Drug Guideline ICU Drug Calculations - aci.health.nsw.gov.au

1 Liverpool Hospital ICU: Pharmacology Intensive Care Unit ICU drug Calculations LH_ICU2014_Pharmacology_ ICU drug Calculations Page 1 of 3 drug Guideline ICU drug Calculations Summary: This Guideline outlines the formulas to be used for drug Calculations Approved by: ICU Medical Director Publication (Issue) Date: February 2014 Next Review Date: February 2017 Replaces Existing drug Guideline : ICU drug Calculations Previous Review Dates: 2004 1. Introduction: The Aims / Expected Outcome of this drug Guideline : Related Standards or Legislation NSQHS Standard 1 Governance National Standard 4 Medication Safety Related Policies drug Administration drug Prescribing Administration of IV Medication 2. drug Guideline : Policy Statement All care provided within Liverpool Hospital will be in accordance with infection control, manual handling and minimisation and management of aggression guidelines .

2 Medications are to be prescribed and signed by a medical officer/authorised nurse practitioner (NP) unless required during an emergency. All drugs administered during an emergency (under the direction of a medical officer/authorised nurse practitioner) are to be documented during the event, then prescribed and signed following the event. Medications are to be given at the time prescribed (as close to the time as is possible when multiple drugs require same time administration and, when the nurse is caring for more than one patient, recognition is given to a possible short Patient safety Staff will be will be proficient at drug Calculations and the use of drug dose formulae. Liverpool Hospital ICU: Pharmacology Intensive Care Unit ICU drug Calculations LH_ICU2014_Pharmacology_ ICU drug Calculations Page 2 of 3 delay to administration antibiotics and other lifesaving drugs are to be prioritised) and are to be signed by the administering nurse.

3 Parenteral medication prescriptions and the drug are to be checked with a second registered or endorsed enrolled nurse prior to administration. The rights of drug administration must be followed: right: patient, drug , dose, route, administration, time, reason for the drug , documentation, education and evaluation/outcome. Adverse drug reactions are to be documented and reported to a medical officer. Medication errors are to be reported using the hospital electronic reporting system: IIMS. guidelines are for adult patients unless otherwise stated 3. Guideline To Calculate micrograms/kg/min for a Given Flow Rate: Example: A patient is receiving an adrenaline infusion at 5mL/hr. Infusion of 4mg in 50mL sterile normal saline provides a strength of 80micrograms/mL. The patient weighs 90kgs.

4 You need to calculate the dose that the patient is receiving in micrograms/kg/min. Micrograms/kg/min = 5 x 80 -------------- 90 x 60 = micrograms/kg/minute The patient is receiving of adrenaline. To Calculate Flow Rate for a Given Dose in microgram/kg/min: Rate (mL/hr) = [(micrograms/kg/min x weight (kg) x 60] concentration (micrograms/mL) Example: You need to commence a dobutamine infusion at 5 micrograms/kg/min, for a patient who weighs 120kg. The 50mL syringe contains 250mg dobutamine, giving a concentration of 5mg/mL, or 5,000micrograms/mL. What rate would you dial up on the syringe pump? Rate (mL/hr) = [(5 x 120) x 60] ----------------------- 5000 = mL/hr Therefore, you would need to administer Micrograms/kg/min = rate (ml/hr) x concentration (mcg/ml) ---------------------------------------- --------------- Weight (kg) x 60 Liverpool Hospital ICU: Pharmacology Intensive Care Unit ICU drug Calculations LH_ICU2014_Pharmacology_ ICU drug Calculations Page 3 of 3 4.)

5 Performance Measures All incidents are documented using the hospital electronic reporting system: IIMS and managed appropriately by the NUM and staff as directed. 5. References / Links 1. MIMS Online, CIAP: NSW Health Department, Copyright MIMS Australia Pty Ltd. February 2012. 2. The Society of Hospital Pharmacists of Australia 2007, The Australian Injectable Drugs Handbook, 4th Edition, SHPA publications, Australia. Author: CNC ( ) Reviewers: ICU Director, ICU NM, NUM, ICU CNE, ICU CNS, Pharmacist, Endorsed by: A/ Prof. Michael Parr, ICU Director