# Med Math is driving me to reconsider going to Paramedic school.



## jteeters (Oct 4, 2015)

Hey guys. I know there are numerous posts about this topic, but I'm seriously stressed out. I'm going to Paramedic school  currently, and up to this point have been doing very well (a foreign concept to me, if you saw my grades in High School). 

We've come to the dreaded topic of Med math. I know this is bad, but I find it very hard to do basic math. Add in drip rate calculations and I'm as dumb as the day is long.  I feel if I cant get this down, maybe I shouldn't be a Paramedic. Ugh. Idk. Any help?


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## Rano Pano (Oct 4, 2015)

Relax, you've just started this block. If you're bad with math you may have to work extra hard at it, but that's ok. I've always thought the math portion got blown out of the water. There's no tricks in math; but you do need to be precise. Don't doubt yourself. I'm sure you'll be fine. Worse case scenario you get a math tutor.


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## Tigger (Oct 5, 2015)

There aren't many equations, fortunately. For me, it's important that I plug everything in with the units attached so that I can ensure my answer is actually meaningful, IE the answer comes out in gtts/min, and the question is in fact asking for a drip rate.


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## Gurby (Oct 5, 2015)

Work through this Khan Academy series of videos and exercises, and you'll be able to breeze through any med math questions:  https://www.khanacademy.org/math/al...gebra/v/can-a-squirrel-avoid-getting-run-over


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## mgr22 (Oct 5, 2015)

jteeters said:


> Hey guys. I know there are numerous posts about this topic, but I'm seriously stressed out. I'm going to Paramedic school  currently, and up to this point have been doing very well (a foreign concept to me, if you saw my grades in High School).
> 
> We've come to the dreaded topic of Med math. I know this is bad, but I find it very hard to do basic math. Add in drip rate calculations and I'm as dumb as the day is long.  I feel if I cant get this down, maybe I shouldn't be a Paramedic. Ugh. Idk. Any help?



When I was teaching, math was a big issue for some medic students. You do have to have some basic skills to graduate -- say, arithmetic, fractions, decimals, and eighth-grade algebra. If you're missing any of those, you might want to get some tutoring before it's too late.

In my opinion, those who see EMS as a profession instead of a trade should be first in line to embrace at least high-school math, reading and writing competence as necessities.


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## StCEMT (Oct 5, 2015)

Have you sat down with an adjunct/instructor and told them what your problem was and asked them to break it down and guide you through the process with a few examples?


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## Seirende (Oct 5, 2015)

Math is one of my strong suits just because it makes my brain happy. Med math is my drug of choice.  I think that there are some instructors who, while they may be perfectly adequate at teaching medicine, might not be great at communicating mathematical concepts. So, going to learn from someone who specializes more in mathematics might be helpful for you.


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## ExpatMedic0 (Oct 6, 2015)

I know medical doctors, paramedics, and medical/science professors who are terrible at math. I am terrible at math. I was in a class yesterday and one of my favorite professors who is also an MD could barely do simple division on the blackboard and admitted he was terrible at math. Don't let it discourage you, it is intimidating if you struggle with math but you don't need to be great at math and you only need to master a few things beyond very simple arithmetic to function as a paramedic. Drip Rates and concentrations are by far the most difficult in my opinion.  Those are also skills I personally rarely use because I find myself normally bolusing most medications or in the case of pediatric we have tools such as a weight and length based tape for assistance. Also, some of it comes with experience. Once you start using the same drugs for the same kinds of patients it gets easier and you also know ballpark areas you should be in for your answers. However, with that being said if you get a dopamine drip at 3am or a pediatric cardiac arrest at 4am you wanna be prepared and you have to be able to safely function without endangering your patients. I had to pass 2 math classes to graduate with my bachelors degree and I have to take some biostatistics stuff in my masters program. It sucks, I am terrible at it, but I get through it so I can move on. Seek help if you need it and understand you don't need to be a math whiz, or even very good at math, but just how to safely perform your job when administering a limited number medications which require a limited number of formulas or concepts.


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## Jeff T (Oct 6, 2015)

Like this question for example:

You have been ordered to start a maintenance infusion of aminophylline to be run at 5mg/kg/hr.  Your patient weights 202 lbs.  On hand you have two vials containing 250mg in each, and a 250 bag of normal saline, with a minidrip set.  How many drops per minute would you deliver.  I keep coming up with somewhere between 225 and 230 gtts/min, and it doesnt seem right. what am i doing wrong?


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## luke_31 (Oct 6, 2015)

It's correct. You are giving approximately 230ml/hr. It would seem wrong if you are thinking over a minute not hour.


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## Gurby (Oct 6, 2015)

Jeff T said:


> Like this question for example:
> 
> You have been ordered to start a maintenance infusion of aminophylline to be run at 5mg/kg/hr.  Your patient weights 202 lbs.  On hand you have two vials containing 250mg in each, and a 250 bag of normal saline, with a minidrip set.  How many drops per minute would you deliver.  I keep coming up with somewhere between 225 and 230 gtts/min, and it doesnt seem right. what am i doing wrong?



