1. Joint Special Operations Medical Training Center INFUSION RATE CALCULATIONS

2. Joint Special Operations Medical Training Center REVIEW ANESTHESIA DRUG DOSE

3. Joint Special Operations Medical Training Center ATROPINE Dose- 0.4 to 0.6 mg IM 45 to 60 minutes prior to anesthesia

4. Joint Special Operations Medical Training Center PROMETHAZINE Dose- 25 to 50 mg IM, slow IV, rectal, or PO 30 minutes prior to anesthesia

5. Joint Special Operations Medical Training Center DIAZEPAM Induction –Dose- 0.3 to 0.5 mg/kg slow IV Muscle relaxation –Dose- 1.0 to 2.0 mg slow IV prn

6. Joint Special Operations Medical Training Center KETAMINE Induction –Dose- 1.0 to 2.0 mg/kg slow IV Maintenance –Dose- 30 to 90 mcg/kg/min IV drip

7. Joint Special Operations Medical Training Center MIDAZOLAM Induction –Dose- 0.15 to 0.4 mg/kg/ slow IV

8. Joint Special Operations Medical Training Center MORPHINE Maintenance dose 2 to 20 mcg/kg/ IV drip

9. Joint Special Operations Medical Training Center NALOXONE Overdose - 1.0 to 2.0 mg slow IV q 5 minutes up to 3 times Maintenance - 400 mcg IV drip over one hour

10. Joint Special Operations Medical Training Center FLUMAZENIL Reversal of conscious sedation –Dose- 0.2 to 1.0 mg slow IV q 20 minutes @ 0.2 mg/min Overdose –Dose- 3.0 to 5.0 mg slow IV @ 0.5 mg/min

11. Joint Special Operations Medical Training Center INTRAVENOUS INFUSION FORMULA Set up 50ml x 2400mcg x 60gtts 400mg 1 min 1ml

12. Joint Special Operations Medical Training Center INTRAVENOUS INFUSION FORMULA Reduce 1ml x 2.4mg x 60gtts 8mg 1min 1ml

13. Joint Special Operations Medical Training Center INTRAVENOUS INFUSION FORMULA Cancel 1 x 2.4 x 60gtts 8 1min 1

14. Joint Special Operations Medical Training Center INTRAVENOUS INFUSION FORMULA Multiply 144gtts 8min Can this be reduce ?

15. Joint Special Operations Medical Training Center INTRAVENOUS INFUSION FORMULA Reduce 144gtts 8min to 18gtts 1min

16. Joint Special Operations Medical Training Center PR0BLEMS Patient is a 22 year old, 70 kg male with a GSW to the left thigh. Pulse 90 s/r, resp 18 d/r, BP 110/78, temp 98.4. Patient is in fair condition and is stable

17. Joint Special Operations Medical Training Center PR0BLEMS What dose and route for preanesthetic atropine will you give?

18. Joint Special Operations Medical Training Center PR0BLEMS preanesthetic atropine, 0.5mg IM

19. Joint Special Operations Medical Training Center PR0BLEMS What is the dose and route for preanesthetic promethazine for this patient?

20. Joint Special Operations Medical Training Center PR0BLEMS preanesthetic promethazine, 50 mg IV slow

21. Joint Special Operations Medical Training Center PR0BLEMS What is the IV induction dose of diazepam for this patient?

22. Joint Special Operations Medical Training Center PR0BLEMS IV induction dose of diazepam, 35mg What route/rate?

23. Joint Special Operations Medical Training Center PR0BLEMS route/rate, IV @ < 5mg/min

24. Joint Special Operations Medical Training Center PR0BLEMS With an infusion setup of 2.0 grams of ketamine in a 1000ml bag of 0.9% NaCl connected to a microdrip administration set what is the minimum maintenance rate in gtts/min?

25. Joint Special Operations Medical Training Center PR0BLEMS 63gtts/min

26. Joint Special Operations Medical Training Center PROBLEMS What is the maximum infusion rate? Multiply minimum by 3.

27. Joint Special Operations Medical Training Center PROBLEMS 189gtts/min

28. Joint Special Operations Medical Training Center PR0BLEMS How long will this same infusion setup last at the maximum maintenance rate (must know how many drops are in the bag)?

29. Joint Special Operations Medical Training Center PR0BLEMS Take the ml in the bag X the drop of the administration set = drops in bag.

30. Joint Special Operations Medical Training Center PR0BLEMS 1000ml X 60gtts = 60,000gtts

31. Joint Special Operations Medical Training Center PR0BLEMS Then divide 60,000gtts by 189gtts.

32. Joint Special Operations Medical Training Center PR0BLEMS 317minutes (About 5 hours and 28 minutes )

33. Joint Special Operations Medical Training Center PR0BLEMS At the minimum maintenance rate?

34. Joint Special Operations Medical Training Center PR0BLEMS At the minimum maintenance rate? Just multiply maximum by 3

35. Joint Special Operations Medical Training Center PR0BLEMS Just multiply maximum by 3 = 960 minutes

36. Joint Special Operations Medical Training Center PR0BLEMS A 50ml bolus from the maintenance bag will give the patient how much Ketamine?

37. Joint Special Operations Medical Training Center PR0BLEMS 2000mg divided by 1000ml = 2mg per 1ml

38. Joint Special Operations Medical Training Center PR0BLEMS 2mg X 50ml = 100mg Ketamine

39. Joint Special Operations Medical Training Center PR0BLEMS What is the dose and rate of flumazenil for a benzodiazepine overdose in this patient?

40. Joint Special Operations Medical Training Center PR0BLEMS The dose and rate of flumazenil for a benzodiazepine overdose, 5mg IV @ 0.5mg/min

41. Joint Special Operations Medical Training Center PR0BLEMS What is the maximum amount of 2% lidocaine with epinephrine that can be given to this patient ( in ml )?

42. Joint Special Operations Medical Training Center PR0BLEMS The maximum amount of 2% lidocaine with epinephrine that can be given to this patient ( in ml ), 490mg. How many ml?

43. Joint Special Operations Medical Training Center PR0BLEMS 2% lidocaine with epinephrine = 20mg per ml. 490mg divided by 20mg per ml = how many ml?

44. Joint Special Operations Medical Training Center PR0BLEMS 24.5 ml