Measurements of adequacy of anesthesia and level of consciousness during surgery and intensive care

The adequacy of anesthesia has been studied since the introduction of balanced general anesthesia. Commercial monitors based on electroencephalographic (EEG) signal analysis have been available for monitoring the hypnotic component of anesthesia from the beginning of the 1990s. Monitors measuring the depth of anesthesia assess the cortical function of the brain, and have gained acceptance during surgical anesthesia with most of the anesthetic agents used. However, due to frequent artifacts, they are considered unsuitable for monitoring consciousness in intensive care patients. The assessment of analgesia is one of the cornerstones of general anesthesia. Prolonged surgical stress may lead to increased morbidity and delayed postoperative recovery. However, no validated monitoring method is currently available for evaluating analgesia during general anesthesia. Awareness during anesthesia is caused by an inadequate level of hypnosis. This rare but severe complication of general anesthesia may lead to marked emotional stress and possibly posttraumatic stress disorder. In the present series of studies, the incidence of awareness and recall during outpatient anesthesia was evaluated and compared with that of in inpatient anesthesia. A total of 1500 outpatients and 2343 inpatients underwent a structured interview. Clear intraoperative recollections were rare the incidence being 0.07% in outpatients and 0.13% in inpatients. No significant differences emerged between outpatients and inpatients. However, significantly smaller doses of sevoflurane were administered to outpatients with awareness than those without recollections (p<0.05). EEG artifacts in 16 brain-dead organ donors were evaluated during organ harvest surgery in a prospective, open, nonselective study. The source of the frontotemporal biosignals in brain-dead subjects was studied, and the resistance of bispectral index (BIS) and Entropy to the signal artifacts was compared. The hypothesis was that in brain-dead subjects, most of the biosignals recorded from the forehead would consist of artifacts. The original EEG was recorded and State Entropy (SE), Response Entropy (RE), and BIS were calculated and monitored during solid organ harvest. SE differed from zero (inactive EEG) in 28%, RE in 29%, and BIS in 68% of the total recording time (p<0.0001 for all). The median values during the operation were SE 0.0, RE 0.0, and BIS 3.0. In four of the 16 organ donors, EEG was not inactive, and unphysiologically distributed, nonreactive rhythmic theta activity was present in the original EEG signal. After the results from subjects with persistent residual EEG activity were excluded, SE, RE, and BIS differed from zero in 17%, 18%, and 62% of the recorded time, respectively (p<0.0001 for all). Due to various artifacts, the highest readings in all indices were recorded without neuromuscular blockade. The main sources of artifacts were electrocauterization, electromyography (EMG), 50-Hz artifact, handling of the donor, ballistocardiography, and electrocardiography. In a prospective, randomized study of 26 patients, the ability of Surgical Stress Index (SSI) to differentiate patients with two clinically different analgesic levels during shoulder surgery was evaluated. SSI values were lower in patients with an interscalene brachial plexus block than in patients without an additional plexus block. In all patients, anesthesia was maintained with desflurane, the concentration of which was targeted to maintain SE at 50. Increased blood pressure or heart rate (HR), movement, and coughing were considered signs of intraoperative nociception and treated with alfentanil. Photoplethysmographic waveforms were collected from the contralateral arm to the operated side, and SSI was calculated offline. Two minutes after skin incision, SSI was not increased in the brachial plexus block group and was lower (38 ± 13) than in the control group (58 ± 13, p<0.005). Among the controls, one minute prior to alfentanil administration, SSI value was higher than during periods of adequate antinociception, 59 ± 11 vs. 39 ± 12 (p<0.01). The total cumulative need for alfentanil was higher in controls (2.7 ± 1.2 mg) than in the brachial plexus block group (1.6 ± 0.5 mg, p=0.008). Tetanic stimulation to the ulnar region of the hand increased SSI significantly only among patients with a brachial plexus block not covering the site of stimulation. Prognostic value of EEG-derived indices was evaluated and compared with Transcranial Doppler Ultrasonography (TCD), serum neuron-specific enolase (NSE) and S-100B after cardiac arrest. Thirty patients resuscitated from out-of-hospital arrest and treated with induced mild hypothermia for 24 h were included. Original EEG signal was recorded, and burst suppression ratio (BSR), RE, SE, and wavelet subband entropy (WSE) were calculated. Neurological outcome during the six-month period after arrest was assessed with the Glasgow-Pittsburgh Cerebral Performance Categories (CPC). Twenty patients had a CPC of 1-2, one patient had a CPC of 3, and nine patients died (CPC 5). BSR, RE, and SE differed between good (CPC 1-2) and poor (CPC 3-5) outcome groups (p=0.011, p=0.011, p=0.008, respectively) during the first 24 h after arrest. WSE was borderline higher in the good outcome group between 24 and 48 h after arrest (p=0.050). All patients with status epilepticus died, and their WSE values were lower (p=0.022). S-100B was lower in the good outcome group upon arrival at the intensive care unit (p=0.010). After hypothermia treatment, NSE and S-100B values were lower (p=0.002 for both) in the good outcome group. The pulsatile index was also lower in the good outcome group (p=0.004). In conclusion, the incidence of awareness in outpatient anesthesia did not differ from that in inpatient anesthesia. Outpatients are not at increased risk for intraoperative awareness relative to inpatients undergoing general anesthesia. SE, RE, and BIS showed non-zero values that normally indicate cortical neuronal function, but were in these subjects mostly due to artifacts after clinical brain death diagnosis. Entropy was more resistant to artifacts than BIS. During general anesthesia and surgery, SSI values were lower in patients with interscalene brachial plexus block covering the sites of nociceptive stimuli. In detecting nociceptive stimuli, SSI performed better than HR, blood pressure, or RE. BSR, RE, and SE differed between the good and poor neurological outcome groups during the first 24 h after cardiac arrest, and they may be an aid in differentiating patients with good neurological outcomes from those with poor outcomes after out-of-hospital cardiac arrest.

