1 / 22

Med Math

Med Math. The basics… use like units use common sense find a formula/system that works for you. Home. Making weight…. 1 kilogram (kg) = 2.2 pounds (lb) Actual conversion Wt: 220 lb 220 divided by 2.2 = 100kg 10% or “Midnight” rule Half of 220 = 110 10% of 110 = 11

talib
Download Presentation

Med Math

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Med Math • The basics… • use like units • use common sense • find a formula/system that works for you Home

  2. Making weight….. • 1 kilogram (kg) = 2.2 pounds (lb) • Actual conversion • Wt: 220 lb • 220 divided by 2.2 = 100kg • 10% or “Midnight” rule • Half of 220 = 110 • 10% of 110 = 11 • Subtract 11 from 110 = 99kg Home

  3. Metric conversions • 1 gram (g) = 1000 milligrams (mg) • 1 mg = 1000 micrograms (mcg) • 1 liter (L) = 1000 milliliters (ml) • You need to give 500 mcg. How many mg? • Mg - move decimal 3 places to the left = 0.5 mg • OR 500 = half of 1000 so half of 1 = .5 mg • You need to give 100 mg. How many mcg? How many g? • mcg - move decimal point 3 places to the right = 100,000 mcg • g - move decimal point 3 places to the left = 0.1 g Home

  4. Basic calculations Desired dose (D) Known dose on hand (H) x Unit of measure or volume on hand (Q) = volume or unit of measure to be administered (X) D X Q = X H Home

  5. Example • You are ordered to give 5 mg Valium IV. The label states there is 10 mg in 2cc (10mg/2cc). How many cc’s will you give? • The equation will look like this: 5mg x 2cc = X cc 10 mg 1 x 2 = X cc 2 X = 1 cc You will give 1cc! Home

  6. Calculations based on weight Desired dose (D) x Weight in kg (W) Known dose on hand (H) X Unit of measure or volume on hand (Q) = volume or unit of measure to be administered (X) D x W x Q = X H Home

  7. Example • You are to give 0.5 mg/kg IV push. Your patient weighs 80 kg. The drug comes packaged: 100mg/10cc. How many mg will you give? How many cc’s will you deliver? • Your equation to determine mg will look like this: • 0.5 mg/kg x 80 kg = 40 mg to be given • Your equation to determine cc will look like this: • 40 mg x 10 cc = 4cc 100 mg Home

  8. Drip calculations “Clock” method (used only for 4:1 ratio) 60 4 1 15 45 3 2 30 If your dose is 1 mg/min, your drip rate is 15 gtt/min. If the order is greater than 4 mg/min, add them together. A dose of 6 mg/min is 90 gtt/min (4 + 2 =6 so 60 + 30 = 90) Home

  9. Drip calculations Desired dose x Size of bag x gtt set = gtt/min Amount of drug on hand • The order is for 5 mg/min. You have a 500 cc bag of NS, a 60 gtt/cc administration set, and 2 g of drug on hand. How many gtt/min will you administer? 5 mg/min x 500 cc x 60 gtt/cc = 75 gtt/min 2000 mg Note: If the dose is weight based, determine the total dose prior to beginning the equation or multiply everything by the number of kg. Home

  10. Glossary of Terms • Absorption-process of drug moving from site of introduction into circulation • Contraindication-factor that does not allow administration of drug • Dependence-state where absence or less of drug causes physical or emotional effects • Excretion-elimination of drug or toxins • Half life-time it takes for a drug level to reduce by half • Loading dose-large amount of drug given to temporarily increase blood levels Home

  11. Glossary (cont.) • Maintenance dose-amount of drug needed to maintain steady blood levels • Peak level-highest blood level from any given dose • Therapeutic action-wanted and intended effects of a drug • Tolerance-decreased response to drug after repeated administration. May require increased dose. • Toxic level-blood levels are such that they may produce adverse effects Home

  12. Prehospital Medications • The following is a list of drugs given in the TEMS region. Limited information is included for a number of the drugs but due to space constraints, everything could not be listed. Please review all medications you are responsible for administering Home

  13. Oxygen • Standing order: EMT, ST, CT, PM • Dose: 2-15 LPM via nasal cannula, non-rebreather, bag-valve-mask • Indications: Any patient with reduced oxygen levels or increased need for oxygen. Home

