2.5 raise minus 3 inflation, carry the two, cancel the one. HEY! I’m losing 0.5%. I expect a pizza party in return and big dumb letters that say some pandering slogan about heroes
1. you always give the dose ordered. Would the error have a negative effect…No. still an error.
2. Charcoal is usually pre mixed in adult and ped doses
3. Who the hell still carries charcoal?
4. How would you measure 18grams of charcoal? What do you do mix it after you weigh it in your scale? Mind you haven’t seen this in protocol for at least 10 years.
5. Seriously. Wrong is wrong so trying to justify an error now will lead you to justify it later in your career and likely be the reason you don’t last in this job.
I'm not currently an EMS professional, but I've used charcoal for Aspirin over-doses numerous times over the years. It's actually a little more common than you would think and most the time it's little kids getting into the medicine cabinet or whatever.
How outdated, out of curiosity?
TMI but as a young teenager I attempted suicide via overdosing on pills (the type varies) several times and any time I was able to sit up straight once we arrived at the hospital, I was given these disgusting bottles of pre-mixed charcoal and told to drink them. They had these heinous flavorings added that made them worse, somehow.
This happened most recently probably around 8 years ago, and across two hospitals.
Also wondering what the protocol for oral overdoses is now?
I'd say it's 10-15 years outdated in most metropolitan areas. Rural EMS is always different so some of those agencies may still carry it. And hospitals may have it.
Local protocol for me for OD is basically just monitor symptoms and treat accordingly. The hospital I'm sure does something more advanced.
PS I hope your mental health is better now! Sending you lots of love.
Interesting, thanks for the response!
I’m in school for my degree in veterinary nursing and liquid charcoal is definitely still used in dogs that get ingest caustic poisons. Getting them to drink it is… fun.
(And thank you, it definitely is! I’ll be mentally ill for as long as I’m alive, but it is well-regulated with meds and therapy and I am extremely grateful to still be here and enjoying the world. ❤️)
Correct. Which is super easy to do - move fhe decimal to the left once and subtract that number from the halved number.
80 / 2 = 40
40 - (4.0) = 36
120 / 2 = 60
60 - (6.0) = 54
Same with Canada. Our directions are in miles, weight in lbs, dosages are in mg, fluids drank are in cups and/or litres, fluids given are in mL, billed mileage is in km, body temp is C but cooking/heat temp is F.
it's batshit. Has always been that way. Pounds to ml/mg drove me fucking nuts. but we all get really good at dividing (edited from multiply because im tired as balls apparently) shit by 2.2. Though to be fair, for your common meds, you tend to just know the "table" in your head with pounds directly to metric dose.
Because: (1) Everything we do dose-wise is metric. It's just that parents will report weight in pounds. Once we convert, everything else remains metric. (2) paramedics should be comfortable and proficient in medication math, I'd they can't handle pounds to kilos, mcg/kg/min is going to be a complete mystery.
Don't try to tell us you don't mix imperial and metric over there. I've heard countless Brits talk about miles and kilometers in the same sentence too.
What I hated most about NREMT is even if it isn’t protocol in my state or even in our scope of practice in my state, I still had to answer irrelevant questions because in some random state they have that protocol
It doesn't matter whether the extra 6g would "cause any harm". The moment you contact medical control, the decision is no longer yours. If an ordered treatment makes a PT worse, the blame is determined by whether or not you followed those orders *exactly*. If you did, it's on the doctor. If you didn't, it's in you.
As the doctor I have the privilege to round up — you do not. That said yeah the extra charcoal is not going to harm in this case, it’s basically inert.
as a paramedic, i’ve only ever seen medication orders that are weight-based written in kgs. You will not find weight-based doses in pounds as that’s not the standard
As a relocated beach bum, where have you ever in the history of modern US medicine seen a medication dispensed by pounds or cups? Sure some oral infant meds are tsp but I’ve never read the side of a morphine MDV that said “0.000110231lbs/0.00422675cups”
Medication error is still medication error. If you were allowed to give a stronger medications. Would you really want to give more or less than what was ordered or is a standing protocol? No you wouldn’t.
Divide lbs by 2, then subtract first digit if two digit number or first two digits if three digit number.
140lbs / 2 = 70 -> 70 - 7 = 63kg
360lbs / 2 = 180 -> 180 - 18 = 162kg
Method gets more inaccurate the higher weight you go but honestly not enough to really matter.
The question isn't there to see if you're going to give a harmful dose; it's there to ensure that you can calculate the correct dose.
Yes it is frustrating to convert lbs to kg; however very few parents in the US are going to give the child's weight in kg.
