[nimbex]

I admit to relying on the pump and the monitor, HP has the formulas for every drug in it. So my skills are dropping by the minute in drug calc.

One thing I STRESS to the new nurses, is that if they don't double check the rate the pump is running at through "old math", then they need to double check that the pump is programed right by the prior shift. Many a boo boo from this..

[zambezi]

In our unit, our critical care educator has made up "worksheets" to refer to...for dopamine and other weight based meds on the left in kgs, mcgs across the top and in the middle of the graph there are gtts...we have these worksheets for all of our vasoactive drips...also on these sheets is a brief summary of what the med does, how it works, and side effects...very useful, especially for meds that don't come aound much...most of our gtts are standard bottles with the same concentrations of meds...i do double check to keep up the math skills but in a pinch these forms are useful and reliable...we can also figure out all this on our monitors but we don't use that too often...we tirtate to effect 95% of the time unless the dr orders a direct dosage...and usually we still have a protocol to follow and titrate with after it is started...

[helix]

Wow, I feel like I work in the boonies, now...haha! We don't have monitors that do that! Our pharmacy calculates our gtts and puts them on the bag label. You get used to "eyeballing" it, and call them if it seems off. We have the Alaris pumps that calculate, but some of the gtts aren't in the menu.
I would really, really like to have those core numbers if someone could post them! Thanks...)

[nurse51rn]

Our educational services dept have made up cards about the common drugs we use in the critical care areas. We also have drug calculation cards where we figure out the dose (based on the formula found on the drug card), a 2nd nurse verifies the calcs and then co-signs the card. The card is then put with the Med Mar. This way, any nurse can check and verify the dose being given. We also have infusion pumps that can determine the dose. I use them to double check my figures only - I don't want to rely on something mechanical when it comes to giving critical drugs.

[Dierdron]

The ICU I work in uses a formula to figure out a "Konstant". It may be like the core numbers mentioned. I'm not sure. Our iv pumps don't figure out anything for us. We just tell them how many Milliliters to infuse per hour. The Konstant (K) works like this:

K=contentration of drug/patient's weight in Kg/60
The prescribed dose (mcg/kg/min) divided by K = cc/hr

Say the Dopamine concentration is 1600mcg/cc, the patient's weight is 75kg, and the order is to infuse at 4mcg/kg/min.

1600/75/60=0.36---(Konstant will always be 0.36 for this patient at this weight)

4/0.36=11.1 (set pump to infuse at 11.1cc/hr)

same patient needs dose titrated up to 6mcg/kg/min
6/0.36=16.7cc/hr

I've never seen this anywhere else.

[New2CVICU]

Our computerized documentation can calculate our IV drug dosages. We just need to make sure that our rate is current. It also gives us the option to change concentrations. We can also calculate in our bedside monitors. And of course there is good old fashioned long hand as a double check.

[CV CNS CCRN]

It is nice that we all now havavailable technology that will make these calculations for us. However, my personal beief is that one has a better understand of the infusion if one knows how to calculate the dosage manually. In a similar issue, it is OK to have your computer calcualte your SVR, as long as you understand the components that go into the calculation, so that you have a thorough understanding of what influences variations in the SVR. Yea for technology.... but always know what goes into that technology!

[RNCENCCRNNREMTP]

I use a Palm with the program "Infusicalc". It is great, I can pre-program it to my hospital standard concentrations for any drug. Plug in weight (if weight based) and dose needed and BAM I have a drip rate. If the drip is double concentrated it takes a couple of seconds to change the concentration and BAM I once again have the drip rate!

No muss, no fuss, no errors!!!!!

Can do boluses and drips!

[shannibaby]

Did anyone ever feel like nursing school would never end?
Question - what should I do to win over all of the nurses when I start preceptorship? Think brownies will work?

[critcarenurse16]

Originally Posted by healingtouchRN

Hi, In my CCU, our docs tell us the mcg/kg/min or mcg/min or units/hr they want & we figure it out. Daily weights are essential, as we do lots of weight based protocol (Lovenox & heparin). Not too hard once ya learn how. always nice to have a second pair of eyes check your math before you deliver your dose. Just like checking Insulin, double check can save ya a law suit. Ciao!

Exactly as we do in our facility. We also have Horizon NXT infusion pumps that calculate the dose-but we still double check because you can have errors programming the pump.