Epi 1:1000 into Epi 1:10,000

[phideux]

My head hurts. :wacko::unsure::huh::huh:

 

[Veneficus]

Not to get off topic, but does it really matter?

We know there is no evidence showing epi helps.

We know there is some showing it actually hurts.

We also know this pharm concept called volume of distribution, and cpr creates basically a bellows effect, not actual circulation.

Since the deletorious effects are in central circulation, perhaps it might be beneficial that the 10cc of flush might not be enough to get to central circulation?

just a thought...

 

[Handsome Robb]

My head hurts. :wacko::unsure::huh::huh:

Seconded.

There has to be a language barrier or something. I don't know how else to spell it out. It's low level high school math.

Vene he can't get the concentrations why'd you have to go put that nonsense in his head hahaha

 

[Sandog]

Not to get off topic, but does it really matter?

We know there is no evidence showing epi helps.

We know there is some showing it actually hurts.

We also know this pharm concept called volume of distribution, and cpr creates basically a bellows effect, not actual circulation.

Since the deletorious effects are in central circulation, perhaps it might be beneficial that the 10cc of flush might not be enough to get to central circulation?

just a thought...

When I was a kid, I had bad asthma, at the time EPI was the only help. I can speak from experience that EPI brought me back from near suffocation many times. Sure the side affects were unpleasant, but breathing again was worth it.

 

[usalsfyre]

Not to get off topic, but does it really matter?

We know there is no evidence showing epi helps.

We know there is some showing it actually hurts.

We also know this pharm concept called volume of distribution, and cpr creates basically a bellows effect, not actual circulation.

Since the deletorious effects are in central circulation, perhaps it might be beneficial that the 10cc of flush might not be enough to get to central circulation?

just a thought...

I actually had the thought that while his partner made a med error, he actually gave what probably in reality was a far more appropriate dose....

The reason it matters is that while it was likely no harm, no foul in this case, what other med errors are being made because of lack of understanding.

 

[Aidey]

When I was a kid, I had bad asthma, at the time EPI was the only help. I can speak from experience that EPI brought me back from near suffocation many times. Sure the side affects were unpleasant, but breathing again was worth it.

He was talking about epi in cardiac arrest. It definitely can be beneficial in asthma, anaphylaxis and as a pressor.

 

[Aidey]

No.

You have 1 shot of rum. You add it to 1 shot of coke. You now have a 1:1 solution.
You have 1 shot of rum. You add it to 10 shots of coke. You now have a 1:10 solution.
You have 1 shot of rum. You add it to 100 shots of coke. You now have a 1:100 solution.
You have 1 shot of rum. You add it to 1000 shots of coke. You now have a 1:1000 solution.

In each case in order to get the whole shot of rum you have to drink the entire solution. Adding more coke doesn't make the rum stronger. So, if you only drink 10% of the 1:1000 solution you won't get the whole shot of rum.

So, if you medic wanted to give 1mg of epi, he would have had to give all 100cc of the normal saline.

Ok, lets try again.

When describing the concentration of a medication there are two numbers. The first number is the medication, the second number is the diluent. So in this case, 1:1000 means 1 part rum for 1000 parts coke.

In my above explication, the amount of rum never changes. There is always only one shot of rum. All I am doing is adding additional coke. If I take my mix of 1:1000 and pour it into 10 glasses, each glass has 1/10th of a shot of rum, and 100 shots of coke.

So, when your partner put 1mg of 1:1000 epi in 100cc, he created a solution that was 1mg of 1:100,000 epi. 10cc of that equals 1/10th of a mg of epi.

 

[Veneficus]

I actually had the thought that while his partner made a med error, he actually gave what probably in reality was a far more appropriate dose....

The reason it matters is that while it was likely no harm, no foul in this case, what other med errors are being made because of lack of understanding.

Overtreatment and administering an unindicated treatment is an error, we never get broken up over those. (especially where lack of understanding come in, like backboards.)

