Adult Protocols, Drugs and Dosages

Question 1

Adrenal Insufficiency Treatment

Answer 1

Hydrocortisone 100mg IV/IO/IM

Methylprednisolone 125mg IV/IO/IM

Question 2

Allergic Reaction/Anaphylaxis Treatment

Answer 2

Epi-Pen (0.3 mg) IM (2nd dose MC)
Albuterol 2.5-3mg Neb
Diphenhydramine 25-50mg IV/IO/IM
Hydrocortisone/Methylprednisolone 100/125mg IV/IO/IM

Medical Control:
Epinephrine Infusion - 2-10 mcg/min
Dopamine Inbfusuon - 2-20 mcg/kg/min

Question 3

Altered Mental Status

Answer 3

Glucose < 70 mg/dL:
Oral Glucose
Glucagon 1mg IM (repeat once)
Dextrose 12.5g IV/IO (repeate max 25g)

Question 4

Behavioral Emergencies

Answer 4

Haldol 5mg IM and/or
Midazolam 2-6mg IV/IO/IM/IN
Ketamine 4 mg/kg IM (Max 400mg)

Question 5

Bronchospasm/Respiratory Distress

Answer 5

Albuterol 2.5mg NEB
Ipratropium Bromide 0.5mg NEB
Epinephrine 0.3mg IM (once)

Asthma or COPD:
Hydrocortisone/Methylprednisolone 100/125mg IV/IO/IM
Asthma:
Magnesium Sulfate 2-4g IV/IO over 20 minutes

Question 6

Nerve Agents Organophosphate

Answer 6

If symptoms s/p 3 DuoDote kits
Atropine 2mg IV/IO q 5 minutes
Pralidoxime 1-2g IV/IO over 30-60minutes
Diazepam 10mg IM by Auto-injector q 10 minutes or,
Midazolam 2mg IV/IO/IN q 5 min or 6 min IM q 10 minutes

Question 7

Obstetrical Emergneices

Answer 7

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

Magnesium Sulgate 2-4g IV/IO over 5 minutes

Question 8

Pain & Nausea Management

Answer 8

Acetaminaphen 650-1000mg IV/PO
Ibuprofen 600mg PO
Ketorolac 15mg IV or 30mg IM
Fentanyl 1 mcg/kg slow IV/IO/IM/IN (max 150mcg)
Morphine 0.1mg/kg IV/IO/IM/SC (max 10mg)
Ketamine 0.15 mg/kg IV/IO slowly (repeat once 15min)
Ketamine 1 mg/kg IM/IN (repeat once 20min)
Ondansetron 4mg PO/IV/IO/IM

Question 9

Poisoning/Substance Abuse/Overdose/Toxicology

Answer 9

Nalocone 2-5mg IN or 0.4mg IM auto-injector
Calcium Chloride 10% 20mg/kg IV/IO over 5 min (max 1g)
Sodium Bicarbonate 0.5-1mEq/kg IV/IO (TCA/ASA OD)
Furosemide 40mg IV/IO
Glucagon 1-5mg IV/IO/IM (beta/calcium channel blocker)

Question 10

Seizures

Answer 10

Midazolam 2-6mg slow IV/IO/IM
Midazolam 10mg IN
Magneium Sulfate 2-4 g IV/IO over 5 minutes

Question 11

Acute Coronary Syndrome

Answer 11

Aspirin 324mg PO
Nitroglycerin 0.4 mg SL q 3-5 minutes
Fentanyl 1mcg/kg slow IV/IO/IM/IN

Question 12

Atrial Fibrillation/Flutter

Answer 12

Unstable:
Synchronized Cardioversion 200J, 300J, 360J
Flutter: 50J

Stable:
Diltiazem 0.25 mg/kg slow IV/IO over 2 minutes
Repeat 0.35mg/kg slow IV/IO over 2 minutes

If on Beta-Blockers:
Metoprolol 2.5-5mg slow IV/IO over 2 minutes

Question 13

Bradycardia

Answer 13

TCP

Atropine 0.5mg IV/IO q 3-5 minutes (max 3mg)

Question 14

Congestive Heart Failure

Answer 14

Nitroglycerin 0.4mg SL q 5 minutes
Nitropaste 1in if SBP > 120mmHg
CPAP

Question 15

Supraventricular Tachycardia

Answer 15

Unstable:
Synchronized Cardioversion
50J, 100J, 200J, 300J, 360J
Adenosine 6mg rapid IV/IO (repeat 12mg x2)

Question 16

Ventricular Tachycardia w/ Pulses

Answer 16

Unstable:
100J, 200J, 300J, 360J
Stable:
Amiodarone 150mg IV/IO over 8-10 minutes