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Paramedic math!

29 posts in this topic

Posted · Report post

First off I am not an instructor yet, I'm not even a paramedic yet, however I have been charged with making a part of the pretest, for future incoming paramedics.

I have been given the math section as I am very strong in math, and medication calcs.

However the exam I took to get in I thought didn't have enough math and it was too easy, people who scored in the 90's on it, are doing horrible in math in class. I thought stepping it up would be a good idea. I have permission to do just about anything on the exam I want so long as I keep future paramedic candidates best interest in mind.

Trying to make it harder in a way they can succeed better later, as opposed to making it harder just because I can.

The exam currently holds addition subtraction (with the exception of like 2 problems the rest will be removed I think basic addition and subtraction questions are pretty silly) multiplication and division of whole numbers, fractions, and decimals. metric system conversions, percentages, decimal to percent, and thats really it.

I am looking for suggestions on types of problems, there are currently no word problems but I was thinking about adding them in, as part of doing medication calcs is picking and choosing what information you need for that problem.

Also just general advice about test making would be greatly appreciated.

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Posted · Report post

On "Who want's to be a 5th grader?" or whatever they had this problem as 5th grade math...

What is a common factor of 12 and 36?

Miraculously, Mrs. USA knew this, but thought that the heavenly body that made up 99% of our SOLAR SYSTEM'S MASS was (her answer) THE UNIVERSE...She answered both question's with certainty...

I think she ended up winning like $175,000. People applauded...

*Gun to head*

Most EMS math is pretty quick and easy...

EDIT - If anyone here doesn't know within 3 seconds what the answer is to my above "math question", you don't belong in EMS or any job that needs an education above a 6th grade level.

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Posted · Report post

Most EMS math is pretty quick and easy...

Yes I know, however, I don't think the entrance exam reflects the medication calcs as well as it could but not sure how to improve it.

Adding and subtracting problems are pretty silly, I am also planning on setting up the exam to hopefully give a decent item analysis, to see where the student is weak, if they are specifically weak in any area.

Thx for the tidbit about Mrs. America though!

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Posted · Report post

I dunno....

Dopamine calcs?

Want/have calcs?

X fluid over X time?

These are pretty standard... concentration? %? serial dilution?

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Posted · Report post

The school is anti-putting actual calcs on.

They want the math to be there without the actual calc. I think its just silly.

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Posted · Report post

How about using the metric system since all meds are calculated using it.

Oh and vs-eh, 12

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Posted · Report post

I would keep some basic addition and subtraction that if missed your automatically kicked out. Why you ask? I have met paramedics and basics that could not do 2+2. If not trained to pass the test they would not even be allowed to make burgers at the golden arches.

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Posted · Report post

2+2=5 should be an acceptable answer though.

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Posted · Report post

Take my calculator away and I’d be no help at all! Seriously, I couldn’t tell you something as easy as a 6th grade math question… Just in case you think I’m joking, I’m not… I can do basic math like adding and subtracting but anymore than 3 numbers it’s becoming difficult!

This is because my states education system is up S#%t creek without a paddle. Calculators were used in EVERY math class and it was suggested that you take a calculator to exams (because without it the teachers know we’d all fail and they’d look bad and maybe get a pay cut). There was no need to work it out in your head.

I’ve got a mate who’s going into a 2nd year accounting degree, at football he uses a calculator to work out change from someone buying a pie at the canteen! Yet he got top marks in Advanced Math because he had a calculator…

Teachers just assume all kids have a sound knowledge of basic math, which is the biggest load of crap! Most people I know would be able to draw you up a Linear graph or work out a Pythagoras theorem but wouldn’t have the first clue when it came to basic multiplication, division, fractions ect… Every year I did Math in high school, without a doubt we’d spend the first few weeks going through the ‘introduction to calculators’ chapter.

I’d say keep the basic stuff in there! I know it’s going to take a lot of work to bring my math skills to an acceptable level! :lol:

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Posted · Report post

How about using the metric system since all meds are calculated using it.

That's an excellent suggestion. Metric equivalents, like mls in a litre, ccs in an ml, cms in a metre, kgs per pound, etc... I dunno if they are teaching this in public schools these days (I would hope so), but this is something they need to know before class, or else you'll either bog down trying to teach them, or have an unreasonable failure rate.

Also, I applaud you for making it more difficult for the right reasons. There is a real tendency to make things hard just to give their students another hoop to jump through, without really doing anything to achieve the primary goal, which is to either evaluate your students' preparation and potential for paramedic success, or to educate them.

