Class Meds

Question 1

Epi Pulseless Arrest Dosage

Answer 1

1mg IV/IO push (follow w/ flush);
Repeat q 3-5 minutes

0.2mg/kg in beta or calcium channel blockers OD; poison/drug induced shock

PED: 0.01mg/kg q 3-5 minutes;
1mg Max dose

Question 2

Epi Infusion for Bradycardia or hypotension

Answer 2

2-10mcg/min; titrate to response

PED: 0.01mg/kg

Continuous: 0.1-1mcg/kg/minute

Question 3

Epi Anaphylaxis or bronchoconstriction dosage

Answer 3

0.3-0.5mL IM (1:1); repeat q 5-15 min

0.5mcg/kg/minute Rapid Fluid Bolus (if shock persists)

PED: 0.01mg/kg (0.1ml/kg of 1:1) IM;
0.3mg max single dose; repeat q15 minutes prn

0.1-1 mcg/kg/minute IV infusion (if shock persists)

Question 4

Amiodarone

Answer 4

Cardiac Arrest:
300mg IV/IO push
150 mg 2nd dose

Deadly arrhythmias:
Rapid infusion: 150mg IV over 1st 10 minutes; repeat q 10 minutes prn up to 3 doses

2.2g IV/ 24 hours (Adolescents included)

PEDS:
5mg/kg IV/IO bolus, repeat to daily max 15mg/kg (300mg max); over 20-60 minutes in SVT, VT w/ pulses

Question 5

Adenosine

Answer 5

6mg rapid IV push followed by 20mL saline bolus; may double dose in 1-2 minutes

PEDS: 0.1mg/kg IV/IO followed by 5-10mL saline flush, may double dose in 2nd attempt

Question 6

Atropine

Answer 6

1mg bolus, repeat q 3-5 minutes
3mg max

PEDS: 0.02mg/kg; repeat q 3-5 min
Max single dose: 0.5mg
Max total dose: 1mg; 3mg adolescents

Question 7

Atropine SLUGDE dosing

Answer 7

2-4mg or higher

PEDS:
<12 years: 0.05mg/kg IV/IO initially;
Then repeated and doubled dose q 5 minutes until effects reversed

> 12 years: 1mg IV/IO (Same as above)

Question 8

Diltiazem

Answer 8

0.25mg/kg IV over 2 minutes;
*may repeat in 15 minutes-
0.35mg/kg over 2 minutes

Question 9

Mag

Answer 9

Seizure (eclampsia):
4g diluted in D5W or NS for IV piggy back over 15 minutes; followed by continuous load over 15-20 minutes of 1-2g/hr (30-40g/day Max)

Pulseless Torsades: 1-2g (2-4ml of a 50% solution) diluted in 10mL of D5W IO/IV push

Torsades w/ pulse & Respiratory distress:
Loading dose: 1-2g in 50-100mL of D5W over 5-60 minutes IV; followed w/ 0.5-1g/hr IV

Question 10

Mag PEDS

Answer 10

PEDS: 25-50mg/kg IV/IO over 10-20 min; 2g max dose

Question 11

Calcium chloride

Answer 11

500-1000mg (5-10mL of a 10% solution); may be repeated prn

PEDS: 20mg/kg (0.2ml/kg) IV of 10% solution slow IV/IO; may be repeated if indications persist (shouldnt exceed adult dose)

Question 12

Morphine

Answer 12

STEMI: 2-4mg IV; may repeat in doses of 2-8mg IV @ 5-15 minute intervals

Unstable angina/NSTEMI: 1-5mg IV

Pain: 0.1mg/kg IM (15mg Max dose); 10mg max dose IV/IO

PEDS: 0.1-0.2 mg/kg dose IV (15mg max total)

Question 13

Naloxone

Answer 13

IV: 0.4mg until adequate ventilations;
2mg for complete OD reversal; up to 6-10mg in under 10 minutes

PEDS: up to 5yrs or 44lbs (20kg) = 0.1mg/kg

> 5yrs or >44lbs (20kg) = 2mg

Question 14

Solumedrol

Answer 14

2mg/kg up to 125mg IV; 40-125mg IV

PEDS: 2mg/kg IV loading dose
(60mg max)

Question 15

Albuterol

Answer 15

Solution: 2.5-5 mg

*administer over 5-15 minutes; can repeat 3-4x /d by nebulizer

Question 16

Albuterol Peds

Answer 16

Solution: 0.1-0.2 mg/kg per dose diluted in 2 mL of 0.9% NS; may be repeated q 20 minutes.

Question 17

Ipatropium

Answer 17

0.5 mg nebulized; repeated twice. Nebulized ipratropium can be simultaneously administered w/ the first 3 doses of Albuterol or after the first dose of Albuterol.

Question 18

Ipatropium Peds

Answer 18

250-500 mcg (by nebulizer or MDI) q 20 minutes times 3 doses

Question 19

Glucagon hypoglycemia dosage

Answer 19

1mg IM/IN, may be repeated in 7-10 minutes

PEDS: >44lb or >5yr = same as adult
<44lb or <5yr = 0.5mg IM/IN

Question 20

Glucagon Calcium or Beta blocker OD dosage

Answer 20

3-10mg SLOW IV over 3-5 minutes, followed by a 3-5mg/hr infusion

PEDS: 25-40kg = 1mg IV push q 5 minutes prn
<25kg = 0.5mg IV push q 5 minutes prn

Question 21

Dextrose

Answer 21

125-500mL of 10%

PEDS:
5-10mL/kg 10%

*use 10% for infants >1month & neonates

Question 22

Diphenhydramine

Answer 22

1mg/kg IV SLOW/IM/oral
*50mg max dose

PEDS: 1mg/kg IV/IM/oral
*25mg max dose

Question 23

Ondansetron

Answer 23

IV: up to 4mg may be given undiluted (inject over 30-150 seconds)

up to 16mg max (chemotherapy)

PEDS: 0.15mg/kg per dose IV /oral
*4mg max

Question 24

Midazolam

Answer 24

*10mg Max total/ 5mg PEDS

IV: 0.1mg/kg
IM: 0.2mg/kg
PEDS: 0.05mg/kg per dose

Exited delirium:
5mg IV/IM
PEDS: IV= 0.05-0.1mg/kg
IM= 0.1-0.15mg/kg

Question 25

Ketamine

Answer 25

Pain:
0.25mg/kg IV/IO/IM; 25mg max single dose
*100mg max cumulative dose

Exited delirium:
IV: 2mg/kg over 1 minute
IM/IN: 4mg/kg

PEDS (>2yr):
IV: 1mg/kg over 1 minute
IM: 3mg/kg

Question 26

TXA

Answer 26

10mg/kg IV; 15mg/kg in certain situations

PEDS: 10mg/kg IV

Question 27

Sodium Bicarb

Answer 27

1 mEq/kg IV bolus

PEDS: Same as adult, just infuse slowly & only if ventilations are adequate

Question 28

Oxytocin

Answer 28

3-10 units IM after delivery of placenta

Bleeding following Incomplete or Elective Abortion:
Mix 10-40 units (1-4ml) in 1000ml of NS/LR solution;
Infuse @ 10-40 milliunits/min via microdrip tubing, titrate to bleeding or uterine response

Question 29

Thiamine

Answer 29

100mg slow IV/IM

PEDS: 10-25mg IV/IM