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Medical Mathematics for the EMS Provider Lesson by Rory Prue Copyright 2008 Lesson by Rory Prue Copyright 2008 Return to Main Page

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Lesson Topics Reviewing metric system Calculating drug formulas Calculating infusion formulas Calculating drug infusion formulas Practice samples Reviewing metric system Calculating drug formulas Calculating infusion formulas Calculating drug infusion formulas Practice samples Return to Main Page

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Lesson Objectives Review metric system Define desired dose Define volume to infuse Define total concentration Discuss formulas as a basis for performing drug calculations Understand basic drug formulas Review metric system Define desired dose Define volume to infuse Define total concentration Discuss formulas as a basis for performing drug calculations Understand basic drug formulas Return to Main Page

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Metric System Three fundamental units GramsMass MetersDistance LitersVolume Three fundamental units GramsMass MetersDistance LitersVolume Return to Main Page

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Conversion between Prefixes Mass kilo (kg)1000 hecto (hg)100 deka (Dg)10 gram (g)1Base Unit deci (dg)1/10 or 0.01 centi (cg)1/100 or milli (mg)1/1000 or micro (mcg)1/1,000,000 or kilo (kg)1000 hecto (hg)100 deka (Dg)10 gram (g)1Base Unit deci (dg)1/10 or 0.01 centi (cg)1/100 or milli (mg)1/1000 or micro (mcg)1/1,000,000 or Return to Main Page

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Conversion between Prefixes Length or Distance kilo (km)1000 hecto (hm)100 deka (Dm)10 meter (m)1Base Unit deci (dm)1/10 or 0.01 centi (cm)1/100 or milli (mm)1/1000 or micro (mcm)1/1,000,000 or kilo (km)1000 hecto (hm)100 deka (Dm)10 meter (m)1Base Unit deci (dm)1/10 or 0.01 centi (cm)1/100 or milli (mm)1/1000 or micro (mcm)1/1,000,000 or Return to Main Page

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Conversion between Prefixes Volume kilo (kL)1000 hecto (hL)100 deka (DL)10 Liter (L)1Base Unit deci (dL)1/10 or 0.01 centi (cL)1/100 or milli (mL)1/1000 or micro (mcL)1/1,000,000 or kilo (kL)1000 hecto (hL)100 deka (DL)10 Liter (L)1Base Unit deci (dL)1/10 or 0.01 centi (cL)1/100 or milli (mL)1/1000 or micro (mcL)1/1,000,000 or Return to Main Page

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Conversions To go from grams to milligrams move the decimal point to the right 3 spaces. Convert 2 grams to milligrams To go from grams to milligrams move the decimal point to the right 3 spaces. Convert 2 grams to milligrams 2000 Return to Main Page

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Conversions Lets convert milliliters to Liters mL equals how many Liters? Lets convert milliliters to Liters mL equals how many Liters? 3000 Return to Main Page

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Conversions Converting pounds to kilograms 2.2 lbs = 1 kg Divide the weight in pounds by lbs ÷ 2.2 = 80 kg 124 lbs ÷ 2.2 = 56.4 kg 32 lbs ÷ 2.2 = 14.5 kg Converting pounds to kilograms 2.2 lbs = 1 kg Divide the weight in pounds by lbs ÷ 2.2 = 80 kg 124 lbs ÷ 2.2 = 56.4 kg 32 lbs ÷ 2.2 = 14.5 kg Return to Main Page

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Desired Dose Specific quantity of medication needed Most doses expressed as weight: Grams Milligrams Micrograms May be standard or based on body weight Specific quantity of medication needed Most doses expressed as weight: Grams Milligrams Micrograms May be standard or based on body weight Return to Main Page

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Dosage and Volume on Hand The amount of drug available in a solution. Concentration is the weight per volume. The amount of drug available in a solution. Concentration is the weight per volume. Return to Main Page

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Administration Sets Macro set = 15 or 10 gtt/mLMicrodrip = 60 gtt/mL Return to Main Page

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Calculating Medication Doses Volume to be administered = Volume on hand x desired dose Dosage on hand Volume to be administered = Volume on hand x desired dose Dosage on hand Return to Main Page

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Example 1 (1 of 2) A doctor orders 2 mg of Valium to be administered I.V. to a patient experiencing seizures. You have a 5 mL vial that contains 10 mg of Valium. How many milliliters will you draw into the syringe to push into the I.V.? Return to Main Page

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Example 1 (2 of 2) Set up the problem: Order: 2 mg On hand: 10 mg/5 mL Set up the problem: Order: 2 mg On hand: 10 mg/5 mL Return to Main Page

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Example 2 (1 of 2) You are on scene with a pulseless and apneic patient in ventricular fibrillation. The doctor orders 1 mg of epinephrine I.V. The medication comes supplied as 0.1 mg/mL. How many milliliters will you give? Return to Main Page

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Example 2 (2 of 2) Set up the problem. Desired dose: 1 mg On hand: 0.1 mg/mL Set up the problem. Desired dose: 1 mg On hand: 0.1 mg/mL Return to Main Page

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Example 3 (1 of 2) Medical control orders 200 mgs of lidocaine I.V. for your patient in ventricular tachycardia. The prefilled syringe reads 50 mg/mL. How many milliliters will you administer? Return to Main Page

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Example 3 (2 of 2) Set up the problem: Desired dose: 200 mg On hand: 50 mg/mL Set up the problem: Desired dose: 200 mg On hand: 50 mg/mL Return to Main Page