Climate change and forests in India: adaptation opportunities and challenges

Climate change is projected to lead to shift of forest types leading to irreversible damage to forests by rendering several species extinct and potentially affecting the livelihoods of local communities and the economy. Approximately 47% and 42% of tropical dry deciduous grids are projected to undergo shifts under A2 and B2 SRES scenarios respectively, as opposed to less than 16% grids comprising of tropical wet evergreen forests. Similarly, the tropical thorny scrub forest is projected to undergo shifts in majority of forested grids under A2 (more than 80%) as well as B2 scenarios (50% of grids). Thus the forest managers and policymakers need to adapt to the ecological as well as the socio-economic impacts of climate change. This requires formulation of effective forest management policies and practices, incorporating climate concerns into long-term forest policy and management plans. India has formulated a large number of innovative and progressive forest policies but a mechanism to ensure effective implementation of these policies is needed. Additional policies and practices may be needed to address the impacts of climate change. This paper discusses an approach and steps involved in the development of an adaptation framework as well as policies, strategies and practices needed for mainstreaming adaptation to cope with projected climate change. Further, the existing barriers which may affect proactive adaptation planning given the scale, accuracy and uncertainty associated with assessing climate change impacts are presented.

Low-Complexity Detection and Performance in Multi-Gigabit High Spectral Efficiency Wireless Systems

