new to allnurse/calculating drips for ICU/CCU

Home Health Columnist / Guide · Feb 28, 2006

welcome!

got just the website for you. our colleage mark hammerschmidt's www.icufaqs.org

check out our critical care nursing forums too.

rarjn5 · Feb 28, 2006

Thank you for your fast reply. I have actually read everything on Mark H's website. It is great! I found it by accident and was relieved to read answers to some of my "dumb questions" and realized I'm not the only one to wonder about things in the ICU that are never explained. My problem is math, which I'm a little deficit in calculations. This is a totally fictitious problem. Say you have to give a loading dose of Esmolol of 500mcg/kg/min over 10 min. How would you calculate that and what would I set my IV pump at to run the dose over 10 min? What is the math formula to use?

thank you

loricatus · Feb 28, 2006

Thank you for your fast reply. I have actually read everything on Mark H's website. It is great! I found it by accident and was relieved to read answers to some of my "dumb questions" and realized I'm not the only one to wonder about things in the ICU that are never explained. My problem is math, which I'm a little deficit in calculations. This is a totally fictitious problem. Say you have to give a loading dose of Esmolol of 500mcg/kg/min over 10 min. How would you calculate that and what would I set my IV pump at to run the dose over 10 min? What is the math formula to use?
thank you

Multiply the 500 mcg by the kg weight of the patient [eg 50 kg pt, 500 x 50 = 25000 mcg/min for that 50 kg pt.]. Then, convert that answer into mg from the mcg by moving the decimal over 3 places to the left [25000 mcg -> 25 mg]. Now you have that patient needing 25 mg/min (IV pumps usually need mg for testing purposes). In 10 minutes the patient would require 250 mg [25 mg/min x 10 min=250 mg). But, IV pumps go by the ml/hour so you will need to know the mg/ml of the esmolol to continue [just cross multiply 250mg/x mL = mg concentration of esmolol/# ml and solve for x]. Remember to multiply the ml (once figured out) by 6 to account for the pump that only knows ml/hr [10 min X 6 =60 minutes=1hour]-by doing this the dose will be delivered over 10 minutes even though the pump says ml/hour

rarjn5 · Feb 28, 2006

Continuation of loricatus' response. If esmolol comes in a premixed bag of 250ml, concentration of 10mg/ml, my calculation would be to set my IV pump to 150cc to deliver 250mg (25cc) of esmolol over 10 minutes.

Thunderwolf, MSN, RN · Feb 28, 2006

Moved to Medical and Surgical ICU Nursing forum.

Kudra · Mar 2, 2006

here's a site that can help you practice your calculations:

http://www.accd.edu/sac/nursing/math/phtitra.htm

and the adjoining tutorial sites:

http://www.accd.edu/sac/nursing/math/titration.html

lewi450 · Oct 14, 2008

I get backwards in my head when I have to program a pump. I have 50ml of volume, doc wants it to go 1-2 hours, what is the rate on the pump?

I am embarasses this gets me so flustered.

R

may2kd · Oct 15, 2008

If you have 50 mL and the MD wants it to go over 1-2 hours, then just divide it. ie. 50/2=25, so 25 mL/hr will give it over 2 hours. So anywhere between 25-50 mL/hr will give the 50 mL over 1-2 hours.

P.S. No question is dumb...the hospital I'm at doesn't have pumps that automatically do the drip calcs for you. Basically it's at a set rate, and you have to figure out how much of the drug you're giving on your own!

allnurses Guide · Oct 15, 2008

When I started in ICU, I made a laminated card with the formulas and an example of each on it. I attached it behind my ID tag, so I could just flip it over and refer to it when required. After a while, you remember the formulae.

Try not to freak out about the math - just think logically about the problem. If you need to give 50ml over 2 hours, then to work out how much to give over one hour, you halve it = 25ml/hr. If you had to give it over 5 hours, it'd be 50/5 = 10 ml/hr. It helps to write these things down until you're familiar.