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Paramedic math!


tskstorm

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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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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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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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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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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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