Drug dosages to know cold?
Started by EthylMethylMan
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Pain meds
Nausea meds
Sedation meds
Common antibiotics
Cardiac meds (dilt, metoprolol, amio)
Nausea meds
Sedation meds
Common antibiotics
Cardiac meds (dilt, metoprolol, amio)
For what?
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The ones worth knowing are the ones you give often. It's really that simple. Don't overthink it.
On my Oral boards it was apparently essential to know dosing for PTU, and Propranol for thyroid storm. I just admitted to the examiner I would take the hit on those since he claimed I couldn't call pharmacy (phones were down) and the package insert was missing.......
Nowadays, conventional wisdom for the oral boards is that it's OK to say "I'd look that up and then give the correct dosing" for most meds we don't use daily.
To OP: Don't worry about memorizing any dosages except the RSI and ACLS meds. You'll remember the doses for the ones you use daily soon enough. You can just look up the rest on Uptodate. Yeah, this will slow you down initially, but after a few times you'll remember them and then it won't. I still look up dosing for, eg, all pediatric antibiotics except amoxicillin. Don't worry about it.
Honestly….for most of us who see 80% adults and the rest peds, and the peds we do see is simple stuff...the only things we really have to know cold that we don't use on a regular basis would be peds resuscitation meds.
Everything else...you probably already know because you use it all the time. Or just look it up. You usually don't have to know something THIS SECOND to save a life. You have a minute to pull out your phone.
Speaking of that...is there a good (and preferably free) iOS medication only app that people use or like? Hopefully specifically tailored for the ER?
Actually I wouldn't even try to memorize pediatrics resus dosing. That's exactly how people make catastrophic (or at least decimal point) errors. Just use the Breslow tape.
Pediatric vital signs are another story.
it's like 0.1 for everything, right
LOL
epi, versed, tylenol, amoxicillin, glucose, Robaxin. it's 0.1 for everything LOL
Ahh...the cool-aid from CHONY attendings.
I was once told that since I couldn't identify an abnormal vital sign LESS THAN 1 second after it was tested to me in residency that I need to remember it more. You and I both know what attending I'm referring to!
I actually liked him. A bit bonkers...and in retrospect very conservative.
Very bonkers, very conservative attending. I am completely on board with his vital signs shtick though.
I'd be curious what dosing they expected you to know for PTU, because if you asked five endocrinologists you'd probably get six opinions. There's certainly no randomized data. Picking anything high and frequent would probably be "good enough".
Anyone else so happy that they never have to play ER D&D again for the rest of their lives?
Man, if I had thought of that analogy my boards would have gone so differently.
Tester: Patient loses pulses and shows VF on the monitor
Me: I pull out my epi vial of +1 resuscitation. Also, VF can be tough, but has almost no resistance to lightning damage. I cast shocking grasp through my pads of +10 conduction. Unless this ****er rolls a 20 I'm getting ROSC.
Tester: You don't appear to be taking this seriously.
You do not need to know dosages of obscure meds for the oral boards.
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My general rule of thumb, is that I need to have anything memorized that I'll be ordering verbally in a critical situation. Code drugs, RSI, antiarrythmics, TPA for different indications, etc. If you have an ED pharmacist, don't over rely on them, because it's a crutch that you won't have most places.
Most other things, you can look up and you'll just eventually remember them.
Doublecheck on peds dosing as much as possible. I did commit most critical doses to memory during my intern year though, and it certainly impressed some attendings.
Most other things, you can look up and you'll just eventually remember them.
Doublecheck on peds dosing as much as possible. I did commit most critical doses to memory during my intern year though, and it certainly impressed some attendings.
Put PamelaParker... I am a doctor.
Pedi Stat is great for peds dosing
I know about 20 doses.
4 pain meds, 2 nausea meds, 10 abx, few resus drugs
4 pain meds, 2 nausea meds, 10 abx, few resus drugs
I only know one medicine dose by heart, 5 of haldol.
This seriously solves a lot of problems at my shop.
I seriously write in the chart (when I use Haldol): This patient has been managed successfully without the need of narcotic analgesics. I recommend here forth that this patient not receive narcotic analgesics as a part of their treatment plan in the ER.
The bummer is that the nurses complain that "its chemical sedation" and that they need to do an update every :15 min when its in use.
I will shift to using Zyprexa (olanzapine) an see if I run into the same problem.