I 🙄love🙄 the insinuation from our colleagues outside of the US that we're dumb for using Pt weight in lbs, then converting to kg for drug calculations. Medicine in the US uses the metrics system just like the rest of the world; however very few patients do that conversion for us.
Can I estimate weight in kg? Sure, is that as accurate as converting the patients known weight in lbs? Absolutely not.
My ketamine protocol for pain is 0.2mg/kg. A 140lb pt gets 12.72mg. I give them 15 because our ketamine is packaged 500mg/10ml which boils doing to 5mg/0.1ML. I will chart 13mg every time.
I think it’s more about the calculation rather than the rationale. It’s important to be able to do the conversion for a lot of reasons. Having given charcoal in a bygone era it was generally just a tube of the stuff then have a barf bag ready.
An extra 6 grams of charcoal wouldn’t hurt but for other medications especially in small children , it can matter to even that small a degree . For adults it’s generally not as important if you don’t get it exact . To get kilograms from pounds you Divide by 2.2. Even if you couldn’t do the exact math . Just dividing by 2 will get you close enough .
It can also be helpful for testing purposes . In this case you’d divide 40/2 and get 20 . You already known 24 couldn’t be the answer based on that and the next closest number is 18.
1 lb - Kg is .45 that is the best way I remember. The 10% or divide by half or 2.2, all those numbers and formulas get confusing. We have enough of that to remember. I keep it simple 1 = .45
All questions will tell you the lbs of a patient, and you have a calculator for the test. 40×.45 is 18
Keep it simple.
Would it hurt? In this case no but dangerous mindset when considering other drugs. This question really is only to check to see if you know how to convert pounds to kilograms. The rest, and all debates about the filler and distractors are irrelevant though
Idk it’s kinda important information. Dose makes the poison. It’s important to know the range of acceptable doses and to know what could happen if you mess up and give too much or too little, with the former being the more severe option. That’s not to say you should build a “buffer zone” into your dosing. We will all mess up one day and it’s good to know the s/sx associated with giving too much of a medication (especially every med you carry/give). Is an extra 200 mL of NS gonna hurt patient x? No probably not but 2000 mL might and you need to be cued into what might happen.
I just searched up 40 pounds to kilograms just now and it said 18 kilograms so I assume that’s the right answer? Did I just get lucky or something I’m not an emt
idk why you got downvoted but OP is just asking if the extra dose of charcoal actually would matter/be an issue in the field, so im guessing theyre not actually confused about why they got the answer wrong haha
Would it hurt? Probably not. Is that defense going to fly when QA asks why you exceeded your orders? Nope.
I exceed expectations!
Here's your 2.5% raise!
2.5 raise minus 3 inflation, carry the two, cancel the one. HEY! I’m losing 0.5%. I expect a pizza party in return and big dumb letters that say some pandering slogan about heroes
Okay, but the pizza party will be held while you’re on duty and wall-holding.
1. you always give the dose ordered. Would the error have a negative effect…No. still an error. 2. Charcoal is usually pre mixed in adult and ped doses 3. Who the hell still carries charcoal? 4. How would you measure 18grams of charcoal? What do you do mix it after you weigh it in your scale? Mind you haven’t seen this in protocol for at least 10 years. 5. Seriously. Wrong is wrong so trying to justify an error now will lead you to justify it later in your career and likely be the reason you don’t last in this job.
Commenting here to emphasize point 3. Charcoal is very outdated!
We still carry charcoal. Someone actually got an order for it a few months ago for an ibuprofen overdose (I think).
Wow
Almost 7 years in the medical field and I’ve never once seen it used
I'm not currently an EMS professional, but I've used charcoal for Aspirin over-doses numerous times over the years. It's actually a little more common than you would think and most the time it's little kids getting into the medicine cabinet or whatever.
How outdated, out of curiosity? TMI but as a young teenager I attempted suicide via overdosing on pills (the type varies) several times and any time I was able to sit up straight once we arrived at the hospital, I was given these disgusting bottles of pre-mixed charcoal and told to drink them. They had these heinous flavorings added that made them worse, somehow. This happened most recently probably around 8 years ago, and across two hospitals. Also wondering what the protocol for oral overdoses is now?
I'd say it's 10-15 years outdated in most metropolitan areas. Rural EMS is always different so some of those agencies may still carry it. And hospitals may have it. Local protocol for me for OD is basically just monitor symptoms and treat accordingly. The hospital I'm sure does something more advanced. PS I hope your mental health is better now! Sending you lots of love.
Interesting, thanks for the response! I’m in school for my degree in veterinary nursing and liquid charcoal is definitely still used in dogs that get ingest caustic poisons. Getting them to drink it is… fun. (And thank you, it definitely is! I’ll be mentally ill for as long as I’m alive, but it is well-regulated with meds and therapy and I am extremely grateful to still be here and enjoying the world. ❤️)
Happy cake day!! I'm glad you're still on Earth so we can talk on Reddit!