Why is it more of an issue when it is a medication?

 

[Melclin]

This all makes sense, thank you, but what the hell was he doing with a 100ml bag.... Can any of you come up with a way to do it with a 100ml bag... The point of it I remember was lets say for a cardiac arrest you could just keep drawing from the bag whenever epi was up...

On a side note, why does it have to be given as 10mls of 1:10,000? Why can't you take the 1mg/1ml neat and run it into a free flowing line from the bag you presumably have up?

Honestly, just forget the 100ml bag.

 

[RanchoEMT]

Ok, lets try again.

When describing the concentration of a medication there are two numbers. The first number is the medication, the second number is the diluent. So in this case, 1:1000 means 1 part rum for 1000 parts coke.

In my above explication, the amount of rum never changes. There is always only one shot of rum. All I am doing is adding additional coke. If I take my mix of 1:1000 and pour it into 10 glasses, each glass has 1/10th of a shot of rum, and 100 shots of coke.

So, when your partner put 1mg of 1:1000 epi in 100cc, he created a solution that was 1mg of 1:100,000 epi. 10cc of that equals 1/10th of a mg of epi.

Ahh, the point has been explained wrong to me by my medic, He stated that you only needed to deliver 1/10 of the existing Epi in the vial, not dilute it. Hmm wonder if that was an error in explanation or an error all together.... :mellow:

 

[Melclin]

Ahh, the point has been explained wrong to me by my medic, He stated that you only needed to deliver 1/10 of the existing Epi in the vial, not dilute it. Hmm wonder if that was an error in explanation or an error all together.... :mellow:

Yeah that makes sense. Its not a bad way to get the right dilution for your small adrenaline boluses in severe anaphylaxis/asthma/shock etc.

 

[usalsfyre]

Ahh, the point has been explained wrong to me by my medic, He stated that you only needed to deliver 1/10 of the existing Epi in the vial, not dilute it. Hmm wonder if that was an error in explanation or an error all together.... :mellow:

Your medic has fallen victim to on of the classic blunders. The most famous of which is never get involved in a land war in Asia. Only slightly less well known is don't mix up milliliters and milligrams when discussing epinephrine doses.

 

[Aidey]

Does it count for anything in this discussion that I am mostly Sicilian?

 

[phideux]

Does it count for anything in this discussion that I am mostly Sicilian?

Hey Waddaumean???? When it comes to being Sicilian you are, or you ain't. Ain't no mostly allowed.:rofl::rofl:

 

[Handsome Robb]

Why can't you take the 1mg/1ml neat and run it into a free flowing line from the bag you presumably have up?

This is how I was taught to do it if I use my three prefills out of my bag and go onto more rounds h34r:

Push 1:1000 through the top port a tid bit slower, like 5 seconds vs slamming it.

 

[Akulahawk]

Your medic has fallen victim to on of the classic blunders. The most famous of which is never get involved in a land war in Asia. Only slightly less well known is don't mix up milliliters and milligrams when discussing epinephrine doses.

What you do not smell is called iocane powder. It is odorless, tasteless, dissolves instantly in liquid, and is among the more deadlier poisons known to man...

 

[abckidsmom]

What you do not smell is called iocane powder. It is odorless, tasteless, dissolves instantly in liquid, and is among the more deadlier poisons known to man...

I have spent he last several years developing an immunity to iocaine.

He didn't stand a chance.

 

[TYMEDIC]

No, it's not.

That gives you 1 mg in 100 mL or 0.01 mg/mL. 1:10,000 is 1 mg in 10 mL or 0.1 mg/mL

I've always been taught waste 1 mL out of a 10 mL flush and draw 1 mL of 1:1000 epi into that flush to get 1:10,000

Second that!

 

[Tigger]

I have spent he last several years developing an immunity to iocaine.

He didn't stand a chance.

This thread has taken a turn straight for awesome!

 

[usalsfyre]

This thread has taken a turn straight for awesome!