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Drug Calculation Errors in Anesthesia

Would You Pass the Test?

Wanderer, Jonathan P., MD, MPhil; Nathan, Naveen, MD

doi: 10.1213/ANE.0000000000004198
Infographics: Infographic

Vanderbilt University School of Medicine (

Northwestern University Feinberg School of Medicine (

Published ahead of print 27 March 2019.

The Infographic is composed by Jonathan P. Wanderer, MD, MPhil, Vanderbilt University School of Medicine (, and Naveen Nathan, MD, Northwestern University Feinberg School of Medicine ( Illustration by Naveen Nathan, MD.

The authors declare no conflicts of interest.



The practice of anesthesia frequently requires administration of a diverse set of medications under time pressure, without the aid of multiple checks on drug concentrations and infusion rates that occur in other acute care settings. This requires anesthesia providers to consistently and correctly perform complex calculations. In this infographic, through an interactive approach, we review the results of a drug calculation study in which anesthesia attending physicians and residents completed a written assessment of their computation acumen. We describe the factors that influence performance on this examination and factors that might reduce computation errors in the perioperative setting.

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1. Black S, Lerman J, Banks SE, et al. Drug calculation errors in anesthesiology residents and faculty: an analysis of contributing factors. Anesth Analg. 2019;128:1292–1299.
2. Fromer IR, Prielipp RC. Doing the math: computation errors during critical drug administration. Anesth Analg. 2019;128:10681070.
    © 2019 International Anesthesia Research Society