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INFUSION RATE CALCULATIONS. REVIEW ANESTHESIA DRUG DOSE. ATROPINE. Dose- 0.4 to 0.6 mg IM 45 to 60 minutes prior to anesthesia. PROMETHAZINE. Dose- 25 to 50 mg IM, slow IV, rectal, or PO 30 minutes prior to anesthesia. DIAZEPAM. Induction Dose- 0.3 to 0.5 mg/kg slow IV
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ATROPINE • Dose- 0.4 to 0.6 mg IM 45 to 60 minutes prior to anesthesia
PROMETHAZINE • Dose- 25 to 50 mg IM, slow IV, rectal, or PO 30 minutes prior to anesthesia
DIAZEPAM • Induction • Dose- 0.3 to 0.5 mg/kg slow IV • Muscle relaxation • Dose- 1.0 to 2.0 mg slow IV prn
KETAMINE • Induction • Dose- 1.0 to 2.0 mg/kg slow IV • Maintenance • Dose- 30 to 90 mcg/kg/min IV drip
MIDAZOLAM • Induction • Dose- 0.15 to 0.4 mg/kg/ slow IV
MORPHINE • Maintenance dose 2 to 20 mcg/kg/ IV drip
NALOXONE • Overdose - 1.0 to 2.0 mg slow IV q 5 minutes up to 3 times • Maintenance - 400 mcg IV drip over one hour
FLUMAZENIL • Reversal of conscious sedation • Dose- 0.2 to 1.0 mg slow IV q 20 minutes @ 0.2 mg/min • Overdose • Dose- 3.0 to 5.0 mg slow IV @ 0.5 mg/min
INTRAVENOUS INFUSION FORMULA • Set up 50ml x 2400mcg x 60gtts 400mg 1 min 1ml
INTRAVENOUS INFUSION FORMULA • Reduce 1ml x 2.4mg x 60gtts 8mg 1min 1ml
INTRAVENOUS INFUSION FORMULA • Cancel 1 x 2.4 x 60gtts 8 1min 1
INTRAVENOUS INFUSION FORMULA • Multiply 144gtts 8min Can this be reduce ?
INTRAVENOUS INFUSION FORMULA • Reduce 144gtts 8min to 18gtts 1min
PR0BLEMS • Patient is a 22 year old, 70 kg male with a GSW to the left thigh. Pulse 90 s/r, resp 18 d/r, BP 110/78, temp 98.4. Patient is in fair condition and is stable
PR0BLEMS • What dose and route for preanesthetic atropine will you give?
PR0BLEMS • preanesthetic atropine, 0.5mg IM
PR0BLEMS • What is the dose and route for preanesthetic promethazine for this patient?
PR0BLEMS • preanesthetic promethazine, 50 mg IV slow
PR0BLEMS • What is the IV induction dose of diazepam for this patient?
PR0BLEMS • IV induction dose of diazepam, 35mg • What route/rate?
PR0BLEMS • route/rate, IV @ < 5mg/min
PR0BLEMS • With an infusion setup of 2.0 grams of ketamine in a 1000ml bag of 0.9% NaCl connected to a microdrip administration set what is the minimum maintenance rate in gtts/min?
PR0BLEMS • 63gtts/min
PROBLEMS • What is the maximum infusion rate? Multiply minimum by 3.
PROBLEMS • 189gtts/min
PR0BLEMS • How long will this same infusion setup last at the maximum maintenance rate (must know how many drops are in the bag)?
PR0BLEMS • Take the ml in the bag X the drop of the administration set = drops in bag.
PR0BLEMS • 1000ml X 60gtts = 60,000gtts
PR0BLEMS • Then divide 60,000gtts by 189gtts.
PR0BLEMS • 317minutes (About 5 hours and 28 minutes )
PR0BLEMS • At the minimum maintenance rate?
PR0BLEMS • At the minimum maintenance rate? • Just multiply maximum by 3
PR0BLEMS • Just multiply maximum by 3 = 960 minutes
PR0BLEMS • A 50ml bolus from the maintenance bag will give the patient how much Ketamine?
PR0BLEMS • 2000mg divided by 1000ml = 2mg per 1ml
PR0BLEMS • 2mg X 50ml = 100mg Ketamine
PR0BLEMS • What is the dose and rate of flumazenil for a benzodiazepine overdose in this patient?
PR0BLEMS • The dose and rate of flumazenil for a benzodiazepine overdose, 5mg IV @ 0.5mg/min
PR0BLEMS • What is the maximum amount of 2% lidocaine with epinephrine that can be given to this patient ( in ml )?
PR0BLEMS • The maximum amount of 2% lidocaine with epinephrine that can be given to this patient ( in ml ), 490mg. • How many ml?
PR0BLEMS • 2% lidocaine with epinephrine = 20mg per ml. • 490mg divided by 20mg per ml = how many ml?
PR0BLEMS • 24.5 ml