EKG

BASE UNITSQuantity Base Unit SI symbollength metre m kilogram Kgmass second s mole moltime Kelvin Kamount of ampere Asubstancetempelecticalcurrent

Metric SystemMicro-------Milli----Centi----Deci-----BASE-----Deka----Hecto---Kilo.000001 .001 .01 .1 METER 10 100 1000.000001 .001 .01 .1 LITER 10 100 1000.000001 .001 .01 .1 GRAM 10 100 1000Note: When documenting a drug dose that is less than 1, alwaysplace a “0” before the decimal point so that the dosage isn’tmistaken for a larger one.e.g. 0.3 mg epinephrine SC (not .3 mg epinephrine, as this mayappear on the chart as “3” mg which would be an excessive dose)

Metric System gram(G) milligram(mg) microgram(mcg)0.000001 G Click to see answer 1.0 mcg = 0.001 mg =0.001 G = 1.0 mg = 1,000 mcg1.0 G = 1,000 mg = 1,000,000 mcg

ABBREVIATIONSkilogram Kg (= 1,000 G)gram Gmilligram mgmicrogram mcg (= 0.001 mg)liter Lmilliliter ml

WORKING WITH FRACTIONS….The return to school.

MULTIPLYING FRACTIONS1 4 x 10 2 17 x 41 5 12 3 9 21 3 =2 =4 3 27Try creating your own fractions and use the same procedure

DIVIDING FRACTIONS 4/5 1/9 4/15 3/181 x 15 3 = 1 x 18 2 93=415 4 1 1 =3 = 2 3

Treat both sides of the = sign the same X +10 = 5 5 X+10 x5 = 5 x5 51 1Use the opposite function if you move across an ‘=’ sign X+10 = 25 X+10-10 = 25- 10 X= 15

Where will I apply medical math????

MEDICAL MATH• Calculators and medication tables are more thanThisimagecannotcurrentlybedisplayed. welcome, only if you intend on using them in your practice.• You are encouraged to use the formulas supplied. If you have your own method and it works for you, do it your way.

HOW MUCH TO ADMINISTER?WANT = AMOUNT TO---------- ADMINISTER HAVE

WANT = GIVE WANTHAVEMedical Directives i.e. 0.5mg Epi.1:1,000 IMVerbal orders by BHP patchWritten orders on patient chart

WANT = GIVE HAVEHAVEConcentration of the Drug Nitro, Salbutamol, Glucagon, LidocaineContents of the IV BagAmount in a given Ampoule or Vial

WEIGHT vs. VOLUME REMEMBER: Weight and Volume are not the same thingWeight is the amount of a drug -5.0mg of Ventolin Volume is the amount of fluid the drug is dissolved in - 2.5 ml Nebule

REMEMBER:Always document drug administration by weight – e.g. 2.5 mg never 2.5 ml

WANT = GIVEHAVE HAVE = CONCENTRATION Weight Concentration = Volume

CONCENTRATIONmol/L moles per litreG/L grams per litreG% or % grams/100mLmg% mg per 100 mLEq/L equivalents/ Lm/Eq/L milliequivalents per litremg/ml milligrams/millilitremcg/ml micrograms/millilitre

CONCENTRATIONReduce the Volume to 1 ml which will make the math easier mg/ml Click to see answer100 mg in 20 ml = 5 mg/ml250 mg in 100 ml = 2.5 mg/ml60 mg in 15 ml = 4 mg/ml

CONCENTRATION EXAMPLE mg/ml Click to see answer 100 mg in 5 ml = 20 mg/ml

CONCENTRATION EXAMPLE mg/ml Click to see answer 50 mEq in 50 ml = 1 mEq/ml

CONCENTRATION EXAMPLE mg/ml Click to see answer 25 g in 50 ml = 500 mg/ml

INJECTION - mlAmount Ordered (want)Concentration (have) = Amount to administer (ml) 50 mg 0.5 mg = 10 ml = 0.5 ml5 mg/ml 1 mg/ml 0.5 mg 2.5 mg = 1.25 ml = 0.2 ml 5 mg/2.5ml5mg/2ml Reduce to mg per mlReduce to 2.5mg/ml

INFUSION - ml/minAmount Ordered = Amount to AdministerConcentration (ml/min)20 mcg/min 1 mcg/min200 mcg/ml = = 0.1 ml/min 10 mcg/ml15 mg/min 3 mg/min = 3 ml/min 10 mg/ml = 0.3 ml/min 5 mg/ml

IV CONCEPTSTwo concepts: 1. Flow rate: the rate at which IV fluid is given. 2. The drip factor: the number of drops per mL determined by the administration set.

I.V ADMINISTRATION SETS Are constructed to deliver a specific number of drops per milliliter. This is called the DRIP FACTOR and can be found on the package containing the set.Some examples: 10 drops/ml ---(or 10 gtts/ml) Baxter 13drops/ml---Mcgaw 15 drops/ml---Abbot 20 drops/ml---Cutter 60 drops/ml---Micro (delivery of Rx infusion)

I.V ADMINISTRATION SETS The line scribed on the drip chamber denotes 1 ml of fluid• 60 gtt set: takes 60 gtts of the fluid to reach the line.• 10 gtt set: takes only 10 gtts, because the drops are much bigger.

