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Sac Metro Protocols > Medication > Flashcards

Medication Flashcards

0
Q

Benadryl route

A

IV/IM/PO

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1
Q

Benadryl dose for Anaphylaxis

A

50mg IV/IM/PO

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2
Q

Morphine Dose- Cardiac

A

2mg slo IV/IO

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3
Q

Morphine rate/repeat time

A

q-5

slow push

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4
Q

Morphine Cardiac max dose

A

.2mg/kg

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5
Q

Morphine Dose- Burns

A

0.1mg/kg

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6
Q

Morphine Max Dose- Burns

A

0.3 mg/kg

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7
Q

Morphine Consideration for Burns

A

Avoid morphine in hypovolemic pt

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8
Q

Morphine dose- Trauma pt

A

0.1mg/kg

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9
Q

Morphine Max Dose Trauma

A

0.2mg/kg

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10
Q

Morphine Consideration in Trauma pt

A

Avoid in hypovolemic pt

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11
Q

Morphine Dose- Other

A

0.1mg/kg

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12
Q

Morphine Max Dose Other

A

0.2 mg/kg

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13
Q

When administering pain meds you must document.
1)
2)

A

Pain scale with intital assessment
Vital Signs
*must document after each med admin/after all procedures

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14
Q

Can you use 2 pain medications on a pt.

A

No only one pain medication

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15
Q

Allergic reaction-Benadryl Dose

A

50 mg

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16
Q

Benadryl Route

A

PO/IV/IM

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17
Q

Anaphylaxis- Epi
Dose
Route
Concentration

A

0.3mg 1:1000 IM

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18
Q

Anaphylaxis- Benadryl
Dose
Route

A

50mg

IV.IM/IO

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19
Q

Anaphylaxis- Albuterol Dose

A

2.5mg

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20
Q

Anaphylaxis- With Base Contact

  • Epi Dose
  • Route
  • Concentration
  • Rate
  • When to stop
  • Max Dose
A 
0.1mg increments 
slow IV push 
1:10,000
When stroidor is removed or BP >90mm Hg 
0.5mg max dose
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21
Q

Dystonic Reaction - Benadryl Dose
Preferred Route
Available Routes

A

50mg
IV preferred
IM also an option

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22
Q

Beta Blocker OD- Fluid Challenge

-Amount if BP is less than ____

A

500ml if pressure less than 90mmHg

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23
Q

Beta Blocker OD- Atropine

  • First must admin____
  • If HR is less than _____
  • Dose
  • Route
  • Max
A 
500ml NS 
HR <50
1mg 
IV/IO 
No Max
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24
Q

Beta Blocker OD- Glucagon

  • First Admin
  • 2 physiological factors must be present.
  • Dose
  • Route
A 
Fluid Challenge 
Atropine 
HR < 50 and SBP <90
2 Units 
IV/IO
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25
Q 
Beta Blocker OD- Epinephrine 
-1st Must admin \_\_\_\_
Physiological factor must be present
-Dose
-Concentration 
-Rate 
-Route
-Repeat
A 
Fluid Challenge/Atropine/Glucagon
SBP < 70mm HG
0.1mg increments 
slow over 60 seconds
IV/IO push 
Repeat until SBP is greater than 90mm Hg
26
Q

Calcium Channel Blocker OD-
Physiological factor must be present
NS Admin Dose

A

SBP <90mm HG

500ml

27
Q 
Calcium Channel Blocker OD-atropine
First Admin\_\_\_\_\_\_\_\_ 
2 Physiological Factors Must be present
-Dose
-Repeat
A

500ml NS
HR <90
1mg IV/IO
May be repeated once if no response

28
Q 
Calcium Channel Blocker OD- Epi
First Admin \_\_\_\_ 
Physiological Factor must be present 
-Dose
-Concentration
-Rate
-Repeat
A 
Fluid Challenge
Atropine 
SBP must be less than 70
0.1mg 
1:10,000
Slow over 60 seconds
IV/IO 
Repeat until SBP >90
29
Q

TCA OD- Fluid challenge

  • Physiological Factor must be present
  • Dose
A

SBP <90

-500ml

30
Q

TCA OD - Sodium Bicarbonate

  • First admin _______
  • any 1 of 5 factors
  • dose
A

Fluid Challenge

1) HR greater than 120bpm
2) SBP < 90
3) QRS complex greater than .12 sec
4) Seizures
5) PVC greater than 6 per minute
- 1meq/kg IVP

31
Q 
Bradycardia- Atropine 
Dose 
Route 
-Repeat- 
When? 
Dose / Route / Rate / Repeat 
Max Dose 
**Consideration**
A

0.5mg
IVP/IO

Repeat when TCP is not Available
0.5mg-1mg IV/IO every 3-5 minutes
Max 3mg total given
**Avoid in an acute MI setting

32
Q

Bradycardia- Versed
-When to use
Dose
Route (dose with each route)

A 
When TCP 
IV/IO - 1-6mg slow IVP 
IM/IN - 2mg dose 
-May repeat times 2 at 5 min intervals 
titrate to pt comfort
33
Q

Bradycardia- Dopamine

  • When to give
  • Physiological factor must be present
  • Dose
A

Atropine ( Unless 2 type 2 or 3rd degree block)/ TCP
-SBP <90
Must have base hospital order
10mcg/kg/min

34
Q

Adult Tachycardia With Pulse - Versed

  • When to use
  • Route (with dose)
  • Repeat
A

Unstable- Synchronized Cardioversion

  • IV/IO 1-6mg slow IVP titrate to comfort
  • IM/IN- Single 2mg dose may repeat x2 @ 5 min intervals - titrate to comfort
35
Q

Adult Tachycardia - Adenosine

  • When to use
  • dose
  • Rate
  • follow with*
  • Repeat
A 
Stable/Narrow QRS/ Regular Rhythm/post valsalva
-6mg rapid IVP
-follow with 20ml NS Flush 
-Repeat - 2 min no response
12mg IVP followed by 20ml NS
36
Q

Adult Tachycardia - Amiodarone

  • When to use
  • 2 separate ways
  • dose
  • route
  • rate
A

Unstable/ Cardioversion/ Wide/ Now split
Unstable- Amiodarone - 150mg IVP/IO
Stable- Amiodarone 150mg IV/IO over 10 minutes.

37
Q

Respiratory Distress- Albuterol

  • Asthma/COPD dose/route
  • CHF/Pulmonary Edema Route
A

Asthma -mild - 2.5-5mg HHN/Mask/inline neb-may repeat
Asthma-severe- 5mg HHN/mask/in line
repeat as needed

CHF-mild- 2.5-5mg HHN- q as needed
Moderate/severe- 2.5mg-5mg HHN q as needed.

38
Q

Respiratory distress - Nitro

-2 routes and dose

A

CHF-mild distress-0.4mg SL q 5 - SBP >90.

CHF moderate / severe-  Based on BP.
SBP >200 -1.2mg SL
SBP-150-200-0.8mg sl 
SBP-90-150-0.4mg SL
q- 5 min based on BP
Hold if BP <90
Do not delay due to difficult IV
39
Q

NTG use with CPAP

A

1” of paste

40
Q 
Respiratory Distress- Morphine
-when to give it
-dose
-repeat
max
*consideration
A 
moderate to severe CHF after albuterol, nitro, CPAP.
-2mg SIVP 
q 5-10 min
Max 0.1mg/kg
Hold if BP <90
41
Q

Respiratory Distress- Epi

  • when to use
  • dose
  • concentration
  • consideration*
A

Moderate to severe- Asthma/COPD - post albuterol/CPAