Introduction

It’s just a little math, don’t freak out!  If there is anything that strikes fear in the heart of many paramedics, it would be calculating drug dosages and drip rates.   In reality, calculating a drug dose or drip rate uses mathematical principles that you should have learned by the time you were in the 4th or 5th grade. 

For The Sake of All Mankind, Buy A Calculator And Take It To Work

Over and over and over and over again I hear my fellow EMS people complain about their working conditions.  I am sure many of you will ask questions or make comments like this:

• “I just want a formula that I can write down and that is all I want.”
• “How am I supposed to do math at 2:00 in the morning.”
• “What if I don’t have a calculator on my ambulance?”

Since I am sure that is what some of you are probably thinking, I will respond:

• A formula is useless if you don’t remember the formula.  Unless the formula has been proven to work it is equally useless.  A useless formula will be of no defense when you are taken to court after grossly overdosing your patient.
• I don’t know if anybody has ever studied what medications are normally given at what times of the day, but my guess is that very few people actually give Dopamine at 2:00 AM. 
• For the love of all things holy, buy a cheap calculator at a dollar store and keep it in your ambulance or in your uniform.  Spend maybe $15 or so and get a calculator watch.  Almost every cell phone built in the last 8 years has a built in calculator (I think even Sonny Crockett’s cell phone from Miami Vice had a calculator function).

The Mathematical Method

The challenge for Mathematicians is firstly to investigate some idea or part of the Universe, which intrigues them, trying to find if there is some underlying pattern or structure. If the investigation reveals a pattern then an attempt is made to generalize about the pattern – this is called making a conjecture. (This is similar to a scientist formulating an hypothesis from observation.) The Mathematician then goes about trying to prove that the conjecture is correct. (This is slightly different from science, which attempts to falsify the hypothesis – science accepts only those hypotheses, which can be tested). In science an hypothesis is accepted, and lasts in use until it is falsified. In Mathematics, a conjecture is not accepted until its proof is established. If the conjecture is found to be false then we say the conjecture is refuted.

We can sum up the entire mathematical method in three short statements:

1. Investigate – Gather all of the information on hand
2. Make a conjecture – Go out on a limb and make a calculation
3. Prove or refute – Work the problem in another fashion to prove or refute your findings.

In order to properly calculate drug dose calculations, you must be proficient in some basic math fundamentals. Most medical personnel like to use algebraic formulas in order to make accurate drug dose calculations. Unfortunately, one or two formulas will not allow you to calculate an accurate drug dose in all circumstances. So we will begin this lesson with a review of mathematical principles