To the Editor.—
I strongly endorse the view of Hoffman et al1 that "orders including terms such as 'amps,' 'pills,' 'vials,' or 'tab' without further specification should neither be written by physicians nor accepted by nurses. More precise doses of a solution of given concentration must be stated." However, the authors do not go quite far enough. Hoffman et al state in case 1 that the patient "was treated with... normal saline." However, "a normal solution is one having a concentration equivalent to a gram-equivalent of solute per liter."2 Thus, a normal solution of sodium chloride contains 58.45 g/L. This is hardly the 9 g/L meant by the author as "normal saline." It would be nice to see the latter term dropped from the medical literature and replaced with "0.9% sodium chloride solution."
Manson FE. Normal? JAMA. 1989;261(23):3408. doi:10.1001/jama.1989.03420230060014
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