Recently, we reported a low-complexity likelihood ascent search (LAS) detection algorithm for large MIMO systems with several tens of antennas that can achieve high spectral efficiencies of the order of tens to hundreds of bps/Hz. Through simulations, we showed that this algorithm achieves increasingly near SISO AWGN performance for increasing number of antennas in Lid. Rayleigh fading. However, no bit error performance analysis of the algorithm was reported. In this paper, we extend our work on this low-complexity large MIMO detector in two directions: i) We report an asymptotic bit error probability analysis of the LAS algorithm in the large system limit, where N-t, N-r -> infinity keeping N-t = N-r, where N-t and N-r are the number of transmit and receive antennas, respectively. Specifically, we prove that the error performance of the LAS detector for V-BLAST with 4-QAM in i.i.d. Rayleigh fading converges to that of the maximum-likelihood (ML) detector as N-t, N-r -> infinity keeping N-t = N-r ii) We present simulated BER and nearness to capacity results for V-BLAST as well as high-rate non-orthogonal STBC from Division Algebras (DA), in a more realistic spatially correlated MIMO channel model. Our simulation results show that a) at an uncoded BER of 10(-3), the performance of the LAS detector in decoding 16 x 16 STBC from DA with N-t = = 16 and 16-QAM degrades in spatially correlated fading by about 7 dB compared to that in i.i.d. fading, and 19) with a rate-3/4 outer turbo code and 48 bps/Hz spectral efficiency, the performance degrades by about 6 dB at a coded BER of 10(-4). Our results further show that providing asymmetry in number of antennas such that N-r > N-t keeping the total receiver array length same as that for N-r = N-t, the detector is able to pick up the extra receive diversity thereby significantly improving the BER performance.

Fabrication and evaluation of 450 F electrochemical redox supercapacitors using inexpensive and high-performance, polyaniline coated, stainless-steel electrodes

Redox supercapacitors using polyaniline (PANI) coated. stainless-steel (SS) electrodes have been assembled and characterized. PANI has been deposited on SS substrate by a potentiodynamic method from an acidic electrolyte which contains aniline monomer. By employing stacks of electrodes, each with a geometrical area of 24 cm(2), in acidic perchlorate electrolyte, a capacitance value of about 450 F has been obtained over a long cycle-life. Characterization studies have been carried out by galvanostatic charge-discharge cycling of the capacitors singly, as well as in series and parallel configurations. Various electrical parameters have been evaluated. Use of the capacitors in parallel with a battery for pulse-power loads. and also working of a toy fan connected to the charged capacitors have been demonstrated. A specific capacitance value of about 1300 F g(-1) of PANI has been obtained at a discharge power of about 0.5 kW kg(-1). This value is several times higher than those reported in the literature for PANI and is, perhaps, the highest value known for a capacitor material. The inexpensive SS substrate and the high-capacitance PANI are favorable factors for commercial exploitation. (C) 2002 Elsevier Science B.V. All rights reserved.

Crystal Structure, Thermal Expansion and ElectricaH Conductivity of Yo.sCao.2Fel-x Mnx03+o (0 < x < 1.0)

The crystal structure, thennal expansion and electrical conductivity of the solid solutions YOgCao.2Fel-x MnxOJ+c5 (0 ~ x ~ 1.0) were investigated. All compositions had the GdFeOrtype orthorhombic perovskite structure with trace amounts of a second phase present in case of x = 0.8 and 1.0. The lattice parameters were detennined at room tempe'rature by using X-ray powder diffraction (XRPD). The pseudocubic lattice constant decreased with increasing x. The average I inear thermal expansion coefficient (anv) in the temperature range from 673 to 973 K showed negligible change with x up to x = 0.4. The thennal expansion curve for x = I had a slope approaching zero in the temperature range from 648 to 948 K. The calculated activation energy values for electrical conduction indicate that conduction occurs primarily by the small polaron hopping mechanism. The drastic drop in electrical conductivity for a small addition of Mn (0 ~ x ~ 0.2) is caused by the preferential fonnation of Mn4t ion~ (rather than Fe4 +) which act as carrier traps. This continues till the charge compensation for the divalent ions on the A-site is complete. The results indicate that with further increase in manganese content (beyond x =0.4) in the solid solutions, there is an increase in exc :::ss oxygen and consequently, a small increase in Mn'll il>I1~, which are charge compensated by the formation of cation vancancies.

