Can you solve this mcg to mg conversion?

[Emergent]

I was working at my Per Diem job yesterday. One of the acute care nurses came to me, baffled by an order for Fentanyl that read 100mcg/2ml give 0.025 to 0.05 mg. First of all, I think that's a dumb way for pharmacy to transcribe the order. But, nevertheless, I couldn't get this fellow to understand how much to give. He told me that he is usually good at math, but I kind of doubt it. I diplomatically walked him through it several times, not giving any hint that I thought he should know this. It's important for us nurses to be able to ask our co-workers to double check without them rolling their eyes.

So, allnurses cohorts, is this nursing 101 or is this a confusing order? Can you figure out how many ml to give?

[Emergent, RN]

500 mikes of fentanyl will fix their pain along with that annoying breathing habit.

I hear the pt in question was a bit irritating...

[RNexplorer]

I think it makes the most sense to write the order in the same units as the medication is dispensed in. This will lead to the least amount of error. If read correctly, .025 mg is 25 mcg and .050 mg is 50 mcg. Therefore, the amount to give would be 25 mcg(2mL/100 mcg) to 50 mcg (2mL/100mcg) = 0.5 to 1 mL. Likewise, working it all out in mgs: 0.025 mg(2mL/0.1mg) to 0.050 mg (2mL/0.1 mg) = 0.5 mL to 1 mL.

However, I agree that the potential for error here is great! The way orders are written can lead to unnecessary mistakes. To the OP, thanks for bringing up this issue.

[imdeborah]

Check your math....there are 1000 mcg/ mg. 100 MCG to mg is actually. 01, not 0.1. Your calcs give 10 times a normal dose.

.025mg to .050mg is a common dose(although a wonky way to write it).

You would give 1/2 to 1 ml.

[macawake, MSN]

I was working at my Per Diem job yesterday. One of the acute care nurses came to me, baffled by an order for Fentanyl that read 100mcg/2ml give 0.025 to 0.05 mg. First of all, I think that's a dumb way for pharmacy to transcribe the order. But, nevertheless, I couldn't get this fellow to understand how much to give. He told me that he is usually good at math, but I kind of doubt it. I diplomatically walked him through it several times, not giving any hint that I thought he should know this. It's important for us nurses to be able to ask our co-workers to double check without them rolling their eyes.

So, allnurses cohorts, is this nursing 101 or is this a confusing order? Can you figure out how many ml to give?

Well, I've been awake for more than twenty-four hours giving patients Fentanyl and other stuff so I probably shouldn't be attempting any calculations at this point in time...

Stupid order in my opinion, mixing micro- and milligrams.

100 µg / 2 ml = 50 µg / ml.

(Patient supposed to be administered between 0.025 and 0.05 mg).

0.025 mg x 1000 = 25 µg

0.05 mg x 1000 = 50 µg

So the patient should get between 0.5 ml and 1 ml.

[No Stars In My Eyes]

Where on my computer keyboard do I find the u with the tail on the left side????

[Kyrshamarks, BSN, RN]

it's 25 to 50 mcg.

Kind of silly to dose fent in milligrams but still Nsg 101...

0.025 mg * (1000 mcg / 1mg) = 25 mcg which is a common starting dose for fent... For the standard ampule of 100mcg/2ml, give 0.5 ml.

[macawake, MSN]

The more I think about this, the more annoyed I get. Eventhough every nurse should be able to convert milligrams to micrograms and vice versa, mixing different units like that is just a mistake waiting to happen.

Perhaps they should start writing orders in nanokilograms or picotonnes to make things more exciting for both us and the patients

Where on my computer keyboard do I find the u with the tail on the left side????

That depends on your computer (software), for Windows you press down alt and type 230 (remember numeric lock). You can do a search for "keyboard shortcuts" and find many more.

[MunoRN, RN]

it's 25 to 50 mcg.

0.25 - 0.5 mg is 25 to 50 mcg?

[AnnieOaklyRN, BSN, RN, EMT-P]

25-50 mcg. 0.5 ml-1 mL

That was too easy, but I agree stupid way for pharmacy to write the order!

[Here.I.Stand, BSN, RN]

I see you must have fixed the OP, 'cause I got 25-50 mcg. But yeah... 1) my 10 yr old can multiply by 1000, and 2) fentanyl is dosed in mcg, so it should never be dosed in mg. That's a big dosing error waiting to happen.

[KelRN215, BSN, RN]

Check your math....there are 1000 mcg/ mg. 100 MCG to mg is actually. 01, not 0.1. Your calcs give 10 times a normal dose.

.025mg to .050mg is a common dose(although a wonky way to write it).

You would give 1/2 to 1 ml.

100/1000 = 0.1. 1000 mcg = 1 mg, 100 mcg = 0.1 mg, 10 mcg = 0.01 mg and so on/so forth. The errors in the posts on the first page appear to have been related to a typo in the OP, as she explained in a later post.