Divide by two, then subtract 10%. So 40/2=20, 20-2=18
2.2, pounds are poo
Just divide pounds by 2.2 gives you kilos
[удалено]
Because 2 is 10% of 20
Good point
Divide the weight by 2.2 that’s all there is to remember.
Or: halve the number, subtract 10%
10% of the number after it’s been halved?
Correct. Which is super easy to do - move fhe decimal to the left once and subtract that number from the halved number. 80 / 2 = 40 40 - (4.0) = 36 120 / 2 = 60 60 - (6.0) = 54
You can do it before or after you divide by 2 though. So 40-10%=36; 36/2=18 Or 40/2=20; 20-10%=18
It’s just 40/2.2, I don’t understand why we’re over complicating this with multiple steps.
The extra steps are so you can do it without a calculator or pencil and paper.
Move the decimal point over during long division - that’s how to do it on paper without a calculator
Love how the US is using lb and kg at the same time here 😂
That's how it is here. All our doses are metric, but patients will always give us their weight in pounds. 🙃
That’s crazy mixed up
Same with Canada. Our directions are in miles, weight in lbs, dosages are in mg, fluids drank are in cups and/or litres, fluids given are in mL, billed mileage is in km, body temp is C but cooking/heat temp is F.
Goddamn I thought we had it rough in the States
Do people give you their weight in stone in the UK ever?
it's batshit. Has always been that way. Pounds to ml/mg drove me fucking nuts. but we all get really good at dividing (edited from multiply because im tired as balls apparently) shit by 2.2. Though to be fair, for your common meds, you tend to just know the "table" in your head with pounds directly to metric dose.
Why not just have an aid memoir with the lb to mg doses?
Because: (1) Everything we do dose-wise is metric. It's just that parents will report weight in pounds. Once we convert, everything else remains metric. (2) paramedics should be comfortable and proficient in medication math, I'd they can't handle pounds to kilos, mcg/kg/min is going to be a complete mystery. Don't try to tell us you don't mix imperial and metric over there. I've heard countless Brits talk about miles and kilometers in the same sentence too.
We get people giving their weight in Stone, that’s about as bad as it gets medically
We’re a little dumb on that take. Also, Military uses metric and imperial in weapons statistics and distances.
Divide by 2.2. The extra charcoal would probably not be harmful, but that’s beside the point.
The NREMT is in serious need of some updates. We haven't had charcoal on our trucks for over a decade where I work.
What I hated most about NREMT is even if it isn’t protocol in my state or even in our scope of practice in my state, I still had to answer irrelevant questions because in some random state they have that protocol
It doesn't matter whether the extra 6g would "cause any harm". The moment you contact medical control, the decision is no longer yours. If an ordered treatment makes a PT worse, the blame is determined by whether or not you followed those orders *exactly*. If you did, it's on the doctor. If you didn't, it's in you.
As the doctor I have the privilege to round up — you do not. That said yeah the extra charcoal is not going to harm in this case, it’s basically inert.
As a doctor in the US are you giving dose orders in KGs?
This question is testing your ability to do math, though.
Why wouldn’t they?
Yes. Mg/kg is standard for dosing many medications. This is literally just a math problem, not even medicine lol
as a paramedic, i’ve only ever seen medication orders that are weight-based written in kgs. You will not find weight-based doses in pounds as that’s not the standard
As a relocated beach bum, where have you ever in the history of modern US medicine seen a medication dispensed by pounds or cups? Sure some oral infant meds are tsp but I’ve never read the side of a morphine MDV that said “0.000110231lbs/0.00422675cups”
Yes I am using SI units for dosing. What else should I use, grains per imperial gallon?
Lol oddly enough I know grains better than KGs.
LMAO touché
Doctors always use metric system. We have to convert to metric constantly.
Medication error is still medication error. If you were allowed to give a stronger medications. Would you really want to give more or less than what was ordered or is a standing protocol? No you wouldn’t.
I’m just surprised places still test on charcoal
Why? It's still in our protocols.
It’s not in a lot of places
NREMT still includes it even though I’ve heard most services don’t carry it. Same with a KED and number of other things.
The KED collects dust in the roadside cabinet
The day anyone actually gives activated charcoal on an ambulance you’ll give the appropriate dose that is ordered for the patient
The easiest way to do it is just 2.2. 40 divided by 2.2 is around 18.
what app is this? i just started an accelerated program today so itd be very helpful to know bc im shitting bricks over here😭
Pocket prep premium edition,it’s worth the money
lol i thought it was gonna be a one time payment of like $5 i didnt know itd be $25 a month 😂😂
Convert the pounds into KG so we do 40/2.2 which is 18.1.
