NCM 203 SEPT 29 (SEC A) AND SEPT 30 (SEC B) HANDOUTS

IV Infusion
 Amount X set = Drop factor Amount of IVF = Ml/hr , rate per hour
duration in minutes total infusion time

Counting time / Adjusting IV rate.

 Start with solving what is needed
Drop rate
Ml/hr
 End with adding the time started and time computed.

Insulin sliding scale

 If CBG is less than 60 mg/dl = Refer to Endocrinologist
 If CBG is 60-70 mg/dl = Give Dextrose 50% 50 ml intravenous push now.
 If CBG is 71-80 mg/dl = Give Dextrose 50% 25 ml intravenous push now.
 If CBG is 81-120 mg/dl = No insulin
 If CBG is 121-150 mg/dl = Set Insulin drip at 2 ml/hr
 If CBG is 151-180 mg/dl = Set Insulin drip at 3 ml/hr
 If CBG is 181-210 mg/dl = Set Insulin drip at 4 ml/hr
 If CBG is 211-240 mg/dl = Set Insulin drip at 5 ml/hr.
 If CBG is over 240 mg/dl = Refer to Endocrinologist

Safe Dose / Maximum and Minimum Dose

 Identify the therapeutic range.
 Min value X weight
 Max value X weight

Dopamine / Dobutamine computation.

Drop factor
dose in mg X 1000 mcg/mg
diluents in ml X 60 min/hr

Mcg/kg/min
ml/hr X drop factor
weight

Ml/hr
mcg/kg/min X weight
drop factor

Problem: Given are Dobutamine 250 mg in D5W 100 to run at 12 ml/hr. Patient’s Weight is 65kg. How many
mcg/kg/min is the Dobutamine drip running at?

Heparin computation
Heparin
1. Units/h = total units of heparin 2. Cc/hr = units/h X IV diluents 3. Units/cc = total units of heparin
no. of hours to infuse total units of heparin IV diluents
Problem:
How many ml/hr will the Heparin Drip be running if the drip is set 10000 units to run for 16 hours in 500ml IV
fluid?

Pediatric Consideration:
 Fried’s rule: (children less than 1 year) = infant’s age (in months) X average adult dose
150months
 Young’s rule: Child’s dose (1-2 years) = Child’s age (in years) X average adult dose
child’s age (in years) + 12
 Clark’s rule: Children: 2-12 years old = Weight of child in pounds X average adult dose
150 pounds

Surface Area Calculation (consideration of height & weight)

= surface area (in square meters) X average adult dose
1.73