Base Hospital 2003 Fall Recerts.

1. Base Hospital2003 Fall Recerts. Medical Mathand Drug Calculations

2. mg/kg/min ml/cc Milligrams Milligrams Kilograms Making Sence of Medical Math Milliliters gtts/min mg mg Kilograms gtts/min mg/kg/min ml/cc mg Milligrams mg/kg/min gtts/min mg/kg/min ml/cc Kilograms Milliliters Kilograms gtts/min Kilograms ml/cc mg/kg/min ml/cc mg Milliliters Milligrams gtts/min gtts/min Kilograms Milliliters ml/cc Milliliters mg Milligrams mg

3. Pre/Post Course Math • Overall well done • Some problems were found in the Precourse • Paramedics did not show their work, therefore it was hard to determine the problem.

4. Calculators and medication tables are more than welcome, only if you intend on using them in your practice. • You are encouraged to use the formulas supplied. If you have your own method and it works for you, do it your way.

5. Where will I apply medical math??

6. HOW MUCH TO ADMINISTER WANT ---------- = AMOUNT TO ADMINISTER HAVE

7. WANT • Protocols I.e. 0.3mg Epi. 1:1,000 SC • Verbal Orders by patch phone • Written Orders on Patient chart

8. HAVE • Concentration of the Drug • Nitro, Salbutamol, Glucagon, Lidocaine, etc. • Contents of the IV Bag • Amount in a given Ampoule or Vial

9. Weight vs. Volume REMEMBER Weight and Volume are not the same thing Weight is the amount of a drug -5.0mg of Ventolin Volume is the amount of fluid the drug is dissolved in - 2.5 ml nebule

10. Have = Concentration Weight Concentration = Volume

11. mol/L G/L G% or % mg% Eq/L m/Eq/L mg/ml mcg/ml moles per litre grams per litre grams/100mL mg per 100 mL equivalents/ L milliequivalents per litre milligrams/millilitre micrograms/millilitre Concentration

12. Concentration Reduce the Volume to 1 ml which will make the math easier mg/ml 100 mg in 20 ml = 5 mg/ml 250 mg in 100 ml = 2.5 mg/ml 60 mg in 15 ml = 4 mg/ml

13. Injection - ml Amount Ordered = Amount to Administer (ml) Concentration 0.3 mg 50 mg = 10 ml = 0.3 ml 5 mg/ml 1 mg/ml 0.3 mg 1.25 mg = 0.625 ml = 0.12 ml 5mg/2ml 5 mg/2.5ml

14. Infusion - ml/min = Amount to Administer (ml/min) Amount Ordered Concentration 20 mcg/min 1 mcg/min = = 0.1 ml/min 200 mcg/ml 10 mcg/ml 15 mg/min 3 mg/min = 3 ml/min = 0.3 ml/min 5 mg/ml 10 mg/ml

15. Infusion gtt/min Amount Ordered X drip factor =Amount to Administer (gtt/min) Concentration 20 mcg/min = 0.1ml/min = 6 gtt/min x 60 gtt/ml 200 mcg/ml 15 mg/min 3 mg/min = 180gtt/min = 18gtt/min 5 mg/ml 10 mg/ml

16. Weight Based Infusion Amount Ordered x Weight Factor =Amount to administer (ml/min) Concentration 10 mcg/kg/min x 80 kg = 1ml / min 800 mcg/ml If drop/ minute are required multiply by drop factor = 60 gtt/min x 60 gtt/ml

17. mcg/kg 800 400 200 100 50 gtts 60 30 15 7.5 3.75 Single Strength Dopamine Chart

18. mcg/kg 1600 800 400 200 100 50 gtts 60 30 15 7.5 3.75 1.875 Double Strength Dopamine Chart

19. Using the Chart System 1. Estimate the patients weight in kg and round to nearest 10’s. 2. Multiply the (weight) x (order). 3. Use chart to add up drip rate. 4. Run IV at approximate rate or use an infusion pump.

20. IV concepts Two concepts: 1. Flow rate: the rate at which IV fluid is given. 2. The drip factor: the number of drops per mL determined by the administration set.

21. Infusion = ml/hr Calculate the drip rate when the Physician Orders - 400 ml/hr using a 10 gtts/ml drip set 400 ml/hr x 10 gtts/ml 4000 gtts/hr ÷ 60 min/hr 66.67 gtts/min ÷ 60 sec/min = 1 gtt/sec

22. REMEMBER WANT ---------- = AMOUNT TO GIVE HAVE • The WANT may get more complicated involving time or patient weight. • The HAVE is in your possession and may change in concentration depending on service supplies.

23. Questions?