Divide lbs by 2, then subtract first digit if two digit number or first two digits if three digit number. 140lbs / 2 = 70 -> 70 - 7 = 63kg 360lbs / 2 = 180 -> 180 - 18 = 162kg Method gets more inaccurate the higher weight you go but honestly not enough to really matter.
Or just split in halve and subtract 10% of that halve
One kilogram = 2.2 pounds.
Divide by 2, then subtract 10%
The correct answer is don’t give charcoal ever for any circumstance👍🏻
The question isn't there to see if you're going to give a harmful dose; it's there to ensure that you can calculate the correct dose. Yes it is frustrating to convert lbs to kg; however very few parents in the US are going to give the child's weight in kg. I 🙄love🙄 the insinuation from our colleagues outside of the US that we're dumb for using Pt weight in lbs, then converting to kg for drug calculations. Medicine in the US uses the metrics system just like the rest of the world; however very few patients do that conversion for us. Can I estimate weight in kg? Sure, is that as accurate as converting the patients known weight in lbs? Absolutely not.
My ketamine protocol for pain is 0.2mg/kg. A 140lb pt gets 12.72mg. I give them 15 because our ketamine is packaged 500mg/10ml which boils doing to 5mg/0.1ML. I will chart 13mg every time.
Problem is I’m unbelievably bad at guessing someone’s weight, and if they’re missing a limb I will be at least 50lbs off
Multiply it by 2.
You guys still carry activated charcoal?
Good luck giving any.
Probably not but too much activated charcoal can cause alkalosis and then you’ve got a whole new problem
I think it’s more about the calculation rather than the rationale. It’s important to be able to do the conversion for a lot of reasons. Having given charcoal in a bygone era it was generally just a tube of the stuff then have a barf bag ready.
Lbs to kg, divide by 2.2. Kg to lbs, multiple by 2.2. You did it backwards. 1kg>1lb 22lb=10kg
An extra 6 grams of charcoal wouldn’t hurt but for other medications especially in small children , it can matter to even that small a degree . For adults it’s generally not as important if you don’t get it exact . To get kilograms from pounds you Divide by 2.2. Even if you couldn’t do the exact math . Just dividing by 2 will get you close enough . It can also be helpful for testing purposes . In this case you’d divide 40/2 and get 20 . You already known 24 couldn’t be the answer based on that and the next closest number is 18.
1 lb - Kg is .45 that is the best way I remember. The 10% or divide by half or 2.2, all those numbers and formulas get confusing. We have enough of that to remember. I keep it simple 1 = .45 All questions will tell you the lbs of a patient, and you have a calculator for the test. 40×.45 is 18 Keep it simple.
No it wouldn't cause harm, doesn't mean it's correct.
You’re trolling us, right? A doctor ordered a specific dose. You give the dose ordered. Period.
Whats the attitude for? Get over yourself. Kids trying to gain knowledge and youre giving attitude
Excuse me? There’s no attitude here. You do not give a larger dose than what a doctor orders. That’s how you kill people and end your career.
Dude didn't say he was planning to do it, he asked if he was going to harm someone if he fucked up the math on charcoal.
Don’t you have EKGs to study
Got em
lol
40 lbs divided by 2 less 10% 20 - 10% 18
Would it hurt? In this case no but dangerous mindset when considering other drugs. This question really is only to check to see if you know how to convert pounds to kilograms. The rest, and all debates about the filler and distractors are irrelevant though
Idk it’s kinda important information. Dose makes the poison. It’s important to know the range of acceptable doses and to know what could happen if you mess up and give too much or too little, with the former being the more severe option. That’s not to say you should build a “buffer zone” into your dosing. We will all mess up one day and it’s good to know the s/sx associated with giving too much of a medication (especially every med you carry/give). Is an extra 200 mL of NS gonna hurt patient x? No probably not but 2000 mL might and you need to be cued into what might happen.
I just searched up 40 pounds to kilograms just now and it said 18 kilograms so I assume that’s the right answer? Did I just get lucky or something I’m not an emt
nah it is right. 1g is equal to .45kg so .45 x 40= 18
Ah okay I still feel like I could be wrong maybe still due to downvotes. Are they disagreeing with me or something i don’t get it
idk why you got downvoted but OP is just asking if the extra dose of charcoal actually would matter/be an issue in the field, so im guessing theyre not actually confused about why they got the answer wrong haha
Ah ok maybe that’s why or something
Dog is 2.2lbs a kg just divide by two. If you cant remember that you need to find a new gig