AEMT Flashcards
Activated Charcoal
Activated Charcoal
Indications: To treat in cases of poisonings and overdoses. Effectively binds to: ASA, amphetamines, Dilantin, strychnine, and phenobarbital .
Dosage: Adult 50 grams
Ped 1gm/kg, 50 gm max dose
Route: Oral
Therapeutic Effects: It binds and absorbs ingested toxins still present in the gastrointestinal tract following emesis. Once bound, the combination is excreted.
Contraindications: Should not be given in: cyanide poisoning, caustic acids or alkalis, methanol (alcohol), iron pills, and lithium.
Side Effects: May indirectly induce vomiting and cause nausea.
Special Notes: Patient should be alert and able to swallow. Take extra precautions to protect the airway against aspirations. Ruins clothing that it touches.
Supplied: 25 and 50 gram slurry in a pre-filled tube.
Atropine Sulfate
Atropine Sulfate
Indications: Sinus (normal tracing) bradycardia (p<30) and hypotension. Asystole, PEA, organophosphate poisoning.
Route: IV, IO, ET, IM
Dosage: Bradycardia: 0.5 mg with pulse <30 repeat 3-5 minutes to a max dose of 3 mg. Asystole, PEA, 1mg IV push q 3-5 minutes. Max of 0.04mg/kg. Dose 2-2.5 times via ET. Not indicated for Peds.
Contraindications: Tachycardia, Glaucoma, Atrial Fibrillation, Atrial Flutter, Atrial tachycardia, V-fib, V-tach.
Side Effects: Tachycardia, Dry mouth, thirst, flushing skin, blurred vision, headache, pupillary dilation, urine retension.
Supplied: Preloaded Syringe 1mg/10ml at 0.1mg/ml.
Albuterol
Albuterol
Indications: Acute Bronchospasm, wheezing, asthma, allergic reactions (anaphylaxis).
Route: Hand held metered dose inhaler (MDI), hand held nebulizer.
Dosage: Adult MDI 1-2 puffs per dose
Adult nebulizer 2.5 mg in 3ml normal saline, 3 dose max 10 minutes apart
Ped MDI 1-2 puffs per dose
Ped nebulizer 2.5 mg in 3ml normal saline, 3 doses max 10 minutes apart
Therapeutic Effects: Decreases bronchospasm, improves pulmonary function. Main effect is bronchodilator.
Contraindications: Pts with known hypersensitivity to drug.
Side Effects: Tremor, dizziness, nervousness, headache, nausea, tachycardia, angina, palpitations.
Special Notes: Assess pt respiratory status after each dose to determine the need of 2nd and/or 3rd doses.
Supplied: MDI, unit vial of 2.5mg/3ml for use in nebulizer.
Baby Aspirin
Baby Aspirin
Indications: Chest pain suspicious of cardiac origin. Myocardial infarction.
Route: Oral, chew, P.O.
Dosage: 324 mg (4 tabs)
Peds: not recommended.
Therapeutic Effects: Given as an early potent anticoagulant. Blocks platelet aggregation and artery constriction. Reduce overall mortality of acute MI. Reduce nonfatal reinfarction.
Contraindications: Active ulcer/GI bleed. Hypersensitivity or allergy to aspirin. Any type of internal bleeding.
Side Effects: Allergic reaction, nausea/vomiting, indigestion, heartburn, tinnitus.
Supplied: Tablets of 81 mg each.
D-50
D-50
Indications: Suspected hypoglycemia, altered LOC, coma/seizure of unknown etiology.
Route: IV, IO, through free flowing line. 18 gauge IV best. 20 gauge - push slower.
Dosage: Adult: D 50% 25 g in a 50 ml solution, slow admin (titrate)
Peds: D 25% 2ml/kg pediatrics > 3 kg to 27 kg IV titrate to effect. (D50%: 25 g in a 50 ml solution titrate pediatrics > 37kg.) (For D25% mix: add 25 ml of dextrose 50% to 25 ml LR/NS)
Therapeutic Effects: Immediate source of glucose in circulating system.
Contraindications: Intercranial hemorrhage, Known CVA (stroke). (Dextrose can get into that tissue and cause necrosis.)
Side Effects: Local irritation. May precipitate severe neurologic symptoms in alcoholics.
