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Colorado Down and Dirty Dopamine Dose Ditty


Just Plain Ruff

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Kudos to Bob Page on this one.

We just were discussing drug drips and this jumped out at me while reviewing the 2001 Multi-Lead Medics workbook

Credit goes to Bob Page

Weight in pounds/10 subtract 2. This gives you the pump setting in ml/hr or gtts/min for dopamine at 5mcg/kg/min with a bag concentration of 1600mg/ml

Example The patient says they weight 100Kg? Ha ha Yeah right. The patient weighs 220 pounds. That would be

220/10, which is 22 minus 2 leaves 20. Set your pump at 20ml/hr

Bob sure has a way of making this painless huh?

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That has been around for years mate. I even posted it in some threads several years ago on this site.

But yeh for the most part it is quick and easy way to do a dopamine drip at 0300. You will get "around or approximately" 5mcg/kg doing it that way.

The even easier way was to take their weight in lbs and start your drip at whatever the first two numbers are...I mean after all we are approximating the rate here.

220lb = 22 gtts

180lb = 18gtts

This will get you in the area of 5-7 mcg/kg.

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Yeah, it is also in the Brady Critical Care Paramedic textbook. However, I strongly caution against learning and utilizing catch all formulas. This sets you up for complacency and medication errors. Especially, if you happen to mix a "non standard" concentration.

Take care,

chbare.

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I agree. Our service has one single concentration of dopamine. We do not start this drug or any other one like it without a pump and without a drip chart. To do any less is to violate our standard of care.

But we don't have pumps in the ems bags when we go in a house so I'll start the drip in the house and then put it on a pump and use the drip chart.

but yeah, using the rule all the time and not using a pump is askiing for bad juju.

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I agree. Our service has one single concentration of dopamine. We do not start this drug or any other one like it without a pump and without a drip chart. To do any less is to violate our standard of care.

But we don't have pumps in the ems bags when we go in a house so I'll start the drip in the house and then put it on a pump and use the drip chart.

but yeah, using the rule all the time and not using a pump is askiing for bad juju.

What we would do, if we had a pump in the rig, was to have someone go out to the rig with all the pt.'s weight info and set up the pump while others were preparing the pt. for transport. Hopefully someone would have started a line by then so we wouldn't have to stick on the move. It usually worked out quite well.

The biggest problem was that if it was a city call we rarely had a pump back in those days. If medical control insisted on it even though ETA would be no longer than 3 mins., some would go ahead and start the drip but have it at a minimal drip rate. I always thought that was kind of "iffy" on pt. care. But it would be better than accidently OD'ing somebody.

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I dont like shortcuts when it comes to drugs that can kill your patient or not save them if not given correctly. It is not that hard to be exact, you just need a calculator (which most laptops with windows has an accessory -- If not, you can buy one for less than $3.00) :

Remember: Multiply everything together then divide by concentration:

administer 5 mcg/kg/min to a 110kg pt with a concentration of 1600

5x110x60 (min)= 26670 / 1600 = 20.62

8.5mcg for 20kg pt with 800 concentration

8.5 x 20 x 60 = 10,200 / 800 = 12.75

Two of the most important, cheap, pieces of equipment that is missing from many ambulances are:

A REAL thermometer and a calculator !

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I have to go along with the thought that the pump is the way to go. Yes, it's good to know the formula, every good paramedic should, but the pump almost eliminates med errors. Of course, they can still happen, but certainly the frequency of more common errors are eliminated. As for starting care inside the house, shouldn't we be following our basics first before jumping right into dopamine? How about trendeleberg position? If you wanted to move into advanced care, why not try a saline bolus. From there, you've spent enough time inside the house and are probably moving towards the truck. If you want to look towards dopamine, you'll be in the right place to administer it safely.

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