Paramedic II Edison State College Drug Math Lab Final NotesIf you are adding a drug to an IV bag to administer an infusion, you should first pull theamount of fluid out of the bag that is in the vial containing the drug to maintain thecorrect concentration. The rule of thumb is that if the drug is contained in a vial less than10ml than you can avoid this because the difference is negligible. Common Packaging Dopamine: 400mg in a 10ml vial (40mg/ml) When mixed in 250ml bag: 1600mcg/ml Lidocaine: 1gram in a 25ml vial (40mg/ml) When mixed in 250ml bag: 4mg/ml Amiodarone: 150mg in 3ml vial (50mg/ml) When mixed in 100ml bag: 1.5mg/mlDopamineRemember that 400mg of Dopamine is to be placed in to a 250 ml bag of Normal Saline.This gives you a concentration of 1600mcg/ml. You may be asked to use a pre-mixedbag with the same concentration. - Weight based infusion (mcg/kg/min) - Should always be given with a mini/micro-drip (60gtts/ml)Example with 110lb patient: 5mcg/kg/min x 50kg x 60gtts/ml 400mg/250ml 5mcg/kg x 50kg x 60gtts/ml 1600mcg/ml x min 5 x 50 x 60gtts 1600 x min 5 x 5 x 6gtts 16 x minAnswer is about 9.375 = 9gtts/minYou would then mix your bag appropriately & set the drip rate to 9gtts/min (about1gtt/sec) using a 60gtts/ml set.
Paramedic II Edison State CollegeLidocaineRemember that the reduced concentration of Lidocaine is 1gm in a 250 ml bag (4mg/ml).You will need to draw the 25ml out of the bag before putting the Lidocaine into the bag.This is because the Lidocaine will be packaged 1gm in a 25ml vial. Since you will beadding 25ml to the IV bag, you must first remove 25ml to maintain a concentration of1gm/250ml. - Lidocaine is NOT weight-based - You will see that every 1mg/min added is an extra 15gtts/min - Remember to use a mini/micro-drip (60gtts/ml)Note: Since every 60gtts = 1ml, and the concentration is 4mg/ml, if your dose is 4mg/minthat is the same as saying 1ml/min or 60gtts/min.Example: 2mg/min x 60gtts/ml 1gm/250ml 2mg x 60gtts/ml 1000mg/250ml x min 2mg x 60gtts/ml 4mg/ml x min 2mg x 60gtts/ml 4mg/ml x min 2 x 60gtts 4 x min 2 x 15gtts 1 x min 2 x15 = 30 Answer: 30gtts/min - Desired Dose = 1mg/min = 15gtts/min - Desired Dose = 2mg/min = 30gtts/min - Desired Dose = 3mg/min = 45gtts/min - Desired Dose = 4mg/min = 60gtts/minDo the math and see that this is true!
Paramedic II Edison State CollegeAmiodaroneThe loading dose for Amiodarone for a stable patient is 150mg in 100ml bag of D5Wover 10 minutes. Many get confused with this by trying to place the 150mg into theMaster Formula. Leave it out, your Desired Dose is 100ml. - Use a macro-drip Solution Set (10gtts/ml) - Your answer will always be 100gtts/min (5gtts every 3 seconds)Example: 100ml x 10gtts/ml 10min 100 x 10gtts 10min Answer: 100 gtts/minTips: - Remember to pick the right Solution Set o 10gtts/ml for Amiodarone o 60gtts/ml for Lidocaine & Dopamine - Do not try to force the needle into the medication hub of the bag. If you enter through the center of the hub, there should be no resistance. - Remember the 5 Rights o Right Drug o Right Dose o Right Date o Right Patient o Right Route - Check the bag for color, clarity, & sedimentation (obviously the bags in lab are mostly expired and discolored). - You will not be counting for a full minute, so try to reduce your answer to within seconds (ex. 15gtts/min = 1gtt every 4 seconds). - Remember to label the IV bag with a piece of tape, include the drug added, the time started, the concentration, and your name. o ex. Lidocaine 4mg/ml by A. Thomson at 1900