![]() 12 600mcg/hr is the same as 12.6mg/hr.Ī UKCC council meeting in Belfast in June 2000 expressed concern at the lack of basic maths skills (Coombes, 2000 Duffin, 2000) among nurses. Both need to be in the same units, so you must convert one to the other, in this case mcg to mg. The prescription is in micrograms, but in your syringe you have milligrams. Next the prescription rate needs to be converted into rate per hour, that is, The equation for infusion rate calculation is dose stated in prescription (milligrams per hour) times volume in syringe (in millilitres) divided by the amount in the syringe (in milligrams) equals the infusion rate (millilitres per hour), or:ĭose (mg/hr) x volume in syringe (ml) / Amount in syringe (mg) = Infusion rate Type C calculationsĪt what rate do you set the pump (ml/hr)?Īs before, what you want is calculated by multiplying the amount per kg by the patient’s weight, that is: However, if the infusion required that 600 micrograms were to be infused each hour instead, this would first need to be converted into mg before the infusion rate was calculated, that is, 600 micrograms = 0.6mg. This calculation is straightforward when the rate you want (30mg/hour) and the amount of the drug in the bag (250mg) are both in the same units (mg). Therefore the calculation shows that, to give 30mg per hour, the infusion pump rate would need to be set at 6ml per hour. ![]() In this instance, work out how many ml contain ONE mg of drug These are the same as type A calculations, only once you have worked out the volume that contains the amount of drug you need, you set the pump to give that amount per hour. The use of simple, memorable formulae for regular reference can be a great help (Box 1).Īt what rate (ml/hr) do you set the pump? And when using long division it is essential to get it the right way round. The latest guidelines for the administration of medicines (UKCC, 2000) state that the use of calculators ‘should not act as a substitute for arithmetical knowledge and skill’.ĭeveloping calculation skills relies on understanding decimals to make conversion easier. The opinion of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) (now the Nursing and Midwifery Council) is that nurses should not rely too heavily on calculators. Hutton (1998b) argues that calculators are usually available in areas where calculations are complex, and that their use should be encouraged. There is some debate over calculator use. Written accounts obtained from students in the study revealed that many felt unable to perform calculations such as long division and fractions without using a calculator, as they had come to rely on these at school. Her research into students’ competence in drug calculations demonstrated a marked improvement on initial test results after a structured revision programme. ![]() Hutton (1998a) suggests that a degree of ‘de-skilling’ has resulted from the increasingly user-friendliness of drug preparations and widespread use of electronic drip counters. Nursing competence in drug calculations has been a cause for concern (Duffin, 2000 Coombes, 2000). Wheatley et al (2001) call for routine use of pre-filled epidural infusion bags to avoid the risk of calculation error when ward staff prepare infusions. If given in too high concentrations, local anaesthetic used in epidural infusions can cause extensive motor blockade, leading to immobility and pressure ulcers, which is distressing to the patient (Lee, 1991). If opiates or, indeed, most drugs, have been calculated incorrectly, the consequences for patients can be serious. Postoperatively, the epidural route is now common for infusions of opiate and local anaesthetic.
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