Veterinary Anesthesia & Analgesia Support Group
Practical Information for the Compassionate Veterinary Practitioner
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We offer a rich library of resources available for direct download and online use. Included on this page are a large number of drug infusion calculators and drug dosing calculators. Some of the material was developed directly by the VASG; some of the calculators originate from member professionals across the globe. Becuase we all think a bit differently, what solves a problem for one individual may not help another.

As always, please let us know if you cannot find what you need on the site. We will either direct you to a suitable resource or create one for you.

If you have material that you would like to see added to our library please contact the webmaster; drstein@vasg.org.

     
     
    Drug Delivery Calculators
   
   

Below you will find calculators for CRI/MCI drug administration (both IV fluids based and syringe pump based infusions), epidural drug administration, total intravenous anesthesia (alfaxan, propofol, & fentanyl/midazolam), emergency drugs, blood pressure related drug administration, local anesthetic blocks, and IM based anesthesia.

While most of the calculators are based upon specific drug concentrations (clearly delineated in each calculator) some are being developed with a variable drug concentration option to expand their flexibility.

As a point of clarification, the mere fact that a calculator is in our library does not mean that the VASG wholeheartedly embraces that particular product, combination of products, or application in all clinical settings.

Our goal is to improve the quality of life and longevity of animal family members while making life easier for veterinary professionals. We acknowledge that there are professionals in practice settings that limit the availability of drugs and equipment. We embrace the challenges faced by veterinary professionals in limited settings be it a housecall practice in Rwanda, spay neuter programs in Yucatán, or anywhere else across the globe.

     
   
WARNING! THESE ARE CURRENTLY 2011 v2.0 BETA TEST CALCULATORS!
DOUBLE CHECK ANY AND ALL CALCULATIONS PRIOR TO USE!
*Calculators marked as confirmed have passed the late stage release candidate verification process.
As always, it is the practitioner's obligation to become familiar with the drugs and techniques discussed on our website before applying these techniques to their patients.
     
    Need a free office suite to open and manage these files? See the OpenOffice link at bottom of page.
   
  • Analgesic CRIs
  • Epidurals
  • E-Drugs
  • Opioid Reversal
  • BP Drugs
  • TIVA, IM Anesthesia, Local Blocks
Read Me First

IV FLUID BAG INFUSIONS

Please note: the patient's weight does NOT affect the amount of drug added to the fluid bag. Only the IV bag size, the drug dose rate (mg/kg/hr), and the fluid delivery rate (ml/kg/hr) influence the drug amount; larger bags, higher drug dose rates, and slower IV fluid administration rates all increase drug amount added to the bag and vice versa.

SYRINGE PUMP INFUSIONS

Syringe pump based calculators allow you to select one or all of the listed drugs. You choose your preferred drug dose rate and duration. Added saline increases final volume, minimize drug trapped in delivery lines (low volume high pressure extension lines provides an additional benefit in this respect).

While single drug CRI/MCI can be easily managed by a programmable syringe pump like the Medfusion 2010i, these pumps are more costly. Multiple drug syringe pump CRI/MCIs are always volume based infusions which means that we can use of the least expensive syringe pumps; many are available on the secondary used equipment market. The Medfusion 2001 and the Razel A-99 are often available for a minimal investment.

Click on the slider tabs below and scroll through the panes to see our analgesic infusion calculators.

