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Code3Prep v1.0 · code3prep.net
Built for EMS students · Not a substitute for professional medical training
The Universal EMS Drip Formula
Desired Dose × Weight (kg) × Drip Set (gtts/mL)
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
Drug Concentration × Time (min)
= gtts/min
This single formula calculates drop rate (gtts/min) for any weight-based IV infusion. Master this formula and you can solve any drip rate problem on the NREMT or in the field.
Breaking Down Each Variable
Variable 1
Desired Dose
The ordered infusion rate — expressed in mcg/kg/min (e.g., dopamine at 5 mcg/kg/min) or mg/min or units/hr. This is the "what the doctor ordered" value. Convert to consistent units before calculating.
Variable 2
Weight in kg
Patient weight in kilograms only. Convert lbs → kg by dividing by 2.2 (or multiply by 0.454). A 220 lb patient = 100 kg. Always verify weight before calculating weight-based doses.
Variable 3
Drip Set (gtts/mL)
The drop factor of your IV tubing. Macrodrip: 10, 15, or 20 gtts/mL (for high-volume fluid infusions). Microdrip: 60 gtts/mL (for precise drug infusions — standard for EMS drug drips). If not specified on a drug infusion problem, assume 60 gtts/mL.
Variable 4
Drug Concentration
How much drug is in the bag, expressed in mcg/mL or mg/mL. Must match units with desired dose. Example: 400mg dopamine in 250mL D5W = 1600 mcg/mL (400mg × 1000 = 400,000 mcg ÷ 250mL). Unit conversion step is where most errors occur.
Variable 5
Time (minutes)
The time denominator. For continuous drips, use 1 minute as the time base when dose is in mcg/kg/min or mcg/min. For bolus over a set time (e.g., amiodarone over 10 min), use that number. Time and dose must use the same time unit.
⚡ Pro Tip: For microdrip tubing (60 gtts/mL) — if your concentration is also set up so 1 mL/hr = 1 mcg/kg/min, the math simplifies beautifully. Many EMS protocols are designed this way intentionally.
Drip Rate Calculation — Step by Step
📋 Example 1: Dopamine Infusion
Order: Dopamine 5 mcg/kg/min. Patient weighs 80 kg. You have 400mg dopamine in 250mL D5W. Microdrip tubing (60 gtts/mL).
1
Find concentration: 400mg × 1000 = 400,000 mcg ÷ 250mL = 1,600 mcg/mL
2
Apply the formula: (5 mcg/kg/min × 80 kg × 60 gtts/mL) ÷ (1,600 mcg/mL × 1 min)
3
Numerator: 5 × 80 × 60 = 24,000
4
Denominator: 1,600 × 1 = 1,600
5
Divide: 24,000 ÷ 1,600 = 15 gtts/min
✅ Answer: 15 gtts/min (= 15 mL/hr with microdrip)
📋 Example 2: Simple IV Fluid Drip
Order: 1 liter NS over 4 hours. Macrodrip tubing (10 gtts/mL).
1
Convert time: 4 hours × 60 = 240 minutes
2
Formula: (Volume × Drop Factor) ÷ Time = (1,000 mL × 10 gtts/mL) ÷ 240 min
3
Calculate: 10,000 ÷ 240 = 41.7 → round to 42 gtts/min
✅ Answer: 42 gtts/min
📋 Example 3: Epinephrine Infusion
Order: Epinephrine 0.1 mcg/kg/min. Patient = 70 kg. You have 1mg epi in 250mL NS. Microdrip 60 gtts/mL.
1
Concentration: 1mg = 1,000 mcg ÷ 250mL = 4 mcg/mL
2
Numerator: 0.1 × 70 × 60 = 420
3
Denominator: 4 × 1 = 4
4
Answer: 420 ÷ 4 = 105 gtts/min
✅ Answer: 105 gtts/min
⚡ Drip Set Rules: Macrodrip (10/15/20 gtts/mL) = large volume fluids, blood. Microdrip (60 gtts/mL) = drug infusions requiring precise titration. Default for EMS drug drips = 60 gtts/mL unless specified otherwise.
Common IV Drip Reference
Drug
Typical Mix
Range
Dopamine
400mg/250mL
2–20 mcg/kg/min
Norepinephrine
4mg/250mL
0.01–3 mcg/kg/min
Epinephrine
1mg/250mL
0.01–0.5 mcg/kg/min
Lidocaine
2g/500mL
1–4 mg/min
Amiodarone
150mg/100mL
Bolus over 10 min
Weight-Based Dosing — Step by Step
Bolus Dose Formula
Dose (mg or mcg) = Drug Dose (mg/kg) × Weight (kg)

Volume to Draw = Dose ÷ Concentration (mg/mL or mcg/mL)
📋 Example 1: Adenosine for SVT
Order: Adenosine 0.1 mg/kg IV. Patient = 30 kg (child). Available: adenosine 3mg/mL.