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Example 4 (1 of 2) A doctor orders you to give 5 mg/kg of Bretyllium for your 176 lb patient who is in ventricular tachycardia. Bretyllium comes supplied as 500 mg/5 mL. Return to Main Page

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Example 4 (2 of2) Setting up the problem Desired dose: 5 mg/kg On hand: 500 mg/5 mL 176 lbs ÷ 2.2 = 80 kg80 x 5 = 400 Setting up the problem Desired dose: 5 mg/kg On hand: 500 mg/5 mL 176 lbs ÷ 2.2 = 80 kg80 x 5 = 400 Return to Main Page

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Calculating Infusion Rates Fluid Volume over Time Drops/minute = Volume to be administered x drip factor Time in minutes Fluid Volume over Time Drops/minute = Volume to be administered x drip factor Time in minutes Return to Main Page

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Example 5 (1 of 2) A doctor orders 200 mL of 0.9% Saline to be administered over 1 hour using a microdrip administration set (60 gtt/mL). How many gtt/min will you run the I.V.? Return to Main Page

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Example 5 (2 of 2) Set up problem Desired amount: 200 mL Administration set: microdrip (60 gtt/mL) Time: 1 hour (60 minutes) Set up problem Desired amount: 200 mL Administration set: microdrip (60 gtt/mL) Time: 1 hour (60 minutes) Return to Main Page

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Example 6 (1 of 2) A doctor orders you to run 150 mLs of I.V. fluid over 30 minutes using a macrodrip administration set (10 gtt/mL). How many gtt/minute will you run the I.V.? Return to Main Page

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Example 6 (2 of 2) Set up the problem Desired amount: 150 mL Administration set: macrodrip (10 gtt/mL) Time: 30 minutes Set up the problem Desired amount: 150 mL Administration set: macrodrip (10 gtt/mL) Time: 30 minutes Return to Main Page

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Calculating Infusion Rates Medicated Infusions Drops/minute = Volume on hand x drip factor x desired dose Dosage on hand Medicated Infusions Drops/minute = Volume on hand x drip factor x desired dose Dosage on hand Return to Main Page

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Example 7 (1 of 2) A doctor orders 2 mg per minute of lidocaine to be administered to a patient who was experiencing a dysrhythmia. You have an I.V. that contains 1 gram of lidocaine in 250 mLs. Your administration set is a microdrip set (60 gtt/mL). At how many drops per minute will you adjust your administration set? Return to Main Page

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Example 7 (2 of 2) Set up the problem Desired dose: 2 mg/min On hand: 1 gram in 250 mL Administration set: microdrip (60 gtt/mL) Set up the problem Desired dose: 2 mg/min On hand: 1 gram in 250 mL Administration set: microdrip (60 gtt/mL) Return to Main Page

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Sample Problem 1 A radio order is received from medical control to administer 10 mg of Valium IV push to your patient experiencing seizures; 5 mg/mL is printed on the vial of Valium. How many milliliters will you administer? Return to Main Page

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Sample Problem 2 Your patient is exhibiting paroxysmal supraventricular tachycardia (PSVT). Vagal maneuvers are ineffective and medical control orders 6 mg of adenosine rapid IV push. The vial reads 3 mg/mL. How many milliliters will you administer? Return to Main Page

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Sample Problem 3 A patients ventricular fibrillation is refractory to lidocaine and defibrillation attempts. Medical control orders 400 mg of Bretyllium over 1 minute IV. The prefilled syringe reads 50 mg/mL, 10 mL total volume. How many milliliters will you administer? Return to Main Page

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Sample Problem 4 Your 150 lb patient is experiencing multifocal PVCs and complains of chest pain. Your standing orders state to administer 1 mg/kg of lidocaine. The vial reads 100 mg/5 mL. How many milliliters will you administer? Return to Main Page

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Sample Problem 5 The doctor orders 400 mg/min of dopamine to be administered IV. You have a vial that contains 200 mg of dopamine in 10 mL (200 mg/10 mL). Your ambulance has 250 mL bags of D5W, and you choose a microdrip administration set (60 gtt/mL). At how many drops per minute will you adjust your administration set to drip? Return to Main Page

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Sample Problem 6 You are ordered to administer an Isuprel drip at 4 mg/min. You are ordered to place 1 mg into a 250 mL bag of D5W. At what rate will you set your microdrip (60 gtt/mL) administration set? Return to Main Page

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Sample Problem 7 The doctor orders you to start an IV of normal saline to run at 100 mL/hr. You have a microdrip administration set. What is the drip rate? Return to Main Page

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Sample Problem 8 Your standing order is to start an IV of normal saline to run at 90 mL/hr. Now you have a macrodrip administration set of 10 gtt/mL. What is the drip rate? Return to Main Page

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Sample Problem 9 The order on the patients chart in a busy emergency center reads 1500 mL Plasmanate IV over 10 hours. You choose a 15 gtt/mL administration set. What is the drip rate? Return to Main Page

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Sample Problem 10 While doing internship hours at the emergency center, you are asked to start an IV of D5W to run at 200 mL/hr. You have a macrodrip set (15 gtt/mL). What is the drip rate? Return to Main Page

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This concludes our lesson on medical mathematics for the EMS Provider. After you have finished all Sample Problems please them to the instructor. This concludes our lesson on medical mathematics for the EMS Provider. After you have finished all Sample Problems please them to the instructor. Instructor Visit Rorys Home Page Return to Main Page

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