Fluid and Medication Math for Paramedics (Fluid Rates, IVP Boluses, & Dopamine) Pass the NREMT!

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20 Oct 202228:11

EducationalLearning

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TLDRThe transcript details a lecture on fluid and medication math problems, focusing on calculating drip rates for various medical scenarios. The speaker explains the process of converting hours to minutes, determining drops per minute for fluid administration, and calculating IV push and infusion medication orders. The use of formulas and rounding methods are emphasized for accuracy. The lecture also covers dopamine infusion calculations, providing both a formula method and a quicker 'Street Method' for determining drip rates, ensuring effective patient care and exam preparation.

Takeaways

📚 The lecture covers fluid and medication math problems, emphasizing practice and understanding of calculations rather than real-world applicability.
💧 For fluid math, the process involves converting hours to minutes, calculating the total number of drops needed, and finding the drops per minute rate.
🌡️ An example given is administering 1000 milliliters over 5 hours with a 10 drop set, resulting in approximately 33 drops per minute after rounding.
💊 Medication math involves two key formulas: one for IV push medications and another for IV infusions, which require finding the concentration of the medication.
📈 The script provides a detailed example of calculating the administration of calcium chloride via IV push, emphasizing unit conversion and supply interpretation.
🔄 When calculating infusion rates, the order is to divide the order by the supply and multiply by the drip factor, as demonstrated with a drug A example.
🩺 The lecture also addresses dopamine infusion calculations, providing both a formula method and a 'street method' for quick estimation.
🤔 The 'street method' is less accurate but useful for quick calculations or double-checking work, especially in high-stress situations.
📌 The script encourages using the formula method for the most accurate dopamine calculations, but the 'street method' can be helpful for a quick estimate.
📝 The 'street method' involves taking the patient's weight in kilograms, applying the dose order, and using a simplified calculation to estimate drops per minute.
🔢 The script concludes with an example of using the 'street method' for a 7 micrograms per kilogram per minute order, resulting in an estimated 30 drops per minute.

Q & A

What is the primary purpose of the fluid and medication math problems discussed in the lecture?
-The primary purpose of these problems is to provide practice for calculating fluid rates and drip rates, as well as understanding medication dosages. Some problems may not be realistic but serve as valuable exercises for learning and understanding the concepts.
How is the initial fluid math problem solved?
-The initial problem is solved by calculating the total number of drops required (1000 mL * 10 drops/set = 10,000 drops), converting the time from hours to minutes (5 hours * 60 minutes/hour = 300 minutes), and then dividing the total drops by the total minutes to find the drops per minute (10,000 drops / 300 minutes = 33.33 drops/minute, rounded down to 33 drops/minute).
What is the significance of converting hours to minutes in the fluid math calculations?
-Converting hours to minutes is crucial because it allows the practitioner to determine the exact number of drops to be administered per minute, ensuring the correct dosage is given over the specified time period.
How is a decimal in drops per minute rounded in the context of the lecture?
-In the context of the lecture, a decimal in drops per minute is rounded down if it is less than 0.5, and rounded up if it is 0.5 or greater. This is because it is not possible to administer a fraction of a drop.
What are the two key formulas mentioned for medication math problems?
-The two key formulas mentioned are: for IV push medication, use the formula 'order over supply', and for IV infusion, use the formula 'order over mixture or supply times your drip set'.
How is the concentration of a medication calculated?
-The concentration of a medication is calculated by determining the amount of the medication in a given volume of fluid. For example, if a medication is supplied as 1 gram in 10 mL, the concentration is 100 milligrams per milliliter (1000 mg / 10 mL = 100 mg/mL).
What is the significance of converting the patient's weight from pounds to kilograms in the dopamine calculation?
-Converting the patient's weight from pounds to kilograms is essential because the dosage of certain medications, like dopamine, is often calculated based on the patient's weight in kilograms to ensure accurate and safe dosing.
How is the 'Street Method' for dopamine calculation different from the formula method?
-The 'Street Method' is a quick estimation technique that provides a close approximation of the required drip rate for dopamine infusions, while the formula method is a more precise and definitive calculation. The 'Street Method' is useful for quick assessments in the field, while the formula method is preferred for exams and exact calculations.
What is the basic principle behind the 'Street Method' for dopamine calculations?
-The basic principle behind the 'Street Method' is to take the patient's weight in kilograms, adjust it based on the dosage (removing the last digit and subtracting two), and this gives an approximate number of drops per minute for a 5-microgram per kilogram per minute dose with a concentration of 1600 micrograms per mL.
How can the 'Street Method' be used for different dopamine dosages other than 5 micrograms per kilogram per minute?
-For dosages other than 5 micrograms per kilogram per minute, the 'Street Method' can be adjusted by doubling the number of drops for a 10-microgram dose, tripling for a 15-microgram dose, and so on. This method provides a close estimate of the required drip rate for different dosages.
What is the main advantage of using the formula method for dopamine calculations?
-The main advantage of using the formula method for dopamine calculations is its accuracy and definitiveness. It provides the most precise drip rate required to achieve the desired dosage, which is crucial for patient safety and effective treatment.
How can the clock method be used to check the accuracy of dopamine calculations?
-The clock method can be used to check the accuracy of dopamine calculations by plotting the micrograms on the outer edge and the drops on the inner edge of a clock face. By comparing the calculated drops per minute with the expected micrograms per minute, the practitioner can ensure they are in the correct range and make any necessary adjustments.