Because you are keeping your eye on that primary goal, I suggest a practical and pragmatic approach. Obviously, drug calculations are not something they need to have already studied or learned. However, drug calculations are just basic algebra, which is nothing more than solving for x. I would go heavy on those kinds of equations, but utilising common, everyday commodities as your variables, instead of medications and milligrams. Apples and oranges types of word problems that allow the candidate to utilise his ingenuity to solve a problem, rather than numerical problems that require a specific formula. Again, if they can solve the problem, I don't really care what technique or formula they use to do it with, so don't get anal about showing "proper" steps to solve the problem. There are many ways to skin the cat, and if you start dictating how they do it, you suppress their creativity, which is an asset. Also, mix it up by covering a wide range of scenarios, such as length, weight, volume, concentration, etc...

Of course, you're not the first to consider this problem. Almost every nursing school in the country has such a pre-test. Contact a few and see what they have to say. Trying to reinvent the wheels that other health professions have been rolling on for decades is one of the things that is holding EMS back. Benefit from their experience. Not only will it save you a lot of time, research, and effort, it will help improve our image in their eyes to see us actively looking to elevate to their level.

I'm very interested in what you come up with, so I hope you will share the results. Good luck!

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Posted · Report post

One thing I noticed is that many tend to make the math more difficult than it really is. Perhaps from thinking "too much". Or even feel over-whelmed or intimidated about it. Start out with just a couple of basically easy problems so that they aren't blown away by being stumped by the very first problems. If they are stumped at the very beginning they may freeze on the rest.

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Posted · Report post

I am looking for suggestions on types of problems, there are currently no word problems but I was thinking about adding them in, as part of doing medication calcs is picking and choosing what information you need for that problem.

Give these a try:

1. Ordered: Trilafon 24 mg po bid.

Available: Trilafon concentrate labeled 16 mg/5 ml.

How many ml will you administer?

2. Ordered: SoluMedrol 100 mg IM q8h

Available: Vial 1 ml in size labeled 125 mg SoluMedrol/3 ml

How many ml will you administer?

What size syringe is best to administer this dose?

3. Ordered: Ampicillin 400 mg IM q6h

Available: Vial with powder. Label reads: For IM injection, add 3.5 ml diluent (read accompaning circular). Resulting solution contains 250 mg Ampicillin per ml. Use solution within one hour.

How many ml will you administer?

4. The physician orders Lasix 20 mg IV stat for a child weighing 34 lbs. The pediatric handbook states that 1 mg/kg is a safe initial dose. Should you give this dose?

5. A child with a BSA of 0.32 M2 has an order for 25 mg of a drug with an average adult dose of 60 mg. Calculate the child's dosage. Is the physician's order correct?

6. Ordered: Infuse 2 L of Lactated Ringers solution in 24 hours. The administration set has 12 gtts/ml. How many gtts/min will you administer the IV?

7. Ordered: D5W 50 ml with 20 mEq KCl to infuse at 8 mEq KCL/hr per IV pump. How many ml of solution will you administer per hour?

8. Ordered: Gentamycin 100 mg/100ml IVPB q8h. The IV handbook states that it should be given over 90 min. What rate will you set on your IV pump?

9. Ordered: Nafcillin 900 mg IVPB q6h for a 27 kg child. Available: Dry powder in 1 g vials. Admin.. set: 60 gtts/ml. The vial states to reconstitute with 3.4 ml diluent to produce 1g/4 ml with concentration of 250 mg/ml. The medication book recommends giving a concentration of 100 mg/ml, duration of infusion 10-20 minutes.

How many milliliters of the reconstituted medication will you draw up for each dose?

10. How much fluid will you need to add to the medication drawn up in question 9 to achieve the recommended concentration?

11. What rate (gtts/min) will you infuse the medication in question 9?

Good luck!

Be Safe,

WANTYNU

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Posted · Report post

Give these a try:

1. Ordered: Trilafon 24 mg po bid.

Available: Trilafon concentrate labeled 16 mg/5 ml.

How many ml will you administer?

2. Ordered: SoluMedrol 100 mg IM q8h

Available: Vial 1 ml in size labeled 125 mg SoluMedrol/3 ml

How many ml will you administer?

What size syringe is best to administer this dose?

3. Ordered: Ampicillin 400 mg IM q6h

Available: Vial with powder. Label reads: For IM injection, add 3.5 ml diluent (read accompaning circular). Resulting solution contains 250 mg Ampicillin per ml. Use solution within one hour.

How many ml will you administer?