Experimental and computational studies on a gasifier based stove

The work reported here is concerned with a detailed thermochemical evaluation of the flaming mode behaviour of a gasifier based stove. Determination of the gas composition over the fuel bed, surface and gas temperatures in the gasification process constitute principal experimental features. A simple atomic balance for the gasification reaction combined with the gas composition from the experiments is used to determine the CH(4) equivalent of higher hydrocarbons and the gasification efficiency (eta g). The components of utilization efficiency, namely, gasification-combustion and heat transfer are explored. Reactive flow computational studies using the measured gas composition over the fuel bed are used to simulate the thermochemical flow field and heat transfer to the vessel; hither-to-ignored vessel size effects in the extraction of heat from the stove are established clearly. The overall flaming mode efficiency of the stove is 50-54%; the convective and radiative components of heat transfer are established to be 45-47 and 5-7% respectively. The efficiency estimates from reacting computational fluid dynamics (RCFD) compare well with experiments. (C) 2011 Elsevier Ltd. All rights reserved.

Microstructure and dry sliding wear resistance evaluation of plasma nitrided austenitic stainless steel type AISI 316LN against different sliders

In this work, Plasma Nitriding was carried out at a temperature of 570 degrees C on nuclear grade austenitic stainless steel type AISI 316 LN (316LN SS) in a gas mixture of 20% N-2-80% H-2 to improve the surface hardness and thereby sliding wear resistance. The Plasma Nitride (PN) treated surface has been characterized by Vickers microhardness measurements, Scanning Electron Microscopic (SEM) examination, X-ray Diffraction (XRD) and sliding wear assessment. The average thickness of the PN layer was found to be 70 mu m. Microhardness measurements showed a significant increase in the hardness from 210 HV25g (unnitrided sample) to 1040 HV25g (Plasma Nitrided sample). The XRD reveals that PN layer consists of CrN, Fe4N and Fe3N phases along with austenite phase. The tribological parameters such as the friction coefficient and wear mechanism have been evaluated at ambient conditions for PN treated ring (PN ring) vs. ASTM A453 grade 660 pin (ASTM pin), PN ring vs. Nickel based alloy hard faced pin (Colmonoy pin), PN ring vs. 316LN SS pin and 316LN SS ring vs. 316LN SS pin. The wear tracks have been analyzed by SEM, Energy Dispersive X-ray Analysis (EDX) and Optical Profilometry. The untreated 316LN SS ring vs. 316LN SS pin produced severe wear and was characterized by a combination of delamination and adhesion wear mechanism, whereas wear mechanism of the PN rings reveals mild abrasion and a transfer layer from pin materials. (C) 2012 Elsevier B.V. All rights reserved.

DNA and protein targeting 1,2,4-triazole based water soluble dinickel(II) complexes enhances antiproliferation and lactate dehydrogenase inhibition

Water soluble dinickel(II) complexes Ni-2(L)(2)(1-2)](NO3)(4) (1-2), where L1-2 are triazole based dinucleating ligands, were synthesized and characterized. The DNA binding, protein binding, DNA hydrolysis and anticancer properties were investigated. The interactions of complexes 1 and 2 with calf thymus DNA were studied by spectroscopic techniques, including absorption and fluorescence spectroscopy. The DNA binding constant values of the complexes 1 and 2 were found to be 2.36 x 10(5) and 4.87 x 10(5) M-1 and the binding affinities are in the following order: 2 > 1. Both the dinickel(II) complexes 1 and 2, promoted the hydrolytic cleavage of plasmid pBR322 DNA under both anaerobic and aerobic conditions. Kinetic data for DNA hydrolysis promoted by 1 and 2 under physiological conditions give the observed rate constants (k(obs)) of 5.05 +/- 0.2 and 5.65 +/- 0.1 h(-1), respectively, which shows 10(8)-fold rate acceleration over the uncatalyzed reaction of ds-DNA. Meanwhile, the interactions of the complex with BSA have also been studied by spectroscopy. Both the complexes 1 and 2 display strong binding propensity and the binding constant (K-b), number of binding sites (n) were obtained are 0.71 x 10(6) 1.47] and 5.62 x 10(6) 1.98] M-1, respectively. The complexes 1 and 2 also promoted the apoptosis against human carcinoma (HeLa, and BeWo) cancer cells. Cytotoxicity of the complexes was further confirmed by lactate dehydrogenase enzyme level in cancer cell lysate and content media. (c) 2013 Elsevier Ltd. All rights reserved.

