BACKGROUND: The inability of paramedics to perform accurate calculations may result in a compromise of patient safety which may result from under or over dosing of drugs, incorrect joules for defibrillation, or a major adverse event such as death. The objective of this study was to identify the drug calculation and mathematical ability of qualified operational paramedics.

METHODS: The study used a cross-sectional design with a paper-based calculation questionnaire. Twenty paramedics enrolled in an intensive care paramedic course were eligible to participate in the study. The questionnaire consisted of demographic, drug calculation (seven questions), and mathematical (five) questions. Students were given no notice of the impending study and use of a calculator was not permitted.

RESULTS: All eligible students participated in the study. The average time employed as a paramedic was 7.25 years, SD 2.5 years, range four years to twelve years. Four (20%) students got all 12 questions correct, and five (41.6%) got 50% or less. The average score was 8.6 (71.7%) correct, SD 2.8 correct, range 3 to 12 correct questions. There were eight (40%) conceptual errors, 12 (60%) arithmetical errors, and five (25%) computational errors.

CONCLUSION: The results from this study supports similar international studies where paramedic's ability to undertake mathematical and drug calculations without a calculator varies, with some results highlighting the paramedics mathematical skills as a potential risk to patient safety. These results highlight the need for regular continuing mathematical and drug calculation practice and education to ensure a lower error rate.