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Massachusetts 2023 Statewide Treatment Protocols > Adult Doses > Flashcards

Adult Doses Flashcards

1
Q

Adrenal Insufficiency/Adrenal Crisis - Adult Doses

A

Hydrocortisone (Solu-cortef) -100 mgs IV/IO/IM

Methylprednisolone (Solu-Medrol) - 125 mgs IV/IO/IM

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2
Q

When should a stress dose of steroids be given?

A

A stress dose should be given to patients with known chronic adrenal insufficiency who have the following injuries AND known chronic adrenal insufficiency:
-shock
-fever > 100.4 f and ill-appearing
-multi-system trauma
-drownling
-environmental hyperthermia or hypothermia
-multiple long-bone fratures
-vomiting/diarrhea accompanied by dehydration
-respiratory distress
2nd of 3rd degree burns >5% BSA
-Hypoglycemia

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3
Q

Allergic Reaction/Anaphylaxis - Adult Doses

A

Diphenhydramine: 25-50 mgs IV/IO/IM

Epinephrine: 0.3 mgs 1:1,000 IM ONLY. Second dose after 5 minutes

Albuterol: 2.5 mgs via nebulizer. Repeat every 5 minutes up to 4 doses.

Hydrocortisone (Solu-cortef): 100 mgs IV/IO/IM
- OR -
Methylprednisolone (Solu-medrol) 125 mgs IV/IO/IM

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4
Q

Altered Mental Status/Neurological Status/Diabetic Emergency/Coma - Adult Doses

A

Glucagon - 1mg IV/IO/IM/IN
-Check glucose after 15 minutes and may repeat 1mg IV/IO/IM if blood glucose is still <70 mg/dl

Oral glucose - 1 tube

Dextrose 12.5g IV/IO
-May repeat after 5 minutes up to 25g IV/IO if glucose is <70mg/dl with continued altered mental status

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5
Q

Hydrocortisone (Solu-cortef) dose - Adult

A

100 mgs IV/IO/IM

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6
Q

Methylprednisolone (Solu-Medrol) - adult

A

125 mgs IV/IO/IM

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7
Q

Diphenhydramine dose - adult

A

125 mgs IV/IO/IM

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8
Q

Glucagon - adult

A

1mg IV/IO/IM

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9
Q

Dextrose - Adult

A

12.5 mgs IV/IO

Repeat dose after 5 minutes up to a max of 25 mgs.

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10
Q

What is hypoglycemia defined as in adults?

A

Glucose <70 mg/dl with associated altered mental status

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11
Q

Causes of hypoglycemia

A

Medication misuse, missed meals, infection, cardiovascular insults (myocardial infarction, arrhythmia), changes in activity such as exercise

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12
Q

What is hyperglycemia defined as in adults

A

Glucose >300 mg/dl with associated altered mental status

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13
Q

Behavioral Emergencies - Adult

A

Haloperidol: 5mg IM ONLY
-preferable for psychotic patients
-do not administer to patients with a history of seizures or prolonged QTI

Midazolam: 2-6 mg IV/IO/IM/IN

Ketamine 4mg/kg IM ONLY
-max dose of 400mg IM ONLY as a single dose

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14
Q

What is a normal QTI in male and female adults?

A

Men 350-450 ms

Women 360 - 460 ms

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15
Q

Haloperidol - Adult

A

5 mgs IM ONLY

Preferable for psychotic patients

Do not administer with a history of seizures or prolonged QT intervals

IM ONLY

*If >70 years old, half of the dose

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16
Q

Midazolam - Behavioral - Adult

A

2-6 mgs IV/IO/IM/IN

*If >70 years old, half of the dose

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17
Q

Ketamine - Behavioral - Adult

A

4mgs/kg IM ONLY

Max dose of 400mg IM ONLY as a single dose

*If >70 years old, half of the dose

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18
Q

Bronchospasm - Adult Doses

A

Albuterol: 2.5-3 mgs via nebulizer

Ipratropium Bromide 0.5 mgs may be combined with albuterol

Epinephrine: 0.3 mgs IM ONLY as a one time dose

Hydrocortisone (Solu-cortef): 100 mgs IV/IO/IM
-OR-
Methylprednisolone (Solu-medrol): 125 mgs IV/IO/IM

Magnesium sulfate: 2-4 grams IV/IO over 20 minutes
-For asthma only

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19
Q

Albuterol dose - Adult

A

2.5-3 mgs via nebulizer

Bronchosasms

20
Q

Epinephrine for bronchospasm - Adult

A

0.3 mgs IM ONLY one dose

21
Q

Ipratropium Bromide - adult

A

0.5 mgs to be mixed with albuterol

Bronchospams

22
Q

Magnesium sulfate dose - adult

A

2-4 mgs IV over 20 minutes

Only if they have s history of asthma

23
Q

Organophosphate Poisoning - Adult and Pedi

A

Administer duodote kit if available

Atropine 2mg IV/IO every 5 minutes until secretions clear

24
Q

Exlamptic Seizure

A

Magnesium Sulfate 2-4 grams IV/IO over 5 minutes

Midazolam 2-6 mgs IV/IO/IM/IN

25
Q

Adult Pain Management

A

Ibuprofem - 600 mg by liquid or tablets

Acetaminophen - 650-1000 mgs by liquid or tablet

Ketorolac - 15 mg IV or 30 mg IM

Fentanyl: 1 mch/kg IV/IO/IM/IN up to a max dose of 150 mcgs
-if needed, you can repeat up to two additional doses 5 minutes apart not to exceed 450 mcgs