Effects of temperature and clay content on water absorption characteristics of modified MMT clay/cyclic olefin copolymer nanocomposite films: Permeability, dynamic mechanical properties and the encapsulated organic device performance

In the present study, amino-silane modified layered organosilicates were used to reinforce cyclic olefin copolymer to enhance the thermal, mechanical and moisture impermeable barrier properties. The optimum clay loading (4%) in the nanocomposite increases the thermal stability of the film while further loading decreases film stability. Water absorption behavior at 62 degrees C was carried out and compared with the behavior at room temperature and 48 degrees C. The stiffness of the matrix increases with clay content and the recorded strain to failure for the composite films was lower than the neat film. Dynamic mechanical analysis show higher storage modulus and low loss modulus for 2.5-4 wt% clay loading. Calcium degradation test and device encapsulation also show the evidence of optimum clay loading of 4 wt% for improved low water vapor transmission rates compared to other nanocomposite films. (C) 2014 Elsevier Ltd. All rights reserved.

Simultaneous enhancement in mechanical strength, electrical conductivity, and electromagnetic shielding properties in PVDF-ABS blends containing PMMA wrapped multiwall carbon nanotubes

A unique approach was adopted to drive the multiwall carbon nanotubes (MWNTs) to the interface of immiscible PVDF-ABS blends by wrapping the nanotubes with a mutually miscible homopolymer (PMMA). A tailor made interface with an improved stress transfer was achieved in the blends with PMMA wrapped MWNTs. This manifested in an impressive 108% increment in the tensile strength and 48% increment in the Young's modulus with 3 wt% PMMA wrapped MWNTs in striking contrast to the neat blends. As the PMMA wrapped MWNTs localized at the interface of PVDF-ABS blends, the electrical conductivity could be tuned with respect to only MWNTs, which were selectively localized in the PVDF phase, driven by thermodynamics. The electromagnetic shielding properties were assessed using a vector network analyser in a broad range of frequency, X-band (8-12 GHz) and Ku-band (12-18 GHz). Interestingly, enhanced EM shielding was achieved by this unique approach. The blends with only MWNTs shielded the EM waves mostly by reflection however, the blends with PMMA wrapped MWNTs (3 wt%) shielded mostly by absorption (62%). This study opens new avenues in designing materials, which show simultaneous improvement in mechanical, electrical conductivity and EM shielding properties.

Solution processed Cu2SnS3 thin films for visible and infrared photodetector applications

The Cu2SnS3 thin films were deposited using an economic, solution processible, spin coating technique. The films were found to possess a tetragonal crystal structure using X-ray diffraction. The film morphology and the particle size were determined using scanning electron microscopy. The various planes in the crystal were observed using transmission electron microscopy. The optimum band gap of 1.23 eV and a high absorption coefficient of 104 cm-1 corroborate its application as a photoactive material. The visible and infrared (IR) photo response was studied for various illumination intensities. The current increased by one order from a dark current of 0.31 mu A to a current of 1.78 mu A at 1.05 suns and 8.7 mu A under 477.7 mW/cm(2) IR illumination intensity, at 3 V applied bias. The responsivity, sensitivity, external quantum efficiency and specific detectivity were found to be 10.93 mA/W, 5.74, 2.47% and 3.47 x 10(10) Jones respectively at 1.05 suns and 16.32 mA/W, 27.16, 2.53% and 5.10 x 10(10) Jones respectively at 477.7 mW/cm(2) IR illumination. The transient photoresponse was measured both for visible and IR illuminations. (C) 2016 Author(s).