Analgesic CRI/MCI FAQs
  1. Why don't you have original calculators that were totally based in weight by pounds?
    • It became too difficult to maintain two completely separate calculators. As the number of calculators increased it forced the webmaster to duplicate the effort whenever an enhancments was deployed. Contact the webmaster (drstein@vasg.org) if you have a serious need for our older pounds based calculators. In the mean time, give our new unified calculators a try: you can weigh in pounds, use the pounds to kilogram converter at the bottom of the current calculators, then transfer the patient's weight in kilograms to the weight field at the top of the calculator. Even if your brain wants to think of drug doses in mg/lb/hr, you can easily adjust to the kilogram oriented calculators as each calculator clearly provides the drug dose rate range for each drug making it easy to select a low, medium, or higher end dose rate. REMEMBER - WHEN USING THE WEIGHT CONVERTER, YOU WILL NEED TO MANUALLY TRANSFER THE PATIENT'S WEIGHT IN KILGRAMS INTO THE UPPER WEIGHT FIELD - IT WILL NOT TRANSFER AUTOMATICALLY!!!
  2. Why is a maintenance fluid rate calculculator imbedded in the IV fluid bag based calculators?
    • Simply for convenience. Should the user have a need to match drug CRI/MCI drug delivery with maintenance fluids needs, the calculators facilitate this process. REMEMBER - YOU WILL NEED TO MANUALLY TRANSFER THE MAINTENANCE FLUID RATE (IN THE PREFERRED MULTIPLE) INTO THE UPPER FLUID RATE FIELD - IT WILL NOT TRANSFER AUTOMATICALLY!!!
  3. What if the drug concentration of the product at my practice is different than the concentration listed on the calculator?
    • Email the webmaster (drstein@vasg.org) to request a calculator that matches the product you have in inventory. If enough requests are made for a variety of drug concentrations we may make a calculator that allows for variable drug concentrations; but this interjects an additional level of risk should the user fail to input the correct drug concentration.
For IV Fluids Based Delivery Calculators - Click Here
 
Single Agent Infusions
 

Single agent CRI/MCIs can be delivered as solo infusions or as part of a combination of independent infusions. One bag, one drug, insures total control over the delivery of each included drug. There is down side however: each drug demands its own bag, its own line, and its own infusion pump. In addition, you have the challenges associated with tying the lines into the patient. Multiple line T-ports can help facilitate this process.

Caution needs to be exercised regarding the total fluid volume delivered to the patient as you vary drug delivery. Minimizing fluid delivery rates in your CRI/MCI recipe minimizes the risk of fluid overload but it maximizes the amount of drug added to each bag; using smaller IV bags helps mitigate this concern.

 
 
 
Multiple Agent Infusions
 
Multiple agent CRI/MCIs offers clean simplicity: one bag, one pump, one line. The downside is that all drugs are influenced when an increase or decrease is made in the total fluid rate. Given the extremely low cost of the most commonly used CRI/MCI drugs, this seems of minor concern; if you want to adjust your drug dose ratios, simply mix up a new bag of solution.
 
 
 
 
 
For Syring Pump Based Delivery Calculators - Click Here
 
Single Agent Infusions
 

Single agent CRI/MCIs can be delivered as solo infusions or as part of a combination of independent infusions. One syringe, one drug, insures total control over the delivery of each included drug. There is down side however: each drug demands its own syringe, its own line, and its own syringe pump. In addition, you have the challenges associated with tying the lines into the patient. Multiple line T-ports can help facilitate this process.

Eliminating saline added to a syringe pump CRI/MCI should eliminate the risk of fluid overload to small patients.

 
 
 
Multiple Agent Infusions
 
Multiple agent CRI/MCIs offers clean simplicity: one syringe, one pump, one line. The downside is that all drugs are influenced when an increase or decrease is made in the delivery rate. Given the extremely low cost of the most commonly used CRI/MCI drugs, this seems of minor concern; if you want to adjust your drug dose ratios, simply mix up a new syringe of solution.
 
 
 
 
 
Read Me First

These calculators are each based on a different opioid analgesic and each includes the option to use the local anesthetic bupivacaine. If you elect not to use a local anesthetic, you may use saline to achieve your preferred final volume.

Preservative free products are preferred over preservative containing product. Whether or not a practitioner uses a preservative containing product is a personal decision. When preservative containing product is used, methylparaben is preferrable over formaldehyde preserved product.

Please review our Epidural Injections page and consider locating a mentor before attempting these techniques. Mentors may be located through the VIN Anesthesia & Analgesia Board, the ACVA, and the IVAPM.

In addition, see: Michigan State University's Teaching Material, Oklahoma State University's Teaching Material, and Sheilah Robertson's Clinician's Brief PDF.

Click on the slider tab below to see our epidural calculators.

For Opioid Based Epidural Calculators - Click Here
 
Read Me First

We believe that a patient's odds for survival increase during an emergency if exact doses of the main emergency drugs are drawn up and immediately available at the anesthetized patient's side. The calulators below allow you to easily calculate emergency drug doses and print the sheet for inclusion in the patient's planning process.

Inaddition to our calculators, see Wingfield's excellent online emergency drug calculators.

Click on the slider tab below for our emergency drug calculators.

