*Indications (CPFR Drugs, per PCPs) Flashcards
Albuterol:
A. Indication(s)
- Wheezing, allergic reactions (as well as anaphylaxis per PPP p. 45), asthma, COPD ;
- Suspected hyperkalemia;
- Crush Injury Syndrome;
* Pierce Co. EMS Procedures and PCPs, June 2019, p. 45, O-5*
- Ipratropium Bromide: Indication(s)
1.
- Bronchospasms secondary to asthma, COPD and reactive airway disease;
Memory Aid: Ipratropium bromide : bronchospasms;
Pierce County EMS Procedures and PCPs, Medication / IV Guide, p. O-31, June 2019
- Amiodarone: Indication(s)
1.
- Shock-Refractory VF / pVT (AHA ECC Handbook, p. 131 states, “VF / pVT Cardiac Arrest Unresponsive to CPR, Shock, and Vasopressor”);
- Polymorphic VT / wide complex tachycardia of uncertain origin;
- Control of hemodynamically-unstable VT when cardioversion is ineffective;
- Acceptable for termination of ectopic or multifocal atrial tachycardia with preserved LV function;
- Used for rate control in treatment of atrial fibrillation or flutter when other therapies are ineffective;
- Note: *Amiodarone administration should generally occur after the third defibrillation during a cardiac arrest.*
- Pierce County EMS Procedures and PCPs, Medication / IV Guide, p. O-7, June 2019*
- AHA ECC Handbook, Advanced Cardiovascular Life Support Drugs, p. 131, 2015*
- *Highlights of the 2020 AHA Guideline for CPR and ECC, Adult Cardiac Arrest Algorithm*
Epinephrine:
A. Indication(s)
- Allergic reactions;
- Anaphylactic shock;
- Status asthmaticus;
- Croup;
- Obstructive upper airway edema;
- Bradycardia unresponsive to atropine, TCP, dopamine;
- Hypotension;
- Cardiac arrest (VF, pVT, PEA, asystole);
* Pierce Co. EMS Procedures and PCPs, January 2019, p. O-23*
Adenosine:
A. Indication(s)
- Conversion of stable narrow-complex SVT to sinus rhythm;
- Conversion of unstable narrow-complex reentry tachycardia to sinus rhythm;
- Regular and monomorphic wide complex tachycardia, thought to be or previously defined to be reentry SVT;
* Pierce Co. EMS Procedures and PCPs, June 2019, p. O-3*
Etomidate:
A. Indication(s)
- Induction agent for RSI (adults and pediatric patients >= 10 years old);
- Cardioversion pre-sedation;
* Pierce Co. EMS Procedures and PCPs, June 2019, p. O-26*
Succinylcholine:
A. Indication(s)
- Induction of paralysis during sequenced intubation (generally-speaking, for patients with an intact gag reflex);
Pierce Co. EMS Procedures and PCPs, June 2019, p. O-55
Methylprednisolone:
A. Indication(s)
- Mild (PPP p. 36) as well as moderate-to-severe asthma / COPD exacerbations;
- Moderate-to-severe allergic reactions;
- Moderate-to-severe angioedema;
- Anaphylaxis;
* Pierce Co. EMS Procedures and PCPs, June 2019, p. 36, O-39*
Ondansetron:
A. Indication(s)
- Nausea and / or vomiting (as well as to stave-off potential nausea / vomiting related to traumatic eye injuries and the use of oral Dexamethasone during the treatment of pediatric croup);
Pierce Co. EMS Procedures and PCPs, June 2019, Traumatic Emergencies, p. 26, Respiratory Emergencies, p. 37, O-49
Dopamine:
A. Indication(s)
- Symptomatic hypotension secondary to non-hypovolemic states;
- *Low cardiac output states such as cardiogenic, anaphylactic, neurogenic or septic shock (additionally indicated for vasogenic shock and hypotension of unknown etiology);
- Symptomatic bradycardia when atropine and TCP are ineffective;
Note: *These are components of “UV SCAN”, a Berdancronym for the blood pressure-related indications for the use of dopamine.
UV SCAN
U - Unknown-origin hypotension
V - Vasogenic Shock
S - Septic Shock
C - Cardiogenic Shock
A - Anaphylactic Shock
N - Neurogenic Shock
Pierce Co. EMS Procedures and PCPs, June 2019, Medical Emergencies, p. 41, O-21
Lidocaine:
A. Indication(s)
- Cardiac arrest from VF/VT;
- Stable VT, wide-complex tachycardias of uncertain type, wide complex PSVT (indeterminate);
- As anesthetic flush prior to IO infusion (conscious adult patients);
* Pierce Co. EMS Procedures and PCPs, June 2019, p. O-34*
Diphenhydramine:
A. Indication(s)
- Allergic reactions (“uncomplicated allergic conditions);
- Anaphylaxis (as an adjunct to epinephrine);
- Dystonic or extrapyramidal reactions;
* Pierce Co. EMS Procedures and PCPs, June 2019, p. O-20*
Magnesium Sulfate:
A. Indication(s)
- Seizures due to pre-eclampsia, eclampsia;
- Life threatening ventricular arrhythmias due to digitalis toxicity, tricyclic overdose;
- Torsades de pointes;
- Respiratory distress (asthma);
* Pierce Co. EMS Procedures and PCPs, June 2019, p. O-36*
Glucagon:
A. Indication(s)
- Blood glucose < 80, when unable to establish an IV;
- Beta blocker or calcium channel blocker overdose;
- Epinephrine-refractory anaphylaxis secondary to beta-blockade;
* Pierce Co. EMS Procedures and PCPs, June 2019, p. O-28*
Sodium Bicarbonate:
A. Indication(s)
- Correct known hyperkalemia;
- Correct known bicarbonate-responsive acidosis (e.g., diabetic ketoacidosis or *overdose of tricyclic antidepressant, aspirin, cocaine or diphenhydramine);
- Prolonged resuscitation with effective ventilation (including upon return of spontaneous circulation after long arrest interval);
- Crush Injury Syndrome;
Note: *Note: These are components of “TADA! Cocaine!”, a Berdancronym for overdoses producing bicarbonate-responsive acidosis.
TADA! Cocaine!
TA - Tricyclic Antidepressants
D - Diphenhydramine
A - Aspirin
Cocaine!
Pierce Co. EMS Procedures and PCPs, June 2019, p. O-53
Dextrose:
A. Indications
- Suspected hypoglycemia;
- Coma of unknown origin;
- Crush Injury Syndrome;
- Routine IV administration;
* Pierce Co. EMS Procedures and PCPs, June 2019, p. O-16*