Outlines

00:00

📚 Fluid and Medication Math Problems Overview

This paragraph introduces the topic of fluid and medication math problems that will be covered in the lecture. It emphasizes that while some of the problems may seem unrealistic, they are designed for practice purposes. The speaker begins by explaining how to calculate the administration of 1000 milliliters over five hours using a 10 drop set, highlighting the process of converting hours to minutes and determining the number of drops per minute required. The paragraph also touches on rounding rules for drop amounts, ensuring they are practical for administration. The speaker then proceeds to solve additional problems, reinforcing the concept of calculating fluid and medication rates.

05:00

📈 Understanding IV Push and Infusion Calculations

This paragraph delves into two key formulas essential for medication math, particularly for IV push and infusion calculations. The speaker explains the process of determining the concentration of medications and how to apply the formulas to calculate the correct dosage. The paragraph covers the conversion of grams to milligrams and the importance of matching the units of the medication order and supply. It provides examples of calculating dosages for calcium chloride and other drugs, emphasizing the use of drip sets and the need to round up or down to practical drop amounts. The speaker also introduces the concept of drip rates and how they relate to the administration of drugs like dopamine.

10:01

💊 Dopamine Infusion Calculations

This paragraph focuses on the calculation of dopamine infusions, a common medication math problem. The speaker outlines the steps to determine the concentration of dopamine when given its supply in milligrams and volume in milliliters. It explains the conversion of the patient's weight from pounds to kilograms and how to apply the drug dose order using the calculated concentration. The paragraph introduces a practical method for estimating dopamine drip rates using a clock face approach and emphasizes the importance of checking calculations for accuracy. The speaker also presents an alternative 'Street Method' for quick estimation of dopamine drip rates, highlighting its limitations but also its usefulness in certain situations.

15:04

🌡️ Advanced Dopamine Calculation Techniques

The paragraph discusses an advanced technique for calculating dopamine infusions, known as the 'Street Method'. This method provides a quick estimation of the required drops per minute for a 5 microgram per kilogram per minute dose, assuming a concentration of 1600 micrograms per ml. The speaker explains the steps of this method, which involves taking the patient's weight in kilograms, applying the dose order, and using a simple calculation to determine the number of drops. The paragraph also compares this method to the more accurate formula method, showing how the 'Street Method' can provide a close approximation of the required dosage. The speaker emphasizes the usefulness of this method for quick calculations in the field or during exams.

20:05

📊 Applying the Street Method to Various Dopamine Orders

This paragraph demonstrates the application of the 'Street Method' to different dopamine dosage orders. The speaker provides examples of how to calculate the drops per minute for various weights and dosages, highlighting the method's ability to quickly estimate the required infusion rate. The paragraph shows how doubling the number of drops can approximate higher dosage orders and how to estimate dosages between standard rates. The speaker reiterates that while the 'Street Method' is not as precise as the formula method, it is a valuable tool for quick calculations and for confirming the accuracy of the formula method. The paragraph concludes with an encouragement for viewers to reach out with further questions or drug problem scenarios.

Mindmap

Keywords

💡Fluid Math

Fluid Math refers to the calculations required to determine the correct rate of administering intravenous (IV) fluids to patients. In the video, it is used to calculate the number of drops per minute needed to deliver a specific volume of fluid over a set period. For example, calculating how to administer 1000 milliliters over five hours with a 10 drop set involves multiplying the volume by the drip factor and then dividing by the total minutes to find the drops per minute.

💡Medication Math

Medication Math involves the calculations needed to prepare and administer the correct dosage of medications, especially in IV infusions. It requires understanding the concentration of the drug, the order quantity, and how it translates into the actual amount to be administered. The video provides formulas and examples to calculate the correct dosage based on the medication's supply form and the order.

💡Drip Factor

The Drip Factor refers to the number of drops delivered per minute by an IV set. It is crucial in fluid and medication math as it directly affects the rate at which fluids or medications are administered. The video discusses different drip factors like 10 drop set and 60 drop set, and how they are used in calculations to determine the correct drip rate.

