Dopamine Drip calculation

[chbare]

Although there is nothing wrong with doing the above, I prefer to be exact, because I used to work on a neonatal transport team, where we would frequently make the concentration of drugs much higher to reduce the amount of drops that had to be delivered, in that situation you could not "spit-ball" the dosages, so here is an easy way to be exact:

Multiply everything together and divide by the concentration:

Mcgs you want to deliver x Patient KG x 60 / concentration

So if you want to deliver 10mcg to a 50kg patient, 10x50x60= 30,000 / 1600 = 18.75

This formula works for all dosages and all concentrations, and you will amaze everyone as most charts round up 1-2 drops.

This is what I do and this is what I teach. A simple formula with a wide variability in it's application. I do not teach or rely on shortcut methods such as the clock and so on. If you are presented with non-standard concentrations, you need to be able to properly administer medications without said shortcuts.

On a side note, I would never transport a person on vasoactive mess without a pump or syringe driver. My personal bias.

[mobey]

On a side note, I would never transport a person on vasoactive mess without a pump or syringe driver.

A funny; yet applicable mistype there...

Although I wholehartedly agree with your standard, there is little to no chance of my hospital allowing me to take a pump so I end up running stuff by drip.

As a side note, I see no harm in a Nitro and Dope chart kept handy if you always use the same concentration/drop factor.

[chbare]

A funny; yet applicable mistype there...

Although I wholehartedly agree with your standard, there is little to no chance of my hospital allowing me to take a pump so I end up running stuff by drip.

As a side note, I see no harm in a Nitro and Dope chart kept handy if you always use the same concentration/drop factor.

Meh, iPhones are retarded...

Yeah, many services put their providers in situations where their providers are running medications under sub-optimal conditions. I simply will not work for a service that does not provide me with proper logistical support. However, I understand jobs are at a premium and I know that I am exceedingly luck to be in a position where I can discriminate somewhat.

[Petey0397]

Quickest way I was taught:

Take the patient's weight in lbs: (i.e. 180)

Drop the last digit: 18

Subract 2: 16

And that's the drip rate for your standard pre-mix. Can't use it on really heavy or really light people. Actually used this trick a few times on a test and got the questions right.

I have yet to use it in the field, however.

[Doczilla]

In my opinion, there is no place for math in the back of the ambulance. Dosing calculations are a huge source of medical errors, and potentially fatal ones a that. We should be using reference cards every time.

'zilla

[Just Plain Ruff]

Doc I ABSOLUTELY positively agree with you.

There should be charts and cheat sheets.

It does not make you a lesser medic if you use a dosage chart. I always do. I have my hospitals dosage charts reduced down to a 3x5 card that fits in my shirt pocket.

I have travelled around to many hospitals in the USA and in each and everyone of them I see physicians pulling out their Merck manual, their drug reference books and the PDR to get the dosages of the drugs right.

I have seen countless cardiologists and ER docs and peds docs pull out their Iphones, their smart phones and their PDA's and use their tools to determine countless different things that they have their phones/pda's do.

If charts are good enough for physicians then they are surely good enough for a medic who might have to start dopamine on a handful of people in a year.

Put in a epi drip, a dobutamine drip and countless other drug dosages and going by memory is a recipe for disaster. These tools are out there for a reason. USE them.

[Kiwiology]

It's really very simple down here in Kiwi land, we mix 1mg of adrenaline with 1 litre of NaCl and viola!

It's so simple even a dangerously underfed, overworked and fatigued House Surgeon firefighter can do it!

[mobey]

Even better, put 2mg in 1000ml and use even numbers!

Even better, put 2mg in 1000ml and use even numbers!

I am also a huge fan of the "clock" method

[chbare]

I still have potential issues with non-standard concentrations. Sometimes, I run into interesting concentrations mixed by ER nurses and still believe that having a solid, mathematical foundation can be a saver in these situations.

[Eydawn]

Even though "nearly everywhere uses a pump now" last semester in nursing school we had to learn to do drip calculations based on drip set, doseage, volume, time, etc. and were tested out on manually calibrating a drip rate. That's hard to do on an IV pole that doesn't move, it took me about 45 seconds to calibrate the drip to where I wanted it and then if I moved the tubing even slightly, my instructor would end up with a different drip count. It was a pass/fail practical station, yet everyone agreed that so many factors change your "eyeball" rate...

I agree that you should have the math to back up what you're doing or to fit something not on your cheat sheet, but I also very much think ANY medication that needs to be fine-tuned should be run through a pump. Pumps are not that hard to use, really... once you figure them out...

Wendy

CO EMT-B