INFUSION = ml/hrCalculate the drip rate when the Physician Orders - 400 ml/hr using a 10 gtts/ml drip set400 ml/hr x 10 gtts/ml 400 ml/hr ÷ 60 min/hr 4000 gtts/hr ÷ 60 min/hr or 6.667 ml/min ÷ 60 sec/min66.67 gtts/min ÷ 60 sec/min 0.111 ml/sec x 10 gtts/ml = 1 gtt/sec = 1 gtt/sec

INFUSION - gtt/minAmount Ordered X drip factor = Amount to AdministerConcentration (gtt/min)20 mcg/min = 0.1ml/min x 60 gtt/ml = 6 gtt/min200 mcg/ml15 mg/min 3 mg/min = 180gtt/min = 18gtt/min 5 mg/ml 10 mg/ml

POUNDS TO KILOGRAMSSome medications:like Lidocaine and Dopamine,are administered based on body weight.Once you determine the Pt.’s weight in lbs.,simply divide by 2.2 170 Lb = 77 kg 2.2 Lb/ kg

Pounds to Kilograms Exercise work it out by hand or using a calculator, then... Click to see answer1. 39 Lb = how many kg? = 18 kg2. 120 Lb = how many kg? = 55 kg3. 22 Lb = how many kg? = 10 kg4. 88 Lb = how many kg? = 40 kg5. 280 Lb = how many kg? = 127 kg

HOW MUCH ?/KILOGRAM Click to see answer1. 3mg/kg of Lidocaine to a 75 kg Patient = 225 mg2. 5mcg/kg of Dopamine to a 80 kg Patient = 400 mcg3. 1mg/kg of Lidocaine to a 220 lb Patient = 100 mg4. 0.05mg/kg of Epi 1:1000 to a 110 lb Patient = 2.5 mg5. 12mg/kg of Chocolate to a 110 kg Patient = 1320 mg

WEIGHT BASED INFUSIONAmount Ordered x Weight = Amount to administerConcentration (ml/min)10 mcg/kg/min x 80 kg = 1ml / min 800 mcg/mlIf drop/ minute are = 60 gtt/minrequired multiply by drop factor x 60 gtt/ml

PROBLEM Parkland Burn Formula a) total volume to be administered (ml)= 4 ml x weight (kg) x % of burn surface area(BSA) or [4ml x kg x % BSA]• b) administer 1/2 of this volume in first 8 hours• c) administer second half over the next 16 hours

PROBLEM 100 kg patient with 50 % BSA 4ml/kg x weight (kg) x % BSA = ml WORK THIS OUT! (4 x 100 x 50) ÷ 2Click to see answer 20,000 ml or 20 litres in 24 hours = 10 litres in first 8 hours

PROBLEM Now calculate in gtts/min10 litres in first 8 hours (10L / 8hrs.) 10 L = 10,000 ml 10,000 ml/480 min 8 hrs. = 480 min. = 20.833 ml/min. Using a 10 gtt/ml set 20.833 ml/min. x 10 gtts/ml = 208 gtts/min. (fast)

PROBLEM alternative approach 100 kg patient with 50 % BSA 4ml x weight (kg) x % BSA = ml/hour i.e. (4 x 100 x 50) ÷ 2 8Using a 10 gtt/ml set = 1250 ml per hour x 10 gtt/ml (divide by 60 min to get gtts/min) = 208 gtts/min. (fast)

SUMMARY WANT---------- = GIVE HAVEthe WANT may get more complicatedinvolving time or patient weight.the HAVE is in your possession and maychange in concentration depending onservice supplies (“Have” is always based on concentration)

Concentration Exercises Work out equations by hand – then by calculator to verify Click to see answer 1. 100 mg in 20 ml = 5 mg/ml 2. 75 mg in 5 ml = 15 mg/ml 3. 250 mg in 100 ml = 2.5 mg/ml 4. 30 mg in 3 ml = 10 mg/ml 5. 60 mg in 15 ml = 4 mg/ml 6. 10 mg in 10 ml = 1 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentrationtry this 50 mg = 5 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentration 50 mganswer = 10 ml 5 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentrationtry this 45 mg 15 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentrationanswer 45 mg = 3 ml 15 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentrationtry this 0.3 mg 1 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentrationanswer 0.3 mg = 0.3 ml 1 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentrationtry this 160 mg 4 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentrationanswer 160 mg = 40 ml 4 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentrationtry this 25 mg 10 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentrationanswer 25 mg = 2.5 ml 10 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentrationtry this 5 mg 2.5 mg/ml

EXERCISE Concentration = mg/mlAmount Ordered = Amount to Administer (ml) Concentrationanswer 5 mg = 2 ml 2.5 mg/ml