Introduction
LASA stands for ‘look alike or sound alike’. The medical and dental prescription errors are not uncommon in India as a large number of prescriptions are hand written. The dispensing errors in wrong dispensing of medicament due to similar appearance also forms a significant percentage in total errors. These errors because of similar look or sound are called as ‘LASA’ errors and is health threat to patients receiving them; in addendum to this, it also forms 7-20 % of all medication errors. It has been reported in USA that LASA errors contribute more than 1% of total medication errors which resulted in patient harm. The common reasons for LASA errors are medications with similar names, appearance or packaging which may lead to inappropriate dose or drugs. The unreadable handwriting, limited pharamacological knowledge and less manpower are some of the notified reasons for LASA errors. 1, 2
Examples of LASA Errors
‘Cetirizine 10 mg’ and ‘Cinnarizine 25 mg’ is one example of LASA error. Another example is of ‘Calcium 1250 mg’ and ‘Carvedilol 12.5 mg’. In dental practice, there are reported cases of injecting ‘sodium hypochlorite, normal saline, formalin and chloroform’ instead of ‘lignocaine’ in the form of local anaesthesia while doing endodontic treatments. This happens as the syringes loaded with these medicaments appears similar. Therefore, the medical and dental staff should be trained in dispensing these similar looking medicaments with utmost care and clarity.
Advisable remedies to prevent LASA errors:1, 2, 3, 4
Tall an letters
Tall man letters are some specific letters written in uppercase format in a particular name to highlight or distinguish that name. For example, ‘PheNobarb’and ‘PerPhenaZine’, the similar looking names can be distinguished by putting some specific letters in upper case as done in above example (Tall man letters are kept here in bold for explanation). ‘Tall Man’ strategy is widely used in healthcare sectors to prevent LASA errors and the list of Tall Man letters is also available in hospitals to improve the medication safety. However, this measure should be combined with other methods as many subjects doubt the effectiveness of this approach.
LASA signage
Signage refers to signs or symbols used collectively for public displays like signage on roads displayed for safety. LASA signage is method where a sticker or magnet of a specific colour should be fixed on the medication racks or inventory of similar appearing drugs. This signage could be useful as a warning sign for staff awareness in reducing medication errors.
Increasing manpower
Increasing staff members in rush hours of the operatory is also one recommended strategy as the chances of errors increases during this time.
Separate placement of medicines with similar generic names but with different dosses or placement of separate identification marks
The medicines or medicaments of similar appearances can be kept separately or marked with separate identification methods. For example, ‘2ml syringe’ should be used for Local Anaesthesia with lignocaine and ‘5 ml syringe’ to be used for sodium hypochlorite and ‘10 ml syringe’ to be used for normal saline while doing endodontic treatment.