Special Notes: Causes local tissue necrosis if IV infiltrates. Check glucose level prior to administration if possible.
Supplied: Pre-filled syringes and vials containing 50 ml of 50% dextrose (25 grams of dextrose).
Epinephrine 1:10,000
Epinephrine 1:10,000
Indications: Ventricular fibrillation/pulseless ventricular tachycardia, asystole, pulseless electrical activity (PEA).
Route: IV, IO, ET
Dosage: IV/IO 1mg push repeated q 3-5 minutes. ET 2mg repeat every 3-5 minutes.
Peds: 0.01 mg/kg push repeated every 3-5 minutes. ET 0.02? Mg/kg repeated q 3-5 minutes.
Therapeutic Effects: Increased heart rate. Increased myocardial contraction. Increased automaticity.
Contraindications: There are no contraindications in cardiac arrest.
Side Effects: None
Special Notes: None
Supplied: Pre-filled syringes containing 1 mg epinephrine in 10 ml solution.
Epinephrine 1:1,000
Epinephrine 1:1,000
Indications: Anaphylaxis, Bronchospasm/asthma.
Route: SQ, IM
Dosage: SQ 0.3mg, can repeat 3 x with 10 minute intervals.
Ped: SQ 0.01mg/kg up to 0.3mg, can repeat 3x at 10 minute intervals.
Therapeutic Effects: Increase systemic vascular resistance. Increased BP, Increased heart rate. Bronchial dilator.
Contraindications: Hypertension, Dysrhythmias, Tachycardia, Chest Pain.
Side Effects: Palpitations, Dysrhythmias, Hypertension, Tachycardia, Anxiety, Headache, Tremors, Nausea, Vomiting.
Special Notes: Use with pregnant women should be avoided whenever possible. (Vasoconstriction could cut off blood flow to the placenta.)
Supplied: Ampule containing 1mg/ml
Glucagon
Glucagon
Indications: Hypoglycemia. (“Back up” to D 50)
Route: SQ, IM, IV, IO (IM best)
Dosage: 1mg (Use 3cc syringe) 7-15 min to start working.
Ped 0.1mg/kg (max dose 1mg)
Therapeutic Effects: Causes the breakdown of glycogen to glucose. Inhibits glycogen synthesis. Elevates blood glucose level.
Contraindications: Hypersensitivity to the drug.
Side Effects: Relatively free of adverse reactions except for occasional nausea and vomiting.
Special Notes: Use when IV access is unavailable, IM preferred route. May repeat 1-2 times if no response (15-20 minutes between doses). Glucagon only works if the liver has glycogen stores.
Supplied: 2 vials to be mixed (one powder, one liquid) End item: 1mg/ml (1unit)
Lactated Ringers
Lactated Ringers
Indications: Hypotension, dehydration, burns, KVO, boluses.
Route: IV or IO infusion.
Dosage: As indicated by the pt condition and situation being treated.
Therapeutic Effects: Source of electrolytes. Increase circulating volume.
Contraindications: Congestive heart failure, renal failure, fluid overload.
Side Effects: Rare
Special Notes: Classification: Isotonic crystalloid.
Supplied: (Blank)
Lidocaine
Lidocaine
Indications: Pain due to IO infusion.
Route: Slow push IO
Dosage: 20-40 mg SLOW PUSH (so it doesn’t go to the heart. Can kill a person.)
Ped: 0.5mg/kg slow push.
Therapeutic Effects: Anesthetic effect due to IO infusion.
Contraindications: History of allergy to lido or local anesthetics.
Side Effects:
Special Notes:
Supplied: Pre-filled syringes 100mg in 5 ml. (20mg/ml)
Versed (Midazolam)
Versed (Midazolam)
Indications: Major motor seizures, status epilepticus, (Not in current protocol - skeletal muscle relaxant, acute anxiety states.) Active seizure - if not sure, lift eyelid to see eye movement.
Route: Slow IV, IM, IO, IN
Dosage: IV/IO 1-2mg initial 2 min intervals, slow titrate 2mg at a time up to 10 mg max dose or until desired effect obtained.