💡Drip Rate

Drip Rate is the speed at which IV fluids or medications are administered to a patient. It is usually measured in drops per minute (d/min) and is determined by the医嘱 (medical order), the concentration of the medication, and the drip factor of the IV set. The video emphasizes the importance of calculating the correct drip rate to ensure accurate medication delivery.

💡IV Push

IV Push refers to the method of administering medication directly into a vein through an IV line without dilution or being mixed with fluids. It is a rapid method of drug delivery and requires precise calculation to ensure the correct dosage is given quickly. The video explains how to calculate the volume of medication needed for an IV push based on the drug's concentration and the医嘱.

💡IV Infusion

IV Infusion is the process of delivering fluids or medications into a patient's bloodstream over a period of time using an IV setup. It involves calculations to determine the drip rate and concentration to ensure the correct dosage is administered as per the医嘱. The video discusses formulas for calculating drip rates for infusions, taking into account the drug's concentration and the desired dosage rate.

💡Dopamine

Dopamine is a medication often used in critical care settings to support blood pressure and heart function. In the video, it is used as an example to demonstrate the calculations required for administering a dopamine infusion based on the医嘱 of micrograms per kilogram per minute. The video explains how to convert the patient's weight to kilograms and calculate the drip rate needed to achieve the desired dosage.

💡Concentration

Concentration in the context of the video refers to the amount of a medication contained in a given volume of fluid, typically expressed in milligrams or micrograms per milliliter (mg/ml or mcg/ml). It is a crucial factor in medication math as it directly impacts the volume of fluid that needs to be administered to achieve the desired dosage. The video explains how to calculate concentration from the drug's supply information and use it in further calculations.

💡Weight Conversion

Weight Conversion is the process of changing a patient's weight from one unit of measurement (like pounds) to another (like kilograms). This is essential in dosage calculations, especially for drugs like dopamine, where the dosage is often based on the patient's weight in kilograms. The video provides a method for quickly converting pounds to kilograms for practical use in medical settings.

💡Rounding

Rounding in the context of the video refers to adjusting calculated values to the nearest whole number, particularly when dealing with drops per minute in IV administration. Since it is not possible to administer a fraction of a drop, values like 33.33 drops per minute are rounded down to 33 or up to 34 based on specific rules (e.g., rounding up if above 0.5, down if below).

💡Clock Method

The Clock Method is a technique used as a quick reference to estimate the correct IV drip rate without performing detailed calculations. It involves using a clock face to visualize the relationship between the dosage order, the patient's weight, and the medication concentration. The video explains how to use this method to check the work and ensure that the calculated drip rate is within an acceptable range.

💡Street Method

The Street Method is an informal, quick estimation technique for calculating dopamine infusion rates in the field when precise calculations may not be feasible. It relies on memorized patterns and simplifications based on common dosages and concentrations. The video introduces this method as a helpful tool for getting close to the correct drip rate, but emphasizes that the formula method is the most accurate approach.

Highlights

The lecture covers fluid and medication math problems, with a focus on practical application and understanding the concepts.

A fictitious fluid order of 1000 milliliters over five hours with a 10 drop set is used as an example to demonstrate the calculation process.

To calculate the drip rate, the volume in milliliters is multiplied by the drip factor, resulting in the total number of drops.

The total time is converted from hours to minutes to match the drip rate calculation, with 5 hours equaling 300 minutes.

Drops per minute are calculated by dividing the total number of drops by the total number of minutes.

When dealing with decimals in drop rates, values below 0.5 are rounded down, while those above are rounded up.

A second fluid math problem involves 100 milliliters over six hours with a 60 drop set, resulting in a rounded drip rate of 17 drops per minute.

Medication math problems are introduced, emphasizing the importance of knowing two key formulas for the National Registry exam.

An IV push medication order requires calculating the amount to administer based on the drug's concentration and supply.

For IV infusion problems, the order is calculated using the formula of order over mixture or supply times the drip set.

Dopamine is a common medication problem, but its use in pre-hospital settings is declining.

A method for calculating dopamine infusions without using the traditional formula is introduced, known as the Street Method.

The Street Method is less accurate than the formula method but is useful for quick calculations or when precise measurements are not feasible.

The dopamine concentration is calculated by converting milligrams to micrograms and dividing by the volume in milliliters.

Patient weight is converted to kilograms for dosage calculations, with a simplified method provided for quick conversions.

The clock method is mentioned as a way to check work and ensure the correct dosage range is achieved.

The transcript concludes with an invitation for further questions or discussion on the topics covered.

Transcripts

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