Medical Math
October 2014
Paramedic Academy
1
Topics
• Units of measure
• Conversions
• Dose / Volume / Concentration
• Age based medications
• Route based medications
• Weight based medications
• Infusions
2
Topics
• Inhaled / Nebulized medications
• Intranasal medications
• Oral medications
• Sublingual medications
• Intramuscular medications
• IV / IO medications
3
Units of measure
4
Units of measure
5
Units of measure
6
Conversion
7
Conversion
8
Keep track of your units
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Dose/ Volume/ Concentration
• Desired dose
• Concentration
• Dosage on hand
• Volume on hand
• Volume to be administered
10
Dose/ Volume/ Concentration
(Volume on hand) * (Desired dose)
Volume to be administered =
Dosage on hand
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Age based medications
• Diltiazem (<60 = 20mg; >60 = 10mg)
• Haldol (<60 = 5mg; >60 = 2.5mg)
• Ketorolac (>50 = MD only)
12
Route based medications
• Ketorolac (IV = 30mg; IM = 60mg)
• Midazolam (IV/IO/IN = 2.5mg; IM = 5mg)*
*protocol dependant
13
Weight based medications
• All pediatric medications*
• Lidocaine (<40kg = 20mg; >40kg = 50mg)
• Saline fluid bolus (20 mL / kg)
*Albuterol, Atrovent, Epi NEB, Lidocaine, Oxygen, Oxymetazoline
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Infusions
• Diltiazem (5mg / hr)
• Epinephrine (2-10 mcg / min)
• Dopamine (2-10 mcg / kg / min)
Ordered Dose Drop Set
*
Drip Rate (drops/time) = (mass/time) (drops/volume)
Concentration (mass/volume)
15
Infusions
• Lactated Ringers
(0.25 mL / kg) ([Link] in kg) (%TBSA)
Hour
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General Principles
• Why do we administer medications?
• Who/ What authorizes us to administer
medications?
• What precautions do we need to take
when administering medications?
– Six Rights
– Standard Precautions
– Medical Asepsis
– Documentation
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General Principles
• What precautions do we need to take
when administering medications?
– Six Rights
• Person
• Medication
• Dose
• Time
• Route
• Documentation
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General Principles
• What precautions do we need to take
when administering medications?
– Standard Precautions
• Hand hygiene
• Sharps
• PPE
• Resuscitation
• Soiled equipment
• Placement
• Environmental control
• Sneeze/ cough
• Laundry
etiquette
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General Principles
• What precautions do we need to take
when administering medications?
– Medical Asepsis
• Sterilization
• Disinfectant / Antiseptic
• Disposal
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General Principles
• What precautions do we need to take
when administering medications?
– Documentation
• Who
• What
• When
• Where
• Why
• How
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Routes of administration
• Percutaneous
• Pulmonary
• Enteral
• Parenteral
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Routes of administration
• Percutaneous
– Transdermal
– Mucous membranes
• Sublingual
• Buccal
• Ocular
• Nasal
• Aural
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Routes of administration
• Pulmonary
– Nebulizer
– MDI
– ET
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Routes of administration
• Enteral
– Oral
– Gastric tube
– Rectal
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Routes of administration
• Parenteral
– Intradermal
– Subcutaneous
– Intramuscular
– Intravenous
– Intraosseous
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Medication Packaging
• Syringe
• Needle
• Ampule
• Vial
• Prefilled
• IV infusion
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Routes of administration
• Inhalation / Nebulizer
• Intranasal
• Oral
• Sublingual
• Intramuscular
• Intraosseous
• Intraveinous
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Routes of administration
• Inhalation / Nebulizer
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Routes of administration
• Intranasal
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Routes of administration
• Oral
– Capsules; tablets
– Enteric coated/time-release capsules
and tablets
– Lozenges
– Elixirs, Emulsions, Syrups
– Suspensions
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Routes of administration
• Sublingual
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Routes of administration
• Intramuscular
33
Routes of administration
• Intraosseous
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Routes of administration
• Intraveinous
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