4. The physician orders Lasix 20 mg IV stat for a child weighing 34 lbs. The pediatric handbook states that 1 mg/kg is a safe initial dose. Should you give this dose?

5. A child with a BSA of 0.32 M2 has an order for 25 mg of a drug with an average adult dose of 60 mg. Calculate the child's dosage. Is the physician's order correct?

6. Ordered: Infuse 2 L of Lactated Ringers solution in 24 hours. The administration set has 12 gtts/ml. How many gtts/min will you administer the IV?

7. Ordered: D5W 50 ml with 20 mEq KCl to infuse at 8 mEq KCL/hr per IV pump. How many ml of solution will you administer per hour?

8. Ordered: Gentamycin 100 mg/100ml IVPB q8h. The IV handbook states that it should be given over 90 min. What rate will you set on your IV pump?

9. Ordered: Nafcillin 900 mg IVPB q6h for a 27 kg child. Available: Dry powder in 1 g vials. Admin.. set: 60 gtts/ml. The vial states to reconstitute with 3.4 ml diluent to produce 1g/4 ml with concentration of 250 mg/ml. The medication book recommends giving a concentration of 100 mg/ml, duration of infusion 10-20 minutes.

How many milliliters of the reconstituted medication will you draw up for each dose?

10. How much fluid will you need to add to the medication drawn up in question 9 to achieve the recommended concentration?

11. What rate (gtts/min) will you infuse the medication in question 9?

Good luck!

Be Safe,

WANTYNU

This would be more medic level questions, not pre-medic entrance exam.

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Posted · Report post

One thing I noticed is that many tend to make the math more difficult than it really is. Perhaps from thinking "too much". Or even feel over-whelmed or intimidated about it. Start out with just a couple of basically easy problems so that they aren't blown away by being stumped by the very first problems. If they are stumped at the very beginning they may freeze on the rest.

The test will be arranged into mini subjects, first 5 questions will be addition/subtraction, next 5 would be fraction multiplication etc....

This way when the results come in, it will be easy for the program to evaluate the candidates weaknesses, and possibly get them appropriate help before class starts.

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Take my calculator away and I’d be no help at all! Seriously, I couldn’t tell you something as easy as a 6th grade math question… Just in case you think I’m joking, I’m not… I can do basic math like adding and subtracting but anymore than 3 numbers it’s becoming difficult!

This is because my states education system is up S#%t creek without a paddle. Calculators were used in EVERY math class and it was suggested that you take a calculator to exams (because without it the teachers know we’d all fail and they’d look bad and maybe get a pay cut). There was no need to work it out in your head.

I’ve got a mate who’s going into a 2nd year accounting degree, at football he uses a calculator to work out change from someone buying a pie at the canteen! Yet he got top marks in Advanced Math because he had a calculator…

Teachers just assume all kids have a sound knowledge of basic math, which is the biggest load of crap! Most people I know would be able to draw you up a Linear graph or work out a Pythagoras theorem but wouldn’t have the first clue when it came to basic multiplication, division, fractions ect… Every year I did Math in high school, without a doubt we’d spend the first few weeks going through the ‘introduction to calculators’ chapter.

I’d say keep the basic stuff in there! I know it’s going to take a lot of work to bring my math skills to an acceptable level! :|

The thing here, is two things, one, you will have to do basic subtraction in your long division, so 2 or 3 basic additions and subtractions questions should suffice, I mean if you can't do the 2 or 3 right, you wont get 10 of them right either. :)

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The test will be arranged into mini subjects, first 5 questions will be addition/subtraction, next 5 would be fraction multiplication etc....

This way when the results come in, it will be easy for the program to evaluate the candidates weaknesses, and possibly get them appropriate help before class starts.

Sounds like a good format.

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Posted · Report post

That's an excellent suggestion. Metric equivalents, like mls in a litre, ccs in an ml, cms in a metre, kgs per pound, etc... I dunno if they are teaching this in public schools these days (I would hope so), but this is something they need to know before class, or else you'll either bog down trying to teach them, or have an unreasonable failure rate.

Also, I applaud you for making it more difficult for the right reasons. There is a real tendency to make things hard just to give their students another hoop to jump through, without really doing anything to achieve the primary goal, which is to either evaluate your students' preparation and potential for paramedic success, or to educate them.

