Guest guest Posted March 23, 2004 Report Share Posted March 23, 2004 The dose range usually stated for Dopamine infusions is 5-20 mcg/kg. In practice, where do you start? 5 mcg/kg? 10 mcg/kg? Gene G. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 23, 2004 Report Share Posted March 23, 2004 Ok, now I'm officially scared of paramedic school.... 8o) Tempy Re: Dopamine Drips I don't know about easy- but here's one way. calculator preferred. Infusions should be administered using a 60gtt set. Take your drop factor (60) divided by the concentration per ml. Dopamine standard is 1600 mcg/ml. 60 divided by 1600 = 0.0375. Every drop that drips through that set contains 0.0375mcg of dopamine. Now, your patient & rate. Suppose your patient weighs 84 kg, and you want to run dopamine at 2-10mcg/kg/min. 84 x 2-10 = infusion rate range of 168 mcg/min to 840 mcg/min. Mulitlply amount per drop times the desired dose to get drops per minute. (0.0375 x 168 =) 6.3 to (0.0375 x 840=) 31.5. For the above patient, dopamine rate is 6.3 drops per minute to 31.5 drops perminute to infuse at 2-10 mcg/kg/min. Here's another- are you familiar with the clock method? It's especially helpful if your patient weighs a nice 100kg or so, but can also help you check other calculations. Draw a circle clockface to represent 1 minute, or 60 seconds. Assign the value of 60 at the top. Assign the values for 15, 30, and 45 seconds around the clock. The whole value (60 seconds) also represnts 1 ml using a 60gtt set, and the 'seconds' also represent the drops per ml. Your 'answer' using the clock method will be expressed in drops per minute. Next, apply your solution concentration per ml at the top, with the 60. Dopamine standard is 1600 mcg/ml. Assign the concentration value in 1/4 increments around the rest of the clockface: 15gtt = 400mcg, 30gtt = 800mcg, 45gtt = 1200mcg. 60gtt delivers 1600 mcg of dopamine, 30gtt delivers 800mcg, etc. Now, calculate for your patient. Suppose pt weighs 100kg. Your dopamine infusion range is 2-10mcg/kg/min, or 200-100mcg/min. At a glance of the clockface, you can see that 15 drops per minute delivers 400mcg per minute. Your patient's initial dose is exactly half that- 200mcg per min, or 7.5 drops per minute. At a glance, you can also see that the upper range will fall somewhere between 30gtt (800) and 45gtt (1200).,BUT the easiest way to figure the upper range is to mutlipy your inital times 5; 37.5 drops per minute. The range for 100kg pt at 2-10 mcg/kg/min, or 200-1000mcg/min, is 7.5gtt to 37.5 gtt per minute. The clock method is also helpful to check any patient. Take the first example. The calculation of 6.3 gtt/min to 31.5 gtt/min to deliver 168 to 840 mcg/min...accurate? At a glance you see that 15gtt delivers 400mcg, therefore half that, 7.5 gtt will deliver 200mcg. The calc of 6.5gtt to deliver 168 is reasonable, as is 31.5gtt to deliver 840mcg. Not an exact confirmation, but helpful just in case you screwed up a whole decimal place. Using the clock method to check yourself would quickly tell you there's something wrong if you've started the dopamine at 63 drops per minute instead of 6.3 > Does anyone here know an easy way to figure out a Dopamine Drip? ------------------------------------------------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 23, 2004 Report Share Posted March 23, 2004 Ok, now I'm officially scared of paramedic school.... 