Dextrose 10%???

[VirginiaEMT]

I am trying my best to figure out how to make D50 into 10% for neo-nates. In my mind, if you have 50% Dextrose this equates to 25g of Dextrose in the 50 ml of solution. This is 0.5g per ml. If you dump out 40 ml of solution, this leaves 10 ml X .5g= 5g of Dextrose. If you fill the bag back up to 50ml. this leaves a solution of 5g in 50 ml= 10%. Is this correct?

If yes, how in the world do I show this mathmatically on paper. I have grasped med math very well, I think, but for the life of me I can't figure out how to show this on paper.

BTW, this is not a test question you are helping me cheat on, unless it's on the National Registry exam that I take in July.

 

[dixie_flatline]

I am trying my best to figure out how to make D50 into 10% for neo-nates. In my mind, if you have 50% Dextrose this equates to 25g of Dextrose in the 50 ml of solution. This is 0.5g per ml. If you dump out 40 ml of solution, this leaves 10 ml X .5g= 5g of Dextrose. If you fill the bag back up to 50ml. this leaves a solution of 5g in 50 ml= 10%. Is this correct?

If yes, how in the world do I show this mathmatically on paper. I have grasped med math very well, I think, but for the life of me I can't figure out how to show this on paper.

BTW, this is not a test question you are helping me cheat on, unless it's on the National Registry exam that I take in July.

(a) If less than 2 months of age - Administer 5–10 mL/kg D10W IV/IO (D10W is prepared by mixing one part of D50W with four parts LR).

 

[ArcticKat]

Another alternative is to inject the entire D50 amp into a 500ml bag of D5W, giving you D10W. Infuse what you need and toss the rest.

 

[JJR512]

Another alternative is to inject the entire D50 amp into a 500ml bag of D5W, giving you D10W. Infuse what you need and toss the rest.

Not absolutely correct...

The D50 amp is 25g of dextrose in 50mL of fluid. A bag of D5W is 25g of dextrose in 500mL of fluid.

Add them together and you have a total of 50g of dextrose in 550mL of fluid, so mathmatically, you now have D9.091W, not D10W.

Is D9 close enough to D10 that it makes no difference? I don't know. But since it really isn't difficult at all to squirt out 40mL of the D50 amp and draw in 40mL of plain fluid, thus creating the desired D10, that's what I, personally, would do.

In other words, VirginiaEMT, your first paragraph is correct. As for how do you show it on paper, you've pretty much done that already. The 10mL of liquid left in the amp contains 5g of dextrose, like you showed. You then draw in 40mL of plain fluid (we'd use LR here in MD), for a total of 50mL. And 5 (the mg of dextrose) divided by 50 (the mL of fluid total in the amp) is 0.1, or 10%, thus D10.

 

[MasterIntubator]

You can also break it all down to the basic numbers ( which helped me understand it, thus giving another way to look at it ).

Rule: 1% of any drug is 10mg/ml

With this you can just about show on paper any drug dealing with %.

10% would be 100mg/ml.

100mg........(y) mg
--------- x ---------
1ml............. 500ml

y=50,000mg ( or 50gm in that 500ml bag )

You can make any dilution/volume etc using cross multiplication

Lets say you want a 25% dextrose solution in a 250ml NacL bag.

25% = 250mg/ml

250mg........ (y) mg
----------- x -------
1 ml ........... 250ml

y= 62,500mg ( 62.5gm ) needs to be in there.

Soooooooooooooooooo......

( there is 25gm in 50mls of dextrose 50% ( or 500mg/ml ))

25gm ........ 62.5 gm
--------- x --------
50ml .......... (m) ml

m = 125ml

Soooo, 125mls needs to be added to that bag for a 25% solution

Then use JJR512's info to put it all together

I just made that up for illustration... because you can probably figure out that if you take half the volume of 250ml and replace it with 125ml of D50, you would get D25. But that is how I would show on paper how I derived at that. You can shove any number in the world with the info above, and get results easily.

:-/

 

[Aidey]

My advice, don't waste D50, waste saline. Waaay easier to clean up. Plus if you end up needing more dextrose you didn't just waste 1/2 of it. Trust me, if you try and waste D50 something always gets sticky.

Waste 50mls out of a 250 bag, inject D50, the end result is 25g/250ml, or D10.

 

[dixie_flatline]

My advice, don't waste D50, waste saline. Waaay easier to clean up. Plus if you end up needing more dextrose you didn't just waste 1/2 of it. Trust me, if you try and waste D50 something always gets sticky.

Waste 50mls out of a 250 bag, inject D50, the end result is 25g/250ml, or D10.

This. Sadly, the smallest bags we have are 500.

 

[JPINFV]

This. Sadly, the smallest bags we have are 500.

So waste 300 ml of 0.9% salt water.

 

[ArcticKat]

Not absolutely correct...

The D50 amp is 25g of dextrose in 50mL of fluid. A bag of D5W is 25g of dextrose in 500mL of fluid.

Add them together and you have a total of 50g of dextrose in 550mL of fluid, so mathmatically, you now have D9.091W, not D10W.

Picking Nits.