That's the right answer.  I did it out:


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## Carlos Danger (Oct 6, 2015)

jteeters said:


> We've come to the dreaded topic of Med math. I know this is bad, but I find it very hard to do basic math. Add in drip rate calculations and I'm as dumb as the day is long.  I feel if I cant get this down, maybe I shouldn't be a Paramedic. Ugh. Idk. Any help?



I am terrible at math, too. Really terrible. Terrible as in I can't even help my _young_ kids with much of what they learn in grade school. Always had a really hard time with math; always worked really hard to just squeak through. And I remember being really scared of it as a new paramedic student, too.

The good news is, while it would of course be ideal to build a good comfort level with arithmetic and basic algebra in general, the reality is you don't need to. There are only a few calculations you need to be able to do, and even for someone really bad at math, they aren't hard to memorize. 

Write these down, keep them with you in the field, and review / practice them frequently:

convert pounds to kg = pounds / 2.2, OR divide pounds by two and subtract 10%
_example: patient tells you they weigh 264 pounds. 264 / 2.2 = 120 kg_

calculate concentration: the amount of drug in mcg, mg, or gm  / volume of diluent the drug is in
_example: 10,000 mcg (same as a 10mg vial) of phenylephrine in 100ml = 100 mcg per cc_

dose to give: dose per kg x patient weight in kg
_example: to give 0.1 mcg/kg of phenylephrine to a 120 kg patient: 1 x 120 =  120 mcg total dose_

volume to give: dose to give x kg / concentration
_example: to give 120 mcg of phenylephrine when the concentration is 100mcg/ml: 120 / 100 = 1.2 ml_


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## 18G (Oct 7, 2015)

In school, they make med math out to be 100x harder than it really is. All you need to know are like four simple formulas and some key principles that go along with them and you can figure out ANY drug dose or drip rate. I am not good at math either and cringe when I see dimensional analysis being taught. I overcame my weakness and found ways that aren't hard at all and have them committed to memory. In the field, all of your calculations should be performed on a calculator for greatest accuracy. It would be rare that you didn't have a calculator handy in the field (cell phones, laptop, carry one in a backpack, etc).


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## Gurby (Oct 7, 2015)

18G said:


> cringe when I see dimensional analysis being taught.



Hurts my feelings


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## Ethan (Oct 8, 2015)

dunkin donuts was dropping sugar over their coffee and tea     ddxwxds over cxt


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## EBMEMT (Oct 8, 2015)

@18G: Memorize your 4 formulas and you will be able to solve 4 problems.   The dimensional analysis approach solves thousands.    For example, someone proficient in dimensional analysis can solve your dosage calculations without any formulas, training, etc. specific to dosage calculations.   In some areas, dimensional analysis is currently taught in the 6th grade.

@OP: there are a variety of ways to solve dosage problems, find one that works for you.   There are lots of paramedics, nurses, doctors, etc. who are not good at math and learn to do it.   The math is very trivial compared to math required in many other occupations.  And there are a variety of resources out there to help you learn it.


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## Gurby (Oct 8, 2015)

EBMEMT said:


> @18G: Memorize your 4 formulas and you will be able to solve 4 problems.   The dimensional analysis approach solves thousands.    For example, someone proficient in dimensional analysis can solve your dosage calculations without any formulas, training, etc. specific to dosage calculations.   In some areas, dimensional analysis is currently taught in the 6th grade.
> 
> @OP: there are a variety of ways to solve dosage problems, find one that works for you.   There are lots of paramedics, nurses, doctors, etc. who are not good at math and learn to do it.   The math is very trivial compared to math required in many other occupations.  And there are a variety of resources out there to help you learn it.



I feel like it's best to learn dimensional analysis first, and THEN learn the shortcuts.  If you can solve problems the long way, you'll understand where the shortcuts come from and why they work, and it won't be so mysterious and intimidating.


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## Jeff T (Oct 12, 2015)

Thanks for the help, guys! I think I finally got it down.  I did the 50 questions in the back of the book that we're using and got all but 2 of them right, because I kept messing up the amount of dopamine to give per minute.  Thanks everybody!


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## Joshua Henson (Jan 16, 2019)

This app is awesome for quick calculations and double checking answers.

https://quickdoseapp.com/mobile

Quick Dose


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## Jn1232th (Jan 17, 2019)

I am horrible at math but honestly med math isn't that bad. All it take is some practice and make sure to look at various sources. Some ways of teaching didn't click for me and others did.


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## mgr22 (Jan 17, 2019)

justin1232 said:


> I am horrible at math but honestly med math isn't that bad. All it take is some practice and make sure to look at various sources. Some ways of teaching didn't click for me and others did.



You mean, you're actually using math to do math?  I was starting to wonder if they're still teaching it.


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