8o) Tempy Re: Dopamine Drips I don't know about easy- but here's one way. calculator preferred. Infusions should be administered using a 60gtt set. Take your drop factor (60) divided by the concentration per ml. Dopamine standard is 1600 mcg/ml. 60 divided by 1600 = 0.0375. Every drop that drips through that set contains 0.0375mcg of dopamine. Now, your patient & rate. Suppose your patient weighs 84 kg, and you want to run dopamine at 2-10mcg/kg/min. 84 x 2-10 = infusion rate range of 168 mcg/min to 840 mcg/min. Mulitlply amount per drop times the desired dose to get drops per minute. (0.0375 x 168 =) 6.3 to (0.0375 x 840=) 31.5. For the above patient, dopamine rate is 6.3 drops per minute to 31.5 drops perminute to infuse at 2-10 mcg/kg/min. Here's another- are you familiar with the clock method? It's especially helpful if your patient weighs a nice 100kg or so, but can also help you check other calculations. Draw a circle clockface to represent 1 minute, or 60 seconds. Assign the value of 60 at the top. Assign the values for 15, 30, and 45 seconds around the clock. The whole value (60 seconds) also represnts 1 ml using a 60gtt set, and the 'seconds' also represent the drops per ml. Your 'answer' using the clock method will be expressed in drops per minute. Next, apply your solution concentration per ml at the top, with the 60. Dopamine standard is 1600 mcg/ml. Assign the concentration value in 1/4 increments around the rest of the clockface: 15gtt = 400mcg, 30gtt = 800mcg, 45gtt = 1200mcg. 60gtt delivers 1600 mcg of dopamine, 30gtt delivers 800mcg, etc. Now, calculate for your patient. Suppose pt weighs 100kg. Your dopamine infusion range is 2-10mcg/kg/min, or 200-100mcg/min. At a glance of the clockface, you can see that 15 drops per minute delivers 400mcg per minute. Your patient's initial dose is exactly half that- 200mcg per min, or 7.5 drops per minute. At a glance, you can also see that the upper range will fall somewhere between 30gtt (800) and 45gtt (1200).,BUT the easiest way to figure the upper range is to mutlipy your inital times 5; 37.5 drops per minute. The range for 100kg pt at 2-10 mcg/kg/min, or 200-1000mcg/min, is 7.5gtt to 37.5 gtt per minute. The clock method is also helpful to check any patient. Take the first example. The calculation of 6.3 gtt/min to 31.5 gtt/min to deliver 168 to 840 mcg/min...accurate? At a glance you see that 15gtt delivers 400mcg, therefore half that, 7.5 gtt will deliver 200mcg. The calc of 6.5gtt to deliver 168 is reasonable, as is 31.5gtt to deliver 840mcg. Not an exact confirmation, but helpful just in case you screwed up a whole decimal place. Using the clock method to check yourself would quickly tell you there's something wrong if you've started the dopamine at 63 drops per minute instead of 6.3 > Does anyone here know an easy way to figure out a Dopamine Drip? ------------------------------------------------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 23, 2004 Report Share Posted March 23, 2004 I like the clock method myself---simple like me. Larry Mc PJCEMSP Re: Dopamine Drips > I don't know about easy- but here's one way. calculator preferred. > > Infusions should be administered using a 60gtt set. > > Take your drop factor (60) divided by the concentration per ml. > Dopamine standard is 1600 mcg/ml. > > 60 divided by 1600 = 0.0375. Every drop that drips through that set > contains 0.0375mcg of dopamine. > > Now, your patient & rate. Suppose your patient weighs 84 kg, and you > want to run dopamine at 2-10mcg/kg/min. 84 x 2-10 = infusion rate > range of 168 mcg/min to 840 mcg/min. > > Mulitlply amount per drop times the desired dose to get drops per > minute. (0.0375 x 168 =) 6.3 to (0.0375 x 840=) 31.5. > > For the above patient, dopamine rate is 6.3 drops per minute to 31.5 > drops perminute to infuse at 2-10 mcg/kg/min. > > Here's another- are you familiar with the clock method? It's > especially helpful if your patient weighs a nice 100kg or so, but can > also help you check other calculations. > > Draw a circle clockface to represent 1 minute, or 60 seconds. Assign > the value of 60 at the top. Assign the values for 15, 30, and 45 > seconds around the clock. The