  14. Activated Charcoal (Actidose) • Physician order: EMT, ST, CT, PM • Dose: Adult (50 g), Pediatrics (25-30 g) given by mouth • Action: Binds and absorbs ingested toxin and is then excreted. • Indication: Overdose or poisoning when induction of vomiting is not indicated • Contraindications: Unable to swallow or maintain airway. Not useful in cyanide, methanol, caustic acids or alkalis, heavy metals, or lithium poisonings. • Side Effects: None Home

  15. Oral Glucose • Standing Order: EMT, ST, CT, PM • Dose: One tube • Action: Increases blood glucose • Indication: Consider if patient has an altered level of consciousness and/or known hypoglycemia • Contraindications: Difficulty swallowing or unable to protect own airway. • Side Effects: None Home

  16. Epinephrine-SQ (Adrenalin) • Patient Assisted Med: EMT • Physician Order: ST • Standing Order: CT, PM • Dose: 0.01 mg/kg (up to .3 mg) SQ 1:1000 • Action: Improves force of ventricular contractions and heart, bronchdilatation, peripheral vasoconstriction, and histamine antagonist • Indication: Anaphylaxis, severe asthma • Contraindications: Hypovolemic shock, hypertension, cardiac insufficiency • Side Effects: Anxiety, restlessness, hypertension, dysrhythmias • Note- Physician order for any patient over 40 years of age and or cardiac history! Home

  17. Albuterol (Proventil, Ventolin) • Patient Assisted Med: EMT • Standing Order: ST, CT, PM • Dose: PAM (1-2 puffs from MDI only), 2.5 mg HHN repeated once • Action: Relaxes smooth muscle of bronchial tree and peripheral vasculature • Indication: Relief of bronchospasm, wheezing • Contraindications: Tachycardic dysrhythmias • Side Effects: Anxiety, restlessness, palpitations, increased blood pressure Home

  18. Nitroglycerin (NTG) • Patient Assisted Med: EMT • Physician Order: ST • Standing Order: CT, PM • Dose: 0.4 mg SL every 3-5 min up total of 3 • Action: Dilation of arterioles and peripheral veins causing decreased workload of the heart and decreased oxygen demand by decreasing preload and afterload. • Indications: Chest pain, CHF • Contraindications: Viagra use in past 24 hours, systolic BP<100, head injury, cerebral hemorrhage • Side effects: Headache, hypotension, nausea and vomiting, dizziness, burning sensation under the tongue • Note-Monitor blood pressure closely in-between tablets. Home

  19. Aspirin (ASA) • Physician order: ST • Standing Order: CT, PM • Dose: 324 mg (four 81mg chewable) • Action: Antiplatelet and vasodilatory actions allowed to occur through alterations in enzyme production. • Indication: Chest pain • Contraindications: ASA intake in past 24 hours • Side effects: Bleeding, GI upset Home

  20. Diphenhydramine HCl (Benadryl) • Physician Order: ST • Standing Order: CT, PM • Dose: 50mg IV or IM (adult) 1-2 mg/kg (peds) • Action: Binds to histamine receptor sites blocking the histamine response • Indications: Allergic and EPS/dystonic reactions • Contraindications: Acute asthma attack, taking MAO inhibitors, narrow angle glaucoma • Side Effects: Drowsiness, hypotension, drying of secretions, sedation Home

  21. Naloxone (Narcan) • Physician Order: ST • Standing Order: CT, PM • Dose: 2-4 mg IV titrated to effect • Action: Reverses effects of narcotics by competing for receptor sites • Indications: Narcotic overdose, altered level of consciousness or unconsciousness with unknown origin • Contraindications: Use cautiously in drug dependant patients as administration can cause withdrawals • Side Effects: projectile vomiting and/or cardiac dysrhythmias with rapid admin, withdrawals, diaphoresis • Note-Narcan’s effects are shorter acting than the narcotic’s so monitor patient closely. Home

  22. Dextrose 50% (D50) • Physician order: ST • Standing Order: CT, PM • Dose: 25 g in 50 cc for adult 0.25 g/kg of 25% solution for peds • Action: Increases blood glucose. • Indication: Blood glucose level <60 mg/dl, altered level of consciousness and/or seizure of unknown origin • Contraindications: Intercranial hemorrhage • Side Effects: No systemic effects but may develop necrosis from infiltration locally. Home

More Related