DRT CARDS (DOSAGE/ROUTE/TIMINGS)

Question 1

ACETAMINOPHEN

Answer 1

DOSE: 325–650 mg PO q4–6h (max: 4 g/d)
Onset / Peak / Duration: Onset Varies / Peak 1-3 hours / Duration 3-4 hours
Administration Instructions: PO

Question 2

ERTAPENEM (INVANZ)

Answer 2

DOSE: 1 gram IV/IM q24h
Administration Instructions: For IV reconstitute with 10mL NS; for IM 3.2mL 1.0% lidocaine without epinephrine

Question 3

FENTANYL ORAL LOZENGE

Answer 3

DOSE: 800 mcg oral transmucossally, reassess in 15 min, add a second lozenge in other cheek as necessary.
Administration Instructions: Document AVPU prior to administration. Place lozenge between the cheek and gum; do not chew lozenge. Recommend taping lozenge-on-a-stick to casualty’s finger as an added safety. Monitor for respiratory depression. Administer Nalaxone as reversal if needed. Be prepared to provide ventilatory support with a BVM.

Question 4

KETAMINE (KETALAR)

Answer 4

DOSE: 50 mg IM or IN, Repeat doeses q30min prn IM or IN (max: 4 g/d)
OR
20 mg slow IV or IO, Repeat doses q20min prn IV or IO (max: 4g/d)
Onset / Duration: IM – Onset in 3-4 minutes / Duration 12-25 minutes IV – Onset in 30 seconds / Duration 5-10 minutes
Administration Instructions: Document AVPU prior to administration. IV Ketamine should be administered slowly over 1 minute. End points: Control of pain or development of nystagmus (rhythmic bac-and-forth movement of eyes). Be prepared to suction as Ketamine can increase secretions. Be prepared to provide ventilatory support with a BVM.

Question 5

MELOXICAM (MOBIC)

Answer 5

DOSE: 7.5–15 mg PO daily
Administration Instructions: PO

Question 6

MORPHINE SULFATE (MSO4)

Answer 6

DOSE: 5 mg IV/IO, Reassess in 10 min, repeat dose every 10 min as necessary to control severe pain.
Onset / Peak / Duration: IV – Onset in 5-20 minutes / Peak in 20 minutes / Duration 4-5 hours
Administration Instructions: Document AVPU prior to administration. Monitor for respiratory depression. Administer Nalaxone as reversal if needed. Be prepared to provide ventilatory support with a BVM.

Question 7

MOXIFLOXACIN (AVELOX)

Answer 7

DOSE: 400 mg PO qd
Onset / Peak / Duration: Onset Varies / Peak 1-3 hours / Duration 3-4 hours
Administration Instructions: PO

Question 8

NALAXONE (NARCAN)

Answer 8

DOSE: 0.4–2.0 mg IV, repeat q2–3min up to 10 mg prn
Onset / Peak / Duration: IV – Onset in 1-2 minutes / Peak in 5-15 minutes / Duration 45 minutes or longer
IM – Onset in 2-5 minutes / Peak in 5-15 minutes / Duration 45 minutes or longer
Administration Instructions: Have available when administering opioids. Titrate to effect to manage negative opioid effects, but use caution that pain is still managed.

Question 9

ONDASETRON ORAL DISSOLVING TABLET (ZOFRAN)

Answer 9

DOSE: 325–650 mg PO q4–6h (max: 4 g/d)
Administration Instructions: PO

Question 10

TRANEXEMIC ACID (TXA, CYKLOKAPRON)

Answer 10

DOSE: 1 gram in separate 100cc of NS or LR slow IV push over 10 min. Do not administer in same bag as blood products or Hextend. Administer a second infusion of 1 gram after 500cc fluid challenge.
Administration Instructions: Administer as soon as possible but not later than 3 hours after injury. Ensure documentation on casualty card and/or attach/write on patient’s chest wall.