Flower Garden Banks National Marine Sanctuary: A rapid assessment of coral, fish, and algae using the AGRRA Protocol

The Flower Garden Banks are topographic features on the edge of the continental shelf in the northwest Gulf of Mexico. These banks are approximately 175 km southeast of Galveston, Texas at 28° north latitude and support the northernmost coral reefs on the North American continental shelf. The East and West Flower Garden Banks (EFG and WFG) and Stetson Bank, a smaller sandstone bank approximately 110 km offshore, are managed and protected as the Flower Garden Banks National Marine Sanctuary (FGBNMS). As part of a region-wide initiative to assess coral reef condition, the benthic and fish communities of the EFG and WFG were assessed using the Atlantic and Gulf Rapid Reef Assessment (AGRRA) protocol. The AGRRA survey was conducted during a week-long cruise in August 1999 that was jointly sponsored by the FGBNMS and the Reef Environmental Education Foundation (REEF). A total of 25 coral transects, 132 algal quadrats, 24 fish transects, and 26 Roving Diver (REEF) surveys were conducted. These surveys revealed reefs with high coral cover, dominated by large, healthy corals, little macroalgae, and healthy fish populations. The percent live coral cover was 53.9 and 48.8 at the WFG and EFG, respectively, and the average colony diameter was 93 and 81 cm. Fish diversity was lower than most Caribbean reefs, but large abundances and size of many species reflected the low fishing pressure on the banks. The benthic and fish assemblages at the EFG and WFG were similar. Due to its near pristine conditions, the FGB data will prove to be a valuable component in the AGRRA database and its resulting scale of reef condition for the region. (PDF contains 22 pages.)

Seasonal Climatologies and Variability of Eastern Tropical Pacific Surface Waters

Interannual variability caused by the El Nino-Southern Oscillation in the eastern tropical Pacific Ocean (ETP) is analogous to seasonal variability of comparable magnitude. Climatological spatial patterns and seasonal variability of physical variables that may affect the ETP ecosystem are presented and discussed. Surface temperature, surface salinity, mixed layer depth, thermocline depth, thermocline strength, and surface dynamic height were derived from bathythermograph, hydrocast, and CTD data. Surface current velocity, divergence, and upwelling velocity were derived from ship drift reports. Surface wind velocity, wind stress, wind divergence, wind stress curl, and Ekman pumping velocity were derived from gridded pseudostress data obtained from Florida State University. Seasonal maps of these variables, and their deviations from the annual mean, show different patterns of variation in Equatorial (S°S-SON) and Tropical Surface Water (SOlS0N). Seasonal shifts in the trade winds, which affect the strength of equatorial upwelling and the North Equatorial Countercurrent, cause seasonal variations in most variables. Seasonal and interannual variability of surface temperature, mixed layer depth, thermocline depth and wind stress were quantified. Surface temperature, mixed layer depth and thermocline depth, but not local wind stress, are less variable in Tropical Surface Water than in Equatorial Surface Water. Seasonal and interannual variability are close to equal in most of the ETP, within factors of 2 or less. (PDF file contains 70 pages.)

Impact of Nigerian Agricultural Cooperative and Rural Development Bank (NACRDB) loan to artisanal fishermen in Lake Kainji

This study was conducted to assess the impact of Nigerian Agricultural, Co-operative and Rural Development Bank Loan on beneficiaries and non-beneficiaries fishermen in Lake Kainji. A total of fifty fishermen (25 beneficiaries and 25 non-beneficiaries) were randomly selected from five fishing villages along the lake basin. Data collected were scored and the percentages of the parameters were calculated appropriately. The types of loans disbursed to beneficiaries revealed that 52% was cash and 48% was in kind. The credit package ranged between N5, 000 to N150, 000 only. Only 48% of the loans granted were paid while the rest remained unpaid. The results obtained from the membership of fishermen Cooperative showed that 64% of beneficiaries were members while 36% were non-members. Also 36% of non-beneficiaries were members while 64% were not. The Common fishing gears used by the two categories of fishermen include gillnets longline, castnet and driftnets. Sixty percent of beneficiaries and 8% of non-beneficiaries fishermen were using canoe with outboard engines while the rest used canoes with paddles. Beneficiaries earned a higher income (N1, 000 to N9, 000) daily than non-beneficiaries (N1, 000 to N6, 000) daily from sales of fish caught. Major contrainsts to increased catch and income identified include inadequate capital, non- availability of fishing inputs, stealing of fishing gears, lack of access to credit facilities and menace of stump and water hyacinth in the lake. Lastly, recommendation were made for the bank management, government and other lending institutions on how to improve the livelihood of the Artisanal fishermen by increasing the loan usually granted

