Warning safety alert

ISMP Medication Safety Alert —the nation s only biweekly publication that reaches nearly every U.S. hospital and tens of thousands of healthcare professional with warnings about medication errors and practical prevention strategies. 

As defined by American National Standards Institute (ANSI) 535.4, a sign or label to indicate a hazardons situation that if not avoided, could result in death or serious injury. Warning is to be indicated in black letters on an orange background. See also Cantion Label or Sign Safety Alert Symbol Safety Sign. 

FDA Safety Alert Hazards of Precipitation Associated With Parenteral Nutrition The Food and Drug Administration warned against the risk of precipitations in parenteral nutrition mixtures in 1994 [55]. This warning occurred after two deaths and at least two patients with dyspnoea after infusion of all-in-one nutrition admixmres. The FDA suspected that these admixtures contained calcium phosphate precipitates. 

Caution Use this message to warn of hazardous situations which may result in minor or moderate injury. Do not use for situations where there is a possibility of death or severe injury. Caution signs without a safety alert symbol may be used to alert against unsafe practices that can result in property damage only. Yellow is used to identify Caution signs. 

Control of site equipment is always important for safety and operational concerns. Many sites are remote or not staffed on a daily basis. Remediation equipment should be fitted with failsafe systems to shut down the system in the event of failure, fire, or unusual conditions (such as injection well plugging). Alarm systems should be included, which may be as simple as illuminating a warning hght, or as complex as a teleconnection to a remote computer station or telephone alert to the operator s residence. Many commercial companies offer remote monitoring equipment. 

In Britain, the medical community was alerted to the risks by an editorial in the British Medical Journal in 1971, but it was only in 1973 that the Committee on Safety of Medicines advised against the use of diethylstilbestrol during pregnancy (21). In Britain, drugs were commonly not labelled with information about their contents, nor with warnings of risk until well into the 1990s thus, patients were kept in ignorance. No measures have yet been taken in Britain to alert the public to the need for medical surveillance of women who have been exposed to diethylstilbestrol in utero. 

The safety of praziquantel in children under age 4 years is not established, but no specific problems in young children have been documented. Indeed, the drug appears to be better tolerated in children than in adults. Praziquantel increased abortion rates in rats and therefore should be avoided in pregnancy if possible. Because the drug induces dizziness and drowsiness, patients should not drive during therapy and should be warned regarding activities requiring particular physical coordination or alertness. 

Each item was evaluated both theoretically and experimentally to assure safety and reliability A large number of items were discarded because of inherent hazards or unreliable performance Safety warnings are prominently inserted in the procedures where they apply but it is emphasized that safety is a matter of attitude. It is a proven fact that men who are alert who think out a situation and who take correct precautions have fewer accidents than the careless and indifferent. It is important that work be planz>ed and that instructions be followed to the letter all work should be done In a neat and orderly manner. In the manufacture explosives detonators, propellants and incendiaries, equipment must be kept clean and such energy concentrations as sparks ... 

It would also be possible to input safety data on drugs to computer systems already used by prescribing physicians to store their patients records. The physician would then be alerted to any contraindications, warnings or precautions that may be relevant to individual patients if prescribed the drug. 

The authors also include a discussion of the current ASTM Z 535.2 proposal for Safety Signs. This system combines three elements color, shape, and signal words to create three stinctive levels of hazard alert signs. ASTM uses the traditional signal words Danger , Warning, Caution . These words are not independent elements, but are always combined with specific colors and specific shapes. 

Modern technology should help. For example, pharmacists are developing databases that help them to identify drug interactions. In the future, the medical history of a patient could be added to a card which could be used by a pharmacist to ensure that the patient s prescribed medicine is appropriate. It would also be possible to input safety data on drugs to computer systems already used by prescribing physicians to store their patients records. The physician would then be alerted to any contraindications, warnings or precautions that may be relevant to individual patients if prescribed the drug. 

Highway-rail intersection safety systems coordinates train movements with traffic signals at railroad grade crossings and alerts drivers with in-vehicle warning systems of approaching trains... 

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