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Med Protocols > Adult > Flashcards

Adult Flashcards

1
Q

Afrin

A

0.05% Oxymetazoline

Nasotracheal Intubation

Adrenergic Receptor Antagonist
-Vasoconstrictor & nasal decongestant

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2
Q

Tetracaine

A

2 drops in affected eye (0.5%) every 3 min

Eye injuries/Morgan lens

Local anesthetci/alters Ca2+ release channels

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3
Q

Sodium Bicarb (Crush)

A

50 mEq IV 1 min prior to extrication then 50 mEq slow push every 30 min

Crush Injury- 1 extremity crushed 2 hours, 2 ext. for 1 hour

Electrolyte

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4
Q

Calcium Chloride (Crush)

A

1 g IV over 5 min MC

Crush w/suspected hyperkalemia and ECG changes (QT prolonged or wide QRS)

Electrolyte

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5
Q

Naloxone

A

2 mg IN/IV, repeat as necessary

Suspected Opiate OD

Narcotic Antagonist

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6
Q

Calcium Chloride (OD)

A

1 g IV MC

OD Ca2+ channel blockers

Electrolyte

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7
Q

Diphenhydramine (OD/Toxic Exposure)

A

50 mg IV/IM

Dystonic Rxn (exposure/OD)

Antihistamine

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8
Q

Ondansetron

A

4 mg IV/IM/PO

Nausea/Vomiting

Anti-emetic/nausea
Serotonin 5-HT3 Antagonist

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9
Q

Diphenhydramine (Nausea)

A

25 mg IV/IM

Motion Sickness

Antihistamine

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10
Q

Mag Sulfate (Pre-term labor)

A

4 g in 100 ml NS IV over 10 min MC

Pre-Term labor (24-37 weeks)

Electrolyte, mineral Ca2+ channel blocker, bronchodilator/CNS and muscle depressant

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11
Q

Diphenhydramine (Allergy)

A

50 mg IV/IM

Allergic Rxn

Antihistamine

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12
Q

Epi 1:1,000 (Allergy)

A

0.3 mg IM

Anaphylaxis

Sympathomimetic

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13
Q

Glucose Paste

A

15-24 g PO

Hypoglycemic and can swallow

Carbohydrate

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14
Q

Dextrose 10%

A

25 g in 250 ml NS IV, can redose

Hypoglycemic and can’t swallow

Carbohydrate

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15
Q

Glucagon

A

1 mg IM

Hypoglycemia w/ no IV access
Slight muscle relaxer (choking)

Hormone

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16
Q

Midazolam (Seizure)

A

5 mg IV/IM, can repeat once after 5 min
MC for more

Seizures

Sedative- Benzodiazepine

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17
Q

Mag Sulfate (Preg. Seizure)

A

4 g in 100 ml NS over 20 min IV

Seizures in Preg. Pts

Electrolyte, mineral Ca2+ channel blocker, bronchodilator/CNS and muscle depressant

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18
Q

Atrovent

A

0.5 mg/ 2.5 ml neb

Insp./Exp. wheezing

Parasympatholytic bronchodilator
Anticholinergic

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19
Q

Albuterol

A

2.5 mg/ 3 ml neb

Insp/Exp. wheezing (Asthma, Allergy, COPD, Pulm. Edema)

Beta-2 Agonist

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20
Q

Dexamethasone

A

10 mg PO/IM/IV

Acute Asthma, Anaphylaxis, COPD/Bronchospasm
MC for Shock/Hypoperfusion

Corticosteroid

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21
Q

Epi 1:1,000 (Asthma)

A

0.3 mg IM or 3 mg neb (MC for neb)

Severe asthma

Sympathomimetic

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22
Q

Mag Sulfate (Asthma)

A

2 g in 100 ml IV over 10 min

Asthma- if Pt did not respond to other treatments

Electrolyte, mineral Ca2+ channel blocker, bronchodilator/CNS and muscle depressant

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23
Q

Mag Sulfate (COPD)

A

2 g in 100 ml NS IV over 10 min MC

COPD MC

Electrolyte, mineral Ca2+ channel blocker, bronchodilator/CNS and muscle depressant