whole value (60 seconds) also represnts > 1 ml using a 60gtt set, and the 'seconds' also represent the drops > per ml. > > Your 'answer' using the clock method will be expressed in drops per > minute. > > Next, apply your solution concentration per ml at the top, with the > 60. Dopamine standard is 1600 mcg/ml. Assign the concentration value > in 1/4 increments around the rest of the clockface: 15gtt = 400mcg, > 30gtt = 800mcg, 45gtt = 1200mcg. > > 60gtt delivers 1600 mcg of dopamine, 30gtt delivers 800mcg, etc. > > Now, calculate for your patient. Suppose pt weighs 100kg. Your > dopamine infusion range is 2-10mcg/kg/min, or 200-100mcg/min. > > At a glance of the clockface, you can see that 15 drops per minute > delivers 400mcg per minute. Your patient's initial dose is exactly > half that- 200mcg per min, or 7.5 drops per minute. > > At a glance, you can also see that the upper range will fall > somewhere between 30gtt (800) and 45gtt (1200).,BUT the easiest way > to figure the upper range is to mutlipy your inital times 5; 37.5 > drops per minute. > > The range for 100kg pt at 2-10 mcg/kg/min, or 200-1000mcg/min, is > 7.5gtt to 37.5 gtt per minute. > > The clock method is also helpful to check any patient. Take the first > example. The calculation of 6.3 gtt/min to 31.5 gtt/min to deliver > 168 to 840 mcg/min...accurate? > > At a glance you see that 15gtt delivers 400mcg, therefore half that, > 7.5 gtt will deliver 200mcg. The calc of 6.5gtt to deliver 168 is > reasonable, as is 31.5gtt to deliver 840mcg. > > Not an exact confirmation, but helpful just in case you screwed up a > whole decimal place. Using the clock method to check yourself would > quickly tell you there's something wrong if you've started the > dopamine at 63 drops per minute instead of 6.3 > > > > > > Does anyone here know an easy way to figure out a Dopamine Drip? > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 23, 2004 Report Share Posted March 23, 2004 You should start the drip at 5mcg/kg and titrate to effect as in blood pressure where you need it to be. Danny L. Owner/NREMT-P Panhandle Emergency Training Services And Response (PETSAR) Office FAX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 2004 Report Share Posted March 24, 2004 We usually start around 7 or 8 mcg/kg/min Tom LeNeveu Learning Paramedic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 2004 Report Share Posted March 24, 2004 Is the starting cardiac dose not 10 ug/kg/min ? Larry Mc PJCEMSP Re: Re: Dopamine Drips > We usually start around 7 or 8 mcg/kg/min > > > Tom LeNeveu > Learning Paramedic > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 2004 Report Share Posted March 24, 2004 For renal perfusion enhancement: 2.5-5.0 mcg/kg/min For pressure support: 10-20 mcg/kg/min Bledsoe, DO, FACEP Midlothian, TX Be good and you will be lonesome. -Mark Twain (from " Following the Equator " ) Don't miss EMStock 2004! http://www.emstock.com Re: Re: Dopamine Drips Is the starting cardiac dose not 10 ug/kg/min ? Larry Mc PJCEMSP Re: Re: Dopamine Drips > We usually start around 7 or 8 mcg/kg/min > > > Tom LeNeveu > Learning Paramedic > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 2004 Report Share Posted March 24, 2004 Thought so. Thanks LMc Re: Re: Dopamine Drips > > > > We usually start around 7 or 8 mcg/kg/min > > > > > > Tom LeNeveu > > Learning Paramedic > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 2004 Report Share Posted March 24, 2004 OK, so mantra aside what are the new guidelines and/or studies? By the way, that was a very good mantra. I can hear it in my sleep. Danny L. Owner/NREMT-P Panhandle Emergency Training Services And Response (PETSAR) Office FAX Quote Link to comment Share on other sites More sharing options...
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