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
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