1
Calculate dose: 0.1 mg/kg × 30 kg = 3 mg
2
Check max dose: Max first dose = 6mg for peds. 3mg is within limits. ✓
3
Volume to draw: 3mg ÷ 3mg/mL = 1 mL
✅ Draw 1 mL of adenosine, rapid IV push with 20mL NS flush
📋 Example 2: Ketamine for RSI
Order: Ketamine 2 mg/kg IV for induction. Patient = 85 kg. Available: ketamine 500mg/10mL (50 mg/mL).
1
Calculate dose: 2 mg/kg × 85 kg = 170 mg
2
Volume to draw: 170mg ÷ 50mg/mL = 3.4 mL
3
Give: Slow IV push over 30–60 seconds (to prevent emergence reactions)
✅ Draw 3.4 mL of ketamine (50 mg/mL), give slow IV push
📋 Example 3: Succinylcholine for RSI
Order: Succinylcholine 1.5 mg/kg IV. Patient = 70 kg. Available: succinylcholine 200mg/10mL (20 mg/mL).
1
Dose: 1.5 × 70 = 105 mg
2
Volume: 105mg ÷ 20mg/mL = 5.25 mL → round to 5.3 mL
✅ Draw 5.3 mL succinylcholine — rapid IV push immediately after induction agent
Weight Conversion
lbs → kg: divide by 2.2
110 lbs
= 50 kg
154 lbs
= 70 kg
176 lbs
= 80 kg
220 lbs
= 100 kg
⚡ Shortcut: For quick mental math, estimate weight in kg by dividing lbs by 2.2. For a 200 lb patient: 200 ÷ 2 = 100, then subtract ~9% → ≈90 kg. Close enough for initial dose estimation in the field.
Practice Problems
Tap an answer to reveal the solution.
You have dopamine 400mg in 250mL D5W. The order is 5 mcg/kg/min for a 80 kg patient. Using microdrip tubing (60 gtts/mL), what is the correct drip rate?
Concentration: 400mg = 400,000 mcg ÷ 250mL = 1,600 mcg/mL. Formula: (5 × 80 × 60) ÷ (1,600 × 1) = 24,000 ÷ 1,600 = 15 gtts/min.
Order: 1 liter NS wide open over 20 minutes. You have macrodrip tubing 10 gtts/mL. What is the drip rate?
(1,000 mL × 10 gtts/mL) ÷ 20 min = 10,000 ÷ 20 = 500 gtts/min. (This is why we count drops per 15 sec: 500 ÷ 4 = 125 drops/15 sec — very fast flow.)
A patient weighs 220 lbs. You need to give succinylcholine 1.5 mg/kg IV for RSI. You have succinylcholine 200mg/10mL. How many mL do you draw?
220 lbs ÷ 2.2 = 100 kg. Dose: 1.5 × 100 = 150 mg. Concentration: 200mg/10mL = 20 mg/mL. Volume: 150 ÷ 20 = 7.5 mL.
You have lidocaine 2g in 500mL D5W. The order is a maintenance infusion at 2 mg/min. Using microdrip (60 gtts/mL), what drip rate do you set?
Concentration: 2,000mg ÷ 500mL = 4 mg/mL. Desired dose = 2 mg/min. Volume/min = 2 ÷ 4 = 0.5 mL/min. With 60 gtts/mL: 0.5 × 60 = 30 gtts/min. (Note: A and B are the same — in real exam, only one would be listed.)
A 154 lb patient needs epinephrine at 0.2 mcg/kg/min. You have 4mg epi in 250mL NS. Using 60 gtts/mL microdrip, what is the rate?
154 lbs ÷ 2.2 = 70 kg. Concentration: 4mg = 4,000 mcg ÷ 250mL = 16 mcg/mL. Formula: (0.2 × 70 × 60) ÷ (16 × 1) = 840 ÷ 16 = 52.5 → ~53 gtts/min. (Check your unit conversions — this problem is designed to catch errors.)
Magnesium sulfate for eclampsia: Order is 4g IV over 20 minutes. Available: 50% MgSO4 (500mg/mL). Using 10 gtts/mL macrodrip, what is the drip rate?
Volume to give: 4,000mg ÷ 500mg/mL = 8 mL. But in practice MgSO4 is diluted in 100mL. If diluted in 80mL: (80mL × 10) ÷ 20 min = 40 gtts/min. Always check the concentration of your specific preparation and follow your system protocol.
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