Morphine Sulfate: 0.1 mg/kg IV/IO/IM

Ketamine: 0.15 mg/kg IV/IO
-may repeat one time in 15 minutes
-OR-
Ketamine 0.3 mgs/kg IM
-may repeat one dose in 20 minutes

26
Q

Ibuprofen - Adult

A

600 mg by liquid or tablet
-contraindicated for pregnancy

27
Q

Acetaminophen - Adult

A

650-1000 mgs by liquid or tablet
-contraindicated in patients with liver failure

28
Q

Ketorolac - adult

A

15mg IV

30mg IM

Contraindicated for head injury, chest pain, abd pain, or any potential for bleeding likely needing surgury

29
Q

Fentanyl - adult

A

1mcg/kg up to 150mcgs

May repeat up to two doses 5 minutes apart

Max total dose 450mcgs

30
Q

Morphine Sulfate - adult

A

0.1mgs/kg IV/IO/IM

Max of 10 mgs

31
Q

Ketamine for pain - adult

A

0.15 mg/kg IV/IO
May repeat one time in 15 minutes

-OR-

0.30 mg/kg IM/IN
May repeat one time in 20 minutes

32
Q

Poisoning/Substance Abuse/Overdose/Toxicology - Adult

A

Opioids:
Naloxone - 0.4-8mg IN or IM

ALL MEDICAL CONTROL ORDERS

Calcium blocker toxicity:
Calcium chloride - 20 mg/kg IV/IO over 5 minutes
-max dose of 1g

Organophosphate poisoning:
Atropine - 2-5 mg IV/IO

Beta-blocker or Calcium Channel blocker overdose:
Glucagon - 1-5 mgs IV/IO/IM

33
Q

Calcium blocker toxicity:

A

Calcium chloride - 20 mg/kg IV/IO over 5 minutes
-max dose of 1g

34
Q

Organophosphate poisoning:

A

Atropine - 2-5 mg IV/IO

35
Q

Beta-blocker or Calcium Channel blocker overdose:

A

Glucagon - 1-5 mgs IV/IO/IM

36
Q

Seizures - Adult

A

Midazolam 2-6 mg slow IV/IO/IM

Magnesium Sulfate 2-4 grams IV/IO over 5 minutes if suspected elampsia

37
Q

Shock - Adult

A

Epinephrine Infusion - 2-10 mcg/min IV/IO

Dopamine - 2-20 mcg/kg/min

38
Q

Sepsis Criteria - Adult

A

2 or more of the following:

-Temp less than 96.8 or greater than 100.4
-HR >90 bpm
-RR >22 bpm
-SBP <90 mmHg or MAP <65 mmHg
-New onest AMS or increasing mental status chance with previous AMS
-Serum Lactate level >4 mmol/l
-STCO2 less than or equal to 25 mmHg

Medical Control Can Order:
-Epinephrine infusion 2-10 mcg/min
-OR-
Dopamine 2-20 mcg/kg/min

39
Q

Stroke alert if symptoms are less than __ hours old.

A

24 hours

40
Q

Hyperkalemia - Adult

A

Calcium chloride: 1 gram IV over 5 minutes
-may be repeated once after 5 minutes

Nebulized Albuterol: Up to a max dose of 20 mg

41
Q

ACS - Adult

A

Aspirin: 324mgs

Nitroglycerin - x1 0.4 mg tab or spray SL
-systolic BP must be >120mmHg
-IV must be established before administering nitro!
-Every 3-5 minutes as long as symptoms persist and SBP >120
- AVOID in all patients who have used viagra, cialis, levitra within the last 48 hours
-often used for erectile dysfunction and pulmonary hypertension

42
Q

Atrial Flutter

A

Diltiazem:
HR >150 and the patient is stable but symptomatic
-0.25mg/kg slow IV over 2 minutes
-If no response after 15 minutes repeat at 0.35mg/kg slow IV over 2 minutes

Synchronized cardioversion dose starts at 50 jules

43
Q

Atrial Fibrilation

A

Diltiazem:
HR >150 and the patient is stable but symptomatic
-0.25mg/kg slow IV over 2 minutes
-If no response after 15 minutes repeat at 0.35mg/kg slow IV over 2 minutes

Syncronized cardioversion starting at 120

44
Q

Never give diltiazem to someone who has ______ syndrome

A

wolff-parkinson-white syndrome

45
Q

If patient is already taking a beta blocker, you can use ____ as an alternative

A

Metoprolol
-2.5-5 mg slow IV/IO over 2 minutes
-Repeat dosing 5-minute intervals for a max of 15 mg

46
Q
A

Massachusetts 2023 Statewide Treatment Protocols (1 decks)

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