[Inability of hospital computerised physician order entry systems to secure the use of concentrated potassium intravenous solutions]. / Incapacité des logiciels d'aide à la prescription hospitaliers à sécuriser l'utilisation des solutions concentrées de potassium injectable.

OBJECTIVES: To determine whether hospital computerised physician order entry (CPOE) systems contribute to securing intravenous potassium chloride (KCl) prescriptions with reference to the recommendations issued by French healthcare agencies. METHODS: We sent a questionnaire to the members of the Association pour le Digital et l'Information en Pharmacie. RESULTS: More than three quarters of the 84 responses received involving 23 CPOE systems indicate that it is possible to: prescribe an ampoule of concentrated potassium chloride 10% 10mL intravenously without any diluents (80%); prescribe 4g of KCl in a bag of 500mL of NaCl 0,9% (98%); prescribe a solution that contains 6 grams of KCl per liter (94%); prescribe the administration of an injectable ampoule orally by means of a free text comment (83%). Nearly half of the responses indicate that it is possible to prescribe: concentrated KCl ampoules as administration solvent (50%); an injectable vial to be administered by oral route (52%). CONCLUSION: At least 23 hospital CPOE systems are unable to secure the prescriptions of injectable KCl. This finding lifts the veil on an unthought, namely the role of CPOE systems in securing high-risk medications. In order to solve this problem, it should be mandatory that health information technology vendors pay particular attention to these drugs. With regard to injectable KCl, the utilisation of a dilution vehicle, maximum concentration and maximum infusion flow rate are the first four constraints to be satisfied.

Phononic Crystal Made of Silicon Ridges on a Membrane for Liquid Sensing.

We propose the design of a phononic crystal to sense the acoustic properties of a liquid that is constituted by an array of silicon ridges on a membrane. In contrast to other concepts, the ridges are immersed in the liquid. The introduction of a suitable cavity in the periodic array gives rise to a confined defect mode with high localization in the cavity region and strong solid-liquid interaction, which make it sensitive to the acoustic properties of the liquid. By using a finite element method simulation, we theoretically study the transmission and cavity excitation of an incident flexural wave of the membrane. The observation of the vibrations of this mode can be achieved either outside the area of the phononic crystal or just above the cavity. We discuss the existence of the resonant modes, as well as its quality factor and sensitivity to liquid properties as a function of the geometrical parameters. The performance of the proposed sensor has then been tested to detect the variation in NaI concentration in a NaI-water mixture.

Love Wave Sensor with High Penetration Depth for Potential Application in Cell Monitoring.

Love wave (L-SAW) sensors have been used to probe cell monolayers, but their application to detect changes beyond the focal adhesion points on cell monolayers, as viscosity changes on the cytoskeleton, has not been explored. In this work we present for the first time a Love wave sensor with tuned penetration depth and sensitivity to potentially detect mechanical changes beyond focal adhesion points of cell monolayers. We designed and fabricated a Love wave sensor operating at 30 MHz with sensitivity to detect viscous changes between 0.89 and 3.3 cP. The Love wave sensor was modeled using an acoustic transmission line model, whereas the response of interdigital transducers (IDTs) was modeled with the Campbell's cross-field circuit model. Our design uses a substrate with a high electromechanical coupling coefficient (LiNbO3 36Y-X), and an 8-µm polymeric guiding layer (SU-8). The design aims to overcome the high insertion losses of viscous liquid environments, and the loss of sensitivity due to the low frequency. The fabricated sensor was tested in a fluidic chamber glued directly to the SU-8 guiding layer. Our experiments with liquids of viscosity similar to those expected in cell monolayers showed a measurable sensor response. In addition, experimentation with SaOs-2 cells within a culture medium showed measurable responses. These results can be of interest for the development of novel cell-based biosensors, and novel characterization tools for cell monolayers.