IM 2-5mg
IN (intranasal) 0.25-0.5 mg/kg to max of 20 mg one time dose. (Atomizer)
Peds IV/IO 0.05mg/kg max dose 0.4mg/kg (4 doses) at 2 minute intervals or until desired effect.
IM 0.1-0.15mg/kg
IN 0.25-0.5mg/kg max dose 20 mg one time dose (Atomizer)
WATCH DOSAGES AND ROUTES
Therapeutic Effects: Short acting CNS depressant. Anticonvulsant, Short term sedation.
Contraindications: Hypersensitivity, shock/hypotension, Glaucoma, Coma, Pregnancy, Renal Failure, ETOH Use Half Dose
Side Effects: Cardiac arrhythmias, apnea, hypotension. (Monitor Airway)
Special Notes: SBP must be > 100 mmhg adult, > 70 + (age in years x 2). Impairs memory in 90% of patients.
Supplied: 5 mg multi dose vial at 5mg/ml.
Morphine Sulfate
Morphine Sulfate
Indications: Severe pain in selected situations, acute myocardial infarction (AMI). HAVE NARCAN READY IN CASE OF HYPERSENSITIVITY.
If pain 6+ then consider use. Take vitals between doses.
Route: IV, IO, IM, SQ
Dosage: IV, IO, IM, SQ 1-15 mg (2-4 mg increments) titrate to effect.
Peds same routes 0.1-0.2mg/kg (1-4 mg increments) max 10mg, titrate to effect.
Therapeutic Effects: Decreased to pain perception and anxiety. Peripheral vasodilation/venous pooling. Decreased myocardial work load. (Possible use in chest pain.)
Contraindications: Head injury*, hypotension, asthma/COPD/respiratory depression, hypersensitivity to MS
Side Effects: Respiratory depression, hypotension, bradycardia, nausea/vomiting (Monitor Airway and Breathing)
Special Notes: Have Narcan and respiratory assistance available. Monitor vitals closely. BP>100.
Supplied: 10mg/ml preloaded syringes. 0.1 ml = 1mg
Narcan
Narcan
Indications: Narcotic overdoses (morphine, Demerol, heroin, dilaudid, paregoric, percodan, fentanyl, methadone, codeine)
Synthetic analgesic overdose (Nubain, talwin, stadol, darvon/darvocet)
Route: IV, IO, IM, SQ, ET
Preferred IV
Dosage: 0.4-2mg IV titrated slowly to adequate respirations. 0.8 mg IM per dose when IV is not established.
Ped: 0.1 mg/kg slow admin titrated to adequate respirations.
Therapeutic Effects: Reverses most effects of narcotic and synthetic narcotic agents.
Contraindications: Hypersensitivity to the drug.
Side Effects: Vomiting with rapid administration, ventricular dysrhythmias, precipitate acute narcotic withdrawal syndrome, seizures, hypertension.
(Monitor Resp)
Special Notes: Rapid onset, short acting - possible re-sedation. Slow administration (may induce vomiting if given too quickly)
Supplied: 2 mg at 1mg/ml pre-filled syringe.
Nitroglycerin
Nitroglycerin
Indications: Chest pain consistent with acute coronary symptoms.
Route: Sublingual
Dosage: 0.4 mg q 5 minutes, max 3 doses as long as SBP>100 mmHg, as long as symptoms persist.
Ped: not indicated.
Therapeutic Effects: Dilates coronary and system arteries. Increases blood pooling -> less preload -> less cardio work load.
Contraindications: Increased intracranial pressure (ICP), hypotension/shock, glaucoma, Use of Viagra/Cialis/Levitra med within previous 24 hours.
Side Effects: Headache, dizziness, hypotension
Special Notes: Monitor vitals closely. IV access preferred prior to administration if possible.
Supplied: Ointments, tablets, sustained release capsules, spray or patches. Field use, tablets or spray of 0.4 mg per dose are preferred.
Oral Glucose
Oral Glucose
Indications: Hypoglycemia, altered LOC with Hx of diabetes.
Route: Oral
Dosage: 15 grams
Ped: 15 grams
Therapeutic Effects: Source of glucose that is quickly absorbed.
Contraindications: Inability to swallow or protect airway.
Side Effects:
Special Notes: Takes a long time to get into the system.
Supplied: 15 gr gel filled tube