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24
Q

Haldol

A

2.5 - 5 mg IV/IM MC

Agitated Pt, Excited Delerium
may develop dyskinia

Antipsychotic

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25
Q

Ketamine (Agitated Pt)

A

0.5 - 2 mg/kg IV/IM MC
consider 250 mg loading dose

Highly agitated Pt- needs sedation

NMDA receptor antagonist

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26
Q

Midazolam (Delirium)

A

10 mg IM
MC for more

Excited Delirium

Sedative - Benzodiazepine

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27
Q

Ketamine (Excited Delirium)

A

250 mg IV, may repeat once
or as single dose after Versed
MC for more

Excited Delirium

NMDA receptor antagonist

28
Q

Ketorolac

A

30 mg IV, 30-60 mg IM (reduce in Pts < 50 kg) MC

Pain Management

NSAID

29
Q

Fentanyl

A

1 - 1.5 mcg/kg IN/IV/IM
can be repeated after 5 min up to 200 mcg
MC for more

Pain Management: Ax to morphine, potentially hemodynamically unstable (so no morphine)

Narcotic Analgesic

30
Q

Morphine (Pain)

A

0.05 mg/kg IV or 0.1 mg/kg IM
can be repeated after 5 min up to 10 mg
MC for more

Hemodynamically Stable Pain Management

Narcotic Analgesic - Opiate

31
Q

Ketamine (Pain Management)

A

25 mg IV over 5 min OR 50 mg IM (All MC)

Pain Management

NMDA receptor antagonist

32
Q

Midazolam (Pain)

A

2.5 - 5 mg IV up to 10 mg (generally 5 mg for IM)
MC for more

Pain Management

Sedative - Benzodiazepine

33
Q

Etomidate

A
  1. 1 mg/kg IV for intubation (MC)
  2. 3 mg/kg for induction

Sedation for tubing

Hypnotic

34
Q

Midazolam (Post-tube)

A

up to 5 mg IV every 10 min as needed

Post-intubation Management

Sedative - Benzodiazepine

35
Q

Ketamine (Post-tube)

A

As a substitute for Versed
up to 100 mg every 5 min as needed

Post-Intubation Management

NMDA receptor antagonist

36
Q

Midazolam (Procedural Sedation)

A

2.5 mg IV or 5 mg IM
repeat every 5 min: SBP > 100 mmHg, MAP > 65 mmHg

Procedural Sedation

Sedative - Benzodiazepine

37
Q

Ketamine (Procedural Sedation)

A

0.5 - 2 mg/kg IV or 3.5 mg/kg IM (MC for all)

Procedural Sedation

NMDA receptor antagonist

38
Q

Morphine (Sedation)

A

MC for dose

Procedural Sedation

Narcotic Analgesic - Opiate

39
Q

Ketamine (RSI)

A

2 mg/kg IV rapid push
round to nearest 50 mg for adults

RSI Option for Induction

NMDA receptor antagonist

40
Q

ASA

A

4 x 81 mg PO

Cardiac Symptoms (CP, etc.)

Antiplatelet

41
Q

Nitro (Cardiac)

A

0.4 mg SL 5 min apart: SBP > 120, MAP > 90

CP, STEMI

Nitrate

42
Q

Metoprolol (STEMI)

A

5 mg slow IV push x 4 doses MC
HR > 80, SBP > 120, MAP > 90

STEMI

Beta-blocker

43
Q

Nitro (Pulm. Edema)

A

SBP 120-160: 0.4 mg SL every 5 min
160-200: 0.8 mg
>200: 1.2 mg

Acute Cardiogenic Pulmonary Edema

Nitrate

44
Q

Metoprolol (Stroke)

A

5 mg slow IV MC

Stroke: SBP >220, DBP >120

Beta-blocker

45
Q

Furosemide

A

We don’t do this

Antihypertensive, Pulm. Edema, Heart Failure

Loop Diuretic

46
Q

Dopamine

A

We don’t do this
Low: Renal, Mid: Cardiac Pressor and Brady, High: Pressor

Tachydysrhythmias, Shock Hypovolemic

Sympathomimetic, Neurotransmitter

47
Q

Sodium Bicarb (OD)

