Med Math Simplified Saved My Butt

I strove to go well beyond being “entry level competent” in almost every area of my practice except for one: med math.  As an EMT I marveled as my paramedics calculated medication dosages, and it nearly scared me away from paramedic school. I did it well enough to get by, but even after 12 years never got to the point where I felt comfortable doing it.  Math was always a struggle for me, so much so, that in fifth-grade I got on a bus after lunch each day with three other not-so-stellar students each day to go to another school for “special math.” From there through paramedic school, simply passing final exams in math classes felt like a victory. The thought of having to teach paramedic students how to do it nearly scared me away from a teaching position. I did that anyway too, and dreaded when that day would come.

That day began two months ago. I was terrified, and literally had nightmares about teaching med math. In preparation I scoured several “calculations made easy” books, websites, and YouTube videos. This only made the anxiety worse. I was able to do what those resources described, but was not confident that I would be able to answer questions about how they worked. Then MedicCast host Jamie Davis published his book Med Math Simplified. I felt that there was hope when I read this passage early in the book:

“Let me tell you a story about my math struggles. Maybe it will be familiar to you. When going to nursing school, I had to take a pre-calculus course as part of my degree program. It was far and above the hardest course I took and I would spend hours pouring over the homework to make sure I got it figured out. I could do the work but I really had to plod along to get it right. One night I was sitting at the kitchen table after dinner with my textbook open and a pile of paper and scrap paper piled around me. I had been struggling with the same problem for at least an hour and just couldn’t get it. My wife walked by me. She majored in math in college and always said that calculus was one of her favorite courses. She looked over my shoulder and said, “Oh, I remember doing that.” She grabbed a sheet of paper and a pencil and proceeded to work the problem. In about five minutes, she was done. “That was fun!” Amy said. Then she walked away, taking her solution to the problem with her.

Something like this might have happened to you. Maybe it was a friend, a spouse, or a classmate. It is frustrating. Frankly, for a lot of us, math is just frustrating and that includes drug calculations. Whether you are a nurse, physician, paramedic, or other medical professional, medication and drug calculations are a necessary part of your job. Patient safety depends on you calculating correctly each and every time.

This book and the website and accompanying materials are all designed by me, a math idiot, to review and refresh medication math for medical professionals at all levels. We’ll take the basic concepts and break them down, simplifying them for you (and me). The goal is to make you a better health care professional, provide better and safer patient care, and ultimately give you more time to do what you do best, care for your patients. This is Med Math Simplified.”

Wow, I thought, here is a book about med math written by someone who struggled with and hated it as much as I do.

What follows in the book is one ingenious formula that can be applied to any drug calculation. None of the other books or websites I looked at had anything like it. Jamie’s formula can be used to find the amount of a medication to administer, a weight-based dose in mg, volume to be infused over time, and drip rates. The formula includes safeguards to ensure you are calculating what the question is asking for (it is so sad when a calculation for ml was done correctly when a test question asked for mg). It is also designed to ensure that every component needed for a calculation was included, and that it is set up correctly before doing the actual math. This is especially important with the dreaded dopamine calculation, speaking of which, I read this verbatim to my students at the beginning of that lesson:

“Complex does mean hard, it just has a few more steps. The steps are all simple. So let’s take it one step at a time.”

As great as the formula is, it is not a shortcut. Accurate multiplication, division, fraction reduction, and converting fractions to decimals is needed, which Jamie writes that there is no way around. The book does not go into depth about how to do that, though some links are included for help.

There is also a section at the end of the book on the use of reference cards and shortcuts. I strongly support using them in practice to check the work of any math done, but believe that it is also important to know how to do the calculation accurately.

My students did well overall using the formula, and for the first time ever I felt confident doing math on a white board in front of a group. I wish I had read this years ago. At 2.99 for the Kindle Ebook and $7.99 for the paperback, the price cannot be beat. Even $29.95 for the online Med Math Simplified course costs less than almost any other publisher’s med math book. I highly recommend it both for students and practicing nurses or paramedics.





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