Because you are keeping your eye on that primary goal, I suggest a practical and pragmatic approach. Obviously, drug calculations are not something they need to have already studied or learned. However, drug calculations are just basic algebra, which is nothing more than solving for x. I would go heavy on those kinds of equations, but utilising common, everyday commodities as your variables, instead of medications and milligrams. Apples and oranges types of word problems that allow the candidate to utilise his ingenuity to solve a problem, rather than numerical problems that require a specific formula. Again, if they can solve the problem, I don't really care what technique or formula they use to do it with, so don't get anal about showing "proper" steps to solve the problem. There are many ways to skin the cat, and if you start dictating how they do it, you suppress their creativity, which is an asset. Also, mix it up by covering a wide range of scenarios, such as length, weight, volume, concentration, etc...

Of course, you're not the first to consider this problem. Almost every nursing school in the country has such a pre-test. Contact a few and see what they have to say. Trying to reinvent the wheels that other health professions have been rolling on for decades is one of the things that is holding EMS back. Benefit from their experience. Not only will it save you a lot of time, research, and effort, it will help improve our image in their eyes to see us actively looking to elevate to their level.

I'm very interested in what you come up with, so I hope you will share the results. Good luck!

We do have a decent amount of metric system conversion questions, but they focus mostly on kg, gm, mg, and mcg's. I will try and add in some others. the problem is, they would prefer keeping the math section to only 50 questions, but I can always ask if I could add more, but I suppose coming up with the first 50 will be the challenge as it is, but there are just so many topics in math to cover. Math is only a quarter of the pretest.

I will add the algebra in, however the test must remain multiple choice due to scoring and laziness on the programs part but I will put in word problems with multiple choice answers, the route to get the answer will be quite unimportant. Perhaps I could end the exam with 5 word problems, "...one covering length, weight, volume, concentration etc..."

I will contact some nursing schools but I don't really know where to begin with that, although the college I go to and am writing this for does have a nursing program, perhaps I can speak to some of the professors from that department.

Thx dust

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Also just general advice about test making would be greatly appreciated.

I have not read all replies, so maybe this has already been mentioned, but I would say that it is important to test the validities of your questions. This may just need to be done by carefully looking at the results of the first group of candidates to complete the test, but it is important because some questions that seem well written can end up testing poorly on real people taking the test.

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I have not read all replies, so maybe this has already been mentioned, but I would say that it is important to test the validities of your questions. This may just need to be done by carefully looking at the results of the first group of candidates to complete the test, but it is important because some questions that seem well written can end up testing poorly on real people taking the test.

Great Idea, I will most likely have some classmates(on the bottom end of the scale) take the test and see how they do!

Thanks again !

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This would be more medic level questions, not pre-medic entrance exam.

Don’t get hung up on the specifics, just because they name certain drugs, the questions don’t ask for effect or are the choices correct, they’re really only math questions. You stated you were looking for word questions, not pure math (6/2=3).

Take another look, they not as hard as they seem, and you are testing for aptitude, after all, the purpose of a word problem is to see if the person taking the exam can pick out the relevant information.

-w

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Don’t get hung up on the specifics, just because they name certain drugs, the questions don’t ask for effect or are the choices correct, they’re really only math questions. You stated you were looking for word questions, not pure math (6/2=3).

Yeah, that's what I was trying to say. By "word problems," I meant things like, "If Johnny has five dollars, and apples cost 22 cents a piece, how many apples can Johnny buy?" Those can still be answered in multiple choice format. I didn't mean essay problems that require a composed answer. Sorry for the confusion.

By using apples, you can easier stimulate people to find their own way towards problem solving, showing what they really know. Although anybody who can solve the apples problem should be able to solve the medication problem too -- after all, it's the same equation -- it will throw many candidates for a loop. Yes, I agree that those who aren't thrown for a loop are probably your best candidates. But just showing their ability to do algebraic deductive reasoning is enough for me. If they can do that, it'll only take me a day to show them that drug calcs are just as easy.

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When we were learning drug calcs before I transfered to RN, we used basic nursing medication guidebooks, there are a wide variety available on Ebay and amazon and can be transfered to the EMS field as they relate to over time, weight, conversions *SLED - Smaller to Larger Equals Divide* etc.

Might help might not, worth a shot and consult your pharmaco section of your brady book *hint hint* there is a maths section in there.

Scotty

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I know you had said earlier that the school doesn't want to do much in the way of actual drug calcs. Being that the case, what about drip rates?

For instance: You have a 30 minute transport and need to infuse NS at a rate of 250/hr, how many drops per minute on a 60gtts set up?

Something like that. It's part of the NSC for EMT-B, so it should already be known.

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Attatched is something I put together for my organization. It's not a test, but good referance material based on your topic. I also included something I found on the net.

thanks but your about 15 months too late lol

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