Preparo e administração de medicamentos por sondas em pacientes que recebem nutrição enteral

O objeto de estudo foi o preparo e a administração de medicamentos por cateter pela enfermagem em pacientes que recebem nutrição enteral. O objetivo geral foi investigar o padrão de preparo e administração dos medicamentos por cateter em pacientes que recebem nutrição enteral concomitante. Os objetivos específicos foram apresentar o perfil dos medicamentos preparados e administrados de acordo com a possibilidade de serem administrados por cateter enteral e avaliar o tipo e a freqüência de erros que ocorrem no preparo e administração de medicamentos por cateter. Tratou-se de uma pesquisa com desenho transversal de natureza observacional, sem modelo de intervenção. Foi desenvolvida em um hospital do Rio de Janeiro onde foram observados técnicos de enfermagem preparando e administrando medicamentos por cateter na Unidade de Terapia Intensiva. Foram observadas 350 doses de medicamentos sendo preparados e administrados. Os grupos de medicamentos prevalentes foram os que agem no Sistema Cardiovascular Renal com 164 doses (46,80%), seguido pelos que agem no Sistema Respiratório e Sangue com 12,85% e 12,56% respectivamente. Foram encontrados 19 medicamentos diferentes do primeiro grupo, dois no segundo e cinco no terceiro. As categorias de erro no preparo foram trituração, diluição e misturas. Encontrou-se uma taxa média de 67,71% no preparo de medicamentos. Comprimidos simples foram preparados errados em 72,54% das doses, e todos os comprimidos revestidos e de liberação prolongada foram triturados indevidamente entre sólidos a categoria de erro prevalente foi trituração com 45,47%, preparar misturando medicamentos foi um erro encontrado em quase 40% das doses de medicamentos sólidos. A trituração insuficiente ocorreu em 73,33% das doses de ácido fólico, do cloridrato de amiodarona (58,97%) e bromoprida (50,00%). A mistura com outros medicamentos ocorreu em 66,66% das doses de bromoprida, de besilato de anlodipina (53,33%), bamifilina (43,47%), ácido fólico (40,00%) e ácido acetilsalicílico (33,33%). Os erros na administração foram ausência de pausa e manejo indevido do cateter. A taxa média de erros na administração foi de 32,64%, distribuídas entre 17,14% para pausa e 48,14% para manejo do cateter. A ausência de lavagem do cateter antes foi o erro mais comum e o mais incomum foi não lavar o cateter após a administração. Os medicamentos mais envolvidos em erros na administração foram: cloridrato de amiodarona (n=39), captopril (n=33), cloridrato de hidralazina (n=7), levotiroxina sódica (n=7). Com relação à lavagem dos cateteres antes, ela não ocorreu em 330 doses de medicamentos. O preparo e administração inadequados de medicamentos podem levar à perdas na biodisponibilidade, diminuição do nível sérico e riscos de intoxicações para o paciente. Preparar e administrar medicamentos são procedimentos comuns, porém apresentou altas taxas de erros, o que talvez reflita pouco conhecimento desses profissionais sobre as boas práticas da terapia medicamentosa. Constata-se a necessidade de maior investimento de todos os profissionais envolvidos, médicos, enfermeiros e farmacêuticos nas questões que envolvam a segurança com medicamentos assim como repensar o processo de trabalho da enfermagem.