I am expecting to be told that I have to write out the date in full (as in: "twenty-fourth of February, two thousand and nine" instead of 2/24/09) since it can be confused for "administer 500,000 U Heparin STAT.

 

[Winged Scapula]

Any day now I am expecting to be told that I have to write out the date in full (as in: "twenty-fourth of February, two thousand and nine" instead of 2/24/09) since it can be confused for "administer 500,000 U Heparin STAT.

😆

you forgot "in the year of our Lord, AD"

 

[LucidSplash]

😆

you forgot "in the year of our Lord, AD"

I think you mean Anno Domini.

 

[Winged Scapula]

I think you mean Anno Domini.

I did but was typing from my phone while driving and needed to end the message quickly so couldn't type AD out.

 

[SocialistMD]

I did but was typing from my phone while driving and needed to end the message quickly so couldn't type AD out.

Oprah would be so disappointed...

Did you just use the "0" symbol ("zero") instead of the "O" (letter "O") symbol for oxygen? Oh, one of my pet peeves!...

Initially, I thought this was a very cleverly placed joke about the topic at hand (difficult to read/interpret handwriting). Perhaps, being there has been no reply, I gave Buzz Me too much credit?

 

[LucidSplash]

I did but was typing from my phone while driving and needed to end the message quickly so couldn't type AD out.

And I'm updating from my iPhone between seeing patients who do not need antibiotics and thus forgot to add the appropriate j/k emoticon. 😀

 

[Amy]

Any day now I am expecting to be told that I have to write out the date in full (as in: "twenty-fourth of February, two thousand and nine" instead of 2/24/09) since it can be confused for "administer 500,000 U Heparin STAT.

🤣

 

[Buzz Me]

Initially, I thought this was a very cleverly placed joke about the topic at hand (difficult to read/interpret handwriting). Perhaps, being there has been no reply, I gave Buzz Me too much credit?

No, you got it. I think I was too subtle though. 🙂

 

[Llenroc]

CC is pretty god damn stupid, when you already have the milliliter around.

 

[DylanAsdale]

You'd like to think so, but it isn't that simple.

1. There aren't a specific number of units of anything per mL. See the Dennis Quaid ordeal for one example.

2. The problem is that, when sloppily written, "cc" can appear like an undercase "u," which is what can cause the confusion. One hospital where I work has a poster with actual handwritten orders that are convincingly confusing and illegible. This is the best I could find online:

One could argue that if someone were dosing something by "cc's" and the order was interpreted as "u's," it would make no sense in the context in 99% of the cases, as anything that was dosed in units shouldn't be dosed by volume and vice versa, but the JCAHO recommendations are usually based on actual errors that have occurred. One has to safety-proof the system for the lowest common denominator, be it physician, nurse, tech or pharmacist. It is easier to limit the number of abbreviations used than it is to ensure every person in the hospital can read and comprehend an order.

Hmm, thanks for that. That was actually very informative 🙂