A

1 mEq/kg every 5 min until QRS normalizes

Tricyclicantidepressant OD (tachy and wide QRS)

Electrolyte

48
Q

Calcium Chloride (Hyperkalemia)

A

1 g IV

Hyperkalemia: Arrest, RSI w/ ECG changes (QT prolonged or widening QRS)

Electrolyte

49
Q

Adenosine

A

6, 12 mg IV LAC
MC for second 12 mg

Narrow Complex Tach (reg and stable)

Antidysrhythmic - poss Na+ channel blocker

50
Q

Diltiazem

A

1st: 0.25 mg/kg (max 25 mg) IV over 2 min
if after 15 min and still stable:
2nd: 0.35 mg/kg (max 35 mg) IV over 2 min

Stable Irreg. Tach

Ca2+ Channel Blocker

51
Q

Metoprolol (Arrythmia)

A

5 mg IV over 2 min, 2nd dose in 15 min
MC for more

Irreg. Narrow Tach Stable
-use instead of Cardizem if Pt is on a Beta-blocker or if Metoprolol was used in the first dose

Beta-blocker

52
Q

Amiodarone (Tach)

A

150 mg/ 100 ml NS IV over 10 min (3 drops per 5 sec)

Monomorphic Wide Tachy

Antidysrhythmic - K+ Channel Blocker

53
Q

Mag Sulfate (Arrythmia)

A

Stable: 2 g IV in 100 ml over 10 min
Unstable: 2 g IV over 2 min

Tachy Wide Complex w/ pulse (Torsades)

Electrolyte, Mineral, Ca2+ Channel Blocker, Bronchodilator/CNS and muscle depressant

54
Q

Lidocaine (Arrythmia)

A

1.5 mg/kg IV

Wide Complex Tachy w/ Pulse

Na+ Channel Blocker

55
Q

Atropine

A

0.5 mg every 3 min IV max 3 mg

Symptomatic Brady

Parasympathetic antagonist to vagal, Enhances conduction through AV junction

56
Q

Epi 1:10,000

A

1 mg IV/IO every 3-5 min

Cardiac Arrest

Sympathomimetic

57
Q

Amiodarone (Arrest)

A

300 mg/ 20 ml saline IV then 150 mg 5 min later

Cardiac Arrest V-Fib

Antidysrhythmic - K+ Channel Blocker

58
Q

Lidocaine (Arrest)

A

1.5 mg/kg IV

Pulseless V-Fib or V-Tach

Antidysrhythmic - Na+ Channel Blocker

59
Q

Mag Sulfate (Arrest)

A

2 g IV

Arrest - V-Fib, Pulseless V-Tach

Electrolyte, Mineral, Ca2+ Channel Blocker, Bronchodilator/CNS and muscle depressant

60
Q

Sodium Bicarb (Arrests and Suspected Hyperkalemia)

A

50 mEq IV

Arrest/Suspected Hyperkalemia or Acidosis

Electrolyte

61
Q

Calcium Chloride (Arrest)

A

1 g IV (both Arrests)

Arrests w/ suspected hyperkalemia: QT prolonged or QRS widening

Electrolyte

62
Q

Norepi (Not MC)

A

2 mcg/min titrated to 20 mcg/min after fluid bolus is infused to maintain SBP > 100, MAP >65

ROSC, Symptomatic Brady/Heartblocks, STEMI, ACS-CP (if unstable or in Pulm. Edema [cardio shock]), Anaphylactic Shock

Catecholamine/ Vasopressor

63
Q

Lidocaine (ROSC)

A

1.5 mg/kg IV

ROSC

Na+ Channel Blocker

64
Q

Metoprolol (ROSC)

A

5 mg IV over 5 min, up to 4 doses MC
SBP >200

ROSC

Beta-blocker

65
Q

Norepi (MC)

A

2 mcg/min titrated to 20 mcg/min after fluid bolus infused

Septic, Traumatic shock, LVAD w/ ss shock

Catecholamine/ Vasopressor

Med Protocols (2 decks)

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