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Paramedic Med Math (Practice)
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The physician orders Lasix 20 mg IV stat for a child weighing 34 lbs. The pediatric handbook states that 1 mg/kg is a safe initial dose. Should you give this dose?
34 lbs. X 1kg/2.2 lbs = 15.5 kg
15.5 kg X 1 mg/kg = 15.5 mg
Your medical control orders you to give 25mg of Diphenhydramine to your patient having a mild allergic reaction. It comes packaged as 50mg/1ml in a vial. How many mls do you draw up?
50mg/1ml=25mg/xml
50x=25 x=25/50 x=.5ml
Your first dose for a full arrest of Lidocaine calls for 1.5mg/kg. Your patient weights 176 Lbs. Lidocaine comes packaged as 100mg/5ml. How many mls are you giving your patient?
176lbs= 80kg 1.5mg x 80 kg = 120 mg
120mg/xml = 100mg/5ml
120 x 5= 100x 600=100x 600/100 =x x= 6mg
Your second round of Lidocaine for a full arrest calls for .75mg/kg IVP. You are using the same patient from question #3. How many mls are you giving your patient this time?
176lbs = 80 kg .75mg x 80 kg = 60 mg
60mg/xml = 100mg/5ml
60 x 5 =100x 300=100x 300/100=x x= 3mg
Your 75 yom patient is requiring morphine sulfate. Medical control wants you to 5 mg IV. Morphine sulfate comes in a vial 4 mg/ml. How many mls do you need?
4mg/1ml = 5mg/xml
4x= 1 x 5 4x=5 x=5/4 x=1.25ml
You need to give 4 mg of Diazepam to your seizing patient. It is packed in as 5 mg/ml. How many mls will you be giving?
5mg/1ml = 4mg/xml
5x = 1 x 4 5x=4 x = 4/5 x= .8ml
You need to give Amiodarone to your patient. Per your protocol you take 150mg of Amiodarone and mix it into a 100cc bag of NS. It need to be given over 10 minutes with a mircodrip set. How many drips per minute will you set your drip chamber to?
100cc x 60gtts/10min
6000/10 = 600gtts/min
Use that same problem as #7 but change the drip set to a macro drip. How many drips will you need to set your drip chamber to so you can give your drug over 10 minutes?
100cc x 10gtts/10min
1000/10min = 100gtts/min (This one is easier to count!)
Your medical control has ordered you to hang a lidocaine drip for your patient. Their orders are for you to give your 154 Lbs. patient 2 mg/mins. You have 2 grams of lidocaine, a 500 ml bag of NS and a microdrip set. How many drips do you need per minute?
500ml x 60gtts x 2mg per min/2000mg
30,000 x 2/2000 60,000/2000= 30gtts/min
The ER doctor instructs you to use Dopamine for your 187 Lbs patient with low blood pressure. Dopamine comes in a premixed bag 800mg in 500ml of D5W. You will be giving this medication with a micro set. You are to give 10mcg/kg/min. How many drips will you be giving per minute?
dose (mcg) x weight(kg) x drip set (60gtts)
Total concentration (mcg) = 800000mcg/500ml = 1600 mcg
10 mcg x 85 kg x 60 gtts = 51000
51000/1600 = 31.875gtts/min
Micro drip set
60gtts
Macro drip set
10gtts
Volume to be administered
(Volume on hand) x (Desired dose)
--------------------------------------------
Dosage on hand
Infusion Rates (Drops/Min)
(Volume on hand) x (Drip factor) x (Desired dose)
--------------------------------------------------------------
Dosage on hand
Fluid over time (Drops/Min)
(Volume ordered) x (Drip factor)
--------------------------------------------
Time in Minutes
Dopamine
dose (mcg) x weight(kg) x drip set (gtts)
----------------------------------------------------
Total concentration (mcg)
Dopamine (Trick)
Starting dose of 5mcg/kg/min using 1600mcg/ml concentration and a micro drip (60gtts/ml). This will give you a starting point to titrate from.
First, take your patients weight in pounds (that's right, pounds!).
Then drop the last number off the weight
Then subtract 2
This will be your gtts/min.
Example:
148 lbs
drop the last number
14
subtract 2
14 - 2 = 12
12 gtts/min
Lidocane
Infusion Rates (Drops/Min):
(Volume on hand) x (Drip factor) x (Desired dose)
-------------------------------------------
Dosage on hand
_____________________________
The Lidocaine Clock
60gtts = 4mg (Twelve)
15gtts = 1mg (Three)
30gtts = 2mg (Six)
45gtts = 3mg (Nine)
First you must mix your bag, 2gm in 500cc, or 1gm in 250cc
Use a mini drip (60gtts/ml)
This will give you a concentration of 4mg/ml
Look up the dose you need per min. (example 2mg/min)
Run your dose at the setting according to the clock.
So if your dose is 2mg/min you will run your drip at 30gtts/min. (1gtt/2sec)
If your dose is 4mg you will set your drip at 60gtts/min (1gtt/sec)
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