Drug Calculations

Hi, I’m Mark from ACLS Certification Institute and we’re going to begin today’s segment
with a new segment we call- ACLS Mailbox. Sometimes we get
comments back and we want to address a few of those in our video program. One comment from a viewer came back a great
video blah blah Why did the present to use CC after
lidocane? I can tell you I use cc because
I’m old. The new trend now on a couple years ago they want to replace CC with ml when describing Food Administration. And I agree with
that, its more precise. Ml stands for milliliters, you know its the amount of fluid. CC stands for cubic centimeters and it denotes the amount of space. Know that one milliliter
of fluid will occupy one CC of space. So in the end are almost
interchangeable. For years and years and years I’ve been saying CC. Now the
new guidelines can use ml. Am I gonna change? Probably not. I’ve been saying CCs for twenty years- that’s a hard habit to break. Should you be working a cardiac arrest
me to the head a cardiology and he says go ahead administer 10 CCs 10 per
cent tells him for a give it don’t have to correct him right
there if you want a crack team afterwards that’s fine invite me i’d love to see it on but
there’s no need to see season ml the important protesting most definitely
use them out in your documentation use em out for the
CC slip photos from his mouth know that the Nano actual to purchase thank you very much
people’s comments coming we appreciate it when we look at all over this concludes today’s mail box Hi, I’m Mark for ACLS Certification Institute. And today’s program we’re going
to talk about Drug Calculations. How to drop correctly and administer the proper
dose of medications to your patients. Now first let’s take a look at the drug
packaging. First you’re gonna have the name of the drug. Very helpful. Second, you’re gonna have the total amount of drug in that container. Then, you’re going to
have the total amount of fluid that’s in that container and then you’re
gonna have to concentration and the concentration is how much drug
per cc in that container. And you need to know all these are the
weekend accurately calculate and administer our drugs. Seems about every eight minutes in EMS
someone’s coming up with a new acronym, a name a new pneumonic flip chart, a table guide, something
scribbled on a napkin with the formula so we can remember how
do stuff. And formulas are great and I’m gonna share
with you today’s some formulas that I learn for calculating medications. For simple injectables for one time shots remember the formula: give divided by have times CCs in the vials. equals, CC’s Administered. Let’s break
that down a little bit. Give divided by Have. Give. When we talk about give, we talk about how much drug do I want to
administer that patient. And that’s the dose. The dose is how much drug
were giving the patient. Not how many CC’s but how much drug are we administering to the patient. So how much drug do I want to give, divide that by How much drug do I have? That’s the total amount of drugs in this vial. So give, divided by have, times CC’s in the vial. And that remains
constant even if you start drawing fluid or medication in that vial the numbers CC’s in that vial remains the same ’cause that’s the concentration. So for example if you have
four milligrams in 2 CC’s when you pull up CC is still 2 CC – you don’t subtract that amount. So whatever’s on the vial, whatever is written on the vial, that remains constant throughout the administration of the drug; or repeat administration that drug. So
remember, give divided by have times CC in the vial equals the amount of CCs we drop to administer that dose. So let’s take a
look at that. Let’s run through a practice here. Let’s say
we have a patient, we’ve worked them, we’ve resuscitated them, but that I still need some sedation. So I have some Diazepam here and I have 10 milligrams in 2 mL’s. It gives me the total amount of drug which is 10 milligrams the total amount of fluid which is 2 mL’s and it also gives me the concentration which is 5 milligrams per
ml. So the doctor says okay give him 4 of Diazepam. Okay, 4 Diazepam. How much I want to give the patient? I want to give the patient four
milligrams, that’s the dose of medication I’m going to divide that by how much drug do I have which is 10 milligrams so four divided by ten, equals 0.4, then take that point for them
all to play it by the number see season as well which is to thank you me point eighth that means I’m gonna
drop point game Atmel’s to administer step 4
milligrams a ver got let’s do some practice for a minute
but use that formula give divided by have time cc in the vial I’m gonna give you some drug workers no
homework up the problem and see if you get the right answer %ah %ah the ha the hope ok let’s talk about calculating for
medication infusions now now use example that gold now the person we have to calculate for
figure out is our concentration in you want to be your dosing
concentration you’re working concentration now we all know the starting dose
dopamine for heart failure about five mice per kilogram per minute
this begs to cum four hundred milligrams in 250 fun and
dosing in micrograms signing my concentration in my project
now I can simply look it up on the package
and it gives me that 1600 Mikes per ml for concentrations if this was an iMac
is still figure it out distinctly four hundred milligrams
divided by 250 thank you 1.6 milligrams per ml for them dosing in my program play have
to have the same dosing cramps and you know my
concentration weren’t dosing and in this case it’s micrograms somewhat a
file on point six five thousand by 1600 might
spur CC for an out that’s the first thing you
have to calculate what what is by working concentration than for dopamine simply over that right guard what you want when
you want Minister the peace I wanted you 5 Mikes per kilogram permit also pitch away 7200 possibly write that down fired time
seventy times sixty who is permitted divide that by my concentration which is
1600 and Apple more by have lost corralled all infusion pumps are set openly to
administer ml her out with that’s what talk to any
part how many animals per hour my going to administer to achieve that dole’s for five mice per
kilogram permitted so let’s say we’re gonna start and my
picture Patiala weighs 80 kilograms UK 10 times eighty time sixty divided by my concentration people’s I’m most proud here’s a nifty little trip but saying
that the drug isn’t weight-based it’s just permit take that part out same form okay so
using this method was calculated up some different
dopamine drops again I’ll give you a dosing prather from the doctor possibility of you need to are you
working on your answer but we’re going to couple a problem %ah on the the drug preparations come in all different
kinds the sizes food packaging but when I want to focus
on right now scott Carpenter if you’re not familiar with these I’ll
let me just go through and show you how these guys were now car plunges a prefilled syringe was
designed to go into this actuator you slide this in so wat parts going to
fit into this group here now how do you activate the car project
you’re gonna screw in the bottom and by turning this lever at the bottom
in locking you then what that does is that polls this way
have into the vial there’s a small meal inside here that
punctures along membrane and allow us to talk to be administered
but what has to happen this is why part has to be pushed down to actuate get that needle inside the
well so we can Minister the medications to remove it simply unlock it unscrew and hoping a pop-up now I’m not a math whiz did have a
calculator watch for my risk for a reason we have to use
technology in some bigger calculations back to a more
powerful group you wanted to double check your work which means you’re going
to have to have it not to wear make sure you have the right join route lifetime right documentation and have
someone else double check your through versa but picking on him Yanks noble check United don’t be afraid
to ask absolute this if you look double take a
medication for you I hope these formulas hell hope you had a good time i’m mark very
similar certification institutional see in the next on boats look if you remember him a fun
one min movement remember maintain
accountability you medically for example a moment ago the syringe had
any lot was full Academy I will the classic an ample back I come
back to me knows conga drums car what happened I

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