For Emergency Drug Dose Calculators - Click Here
 
Read Me First

We currently have a very long-term opioid analgesic product on the market with low frequency potential to cause sustained heavy sedation and inappetance. Unlike a patch, this product cannot be removed from the patient; only time will lead to a reduction in unwanted effects. These effects may be high-level and may last 5 or so days.

We believe that any practice utilizing long duration opioid analgesic therapy has a responsibility to maintain the capability of providing sustained opioid antagonism therapy.

We think it is especially important that emergency facilities be fully prepared to manage long-term opioid antagonism therapy.

Naloxone is currently the only useful mu opioid antagonist available for opioid antagonism. Unfortunately, the cost of this drug has skyrocketed making long-term opioid reversal therapy a very costly proposition.

Click on the slider tab below for our naloxone CRI calculators. These calculators so also calculate the cost of the drug for billing and stocking related purposes.

Long-term Opioid Drug Reversal Dose Calculators - Click Here
 
Read Me First

IV FLUID BAG INFUSIONS

Please note: the patient's weight does NOT affect the amount of drug added to the fluid bag. Only the IV bag size, the drug dose rate (mg/kg/hr), and the fluid delivery rate (ml/kg/hr) influence the drug amount; larger bags, higher drug dose rates, and slower IV fluid administration rates all increase drug amount added to the bag and vice versa.

SYRINGE PUMP INFUSIONS

Syringe pump based calculators allow you to select your preferred drug, syringe size, and your preferred drug dose rate. Drug volume, added saline volume, and final fluid delivery rates are calculated for you. Use low volume high pressure extension lines to minimize drug trapped in the estension set.

These are all volume based deliveries which lend themselves to the use of the least expensive syringe pumps; many are available on the secondary used equipment market. The Medfusion 2001 and the Razel A-99 are often available for a minimal investment.

Click on the slider tabs below to view our blood pressure related drug calculators.

For IV Fluids Based Delivery Calculators - Click Here
 
 
 
For Syringe Pump Based Delivery Calculators - Click Here
 
 
 
 
Read Me First

TIVA - Total IntraVenous Anesthesia

TIVA is an attractive option for those patients poorly tolerant of inhalant anesthetics. TIVA can be performed with injectable agents like propofol and alfaxalone or with combinations based upon a mu agonist opioid and a benzodiazepine; most commonly fentanyl and midazolm.

The dose ranges presented by the calculators should be viewed, in a sense, like a vaporizer dial: they establish a framework, a low and high end, to facilitate the dose to effect process. At times the patient may need to be "turned off". At times the patient may need a quick IV bolus of agent to gain control of a "suddenly light" patient.

IM Anesthesia

IM anesthesia is an attractive option in a number of settings including remote locations and spay-neuter clinics. Unfortunately, IM anesthesia is often associated with sacrifices in patient safety; but this does not have to be so.

Once the IM agents are given, the patient should be closely monitored. Once anesthetized, the patient should be intubated and supplemental oxygen initiated. IV catheters and IV fluids are ideal. Once the procedure is complete, alpha-2 antagonists, preferrably atipamezole, should be administered to shorten the time to independent airway protecion.

We promote IM protocols that include flexibility rather than a single rigid protocol applied across a broad patient population; flexibility to adjust to the individual needs of the patient. We suggest protocols that include a mu agonist over those with kappa agonists to improve the overall analgesic impact.

Local Anesthesia - Ring Blocks

Local anesthetics should be applied in almost all surgical situations; they are inexpensive and very low risk when applied correctly. Our protocols include lidocaine for quick onset and bupivacaine for long duration. A mu opioid is included to extend analgesia without extending motor block (as would be expected when corticosteroids are included in local blocks1).

Click on the slider tabs below and scroll through the panes to see our calculators.

TIVA, IM Anesthesia, & Local Block FAQs
TBA
For TIVA Anesthesia Calculators - Click Here
References
1 Dexamethasone with bupivacaine increases duration of analgesia in ultrasound-guided interscalene brachial plexus blockade. Vieira PA, Pulai I, Tsao GC, Manikantan P, Keller B, Connelly NR. Eur J Anaesthesiol. 2010 Mar;27(3):285-8.
 
     
     
     
   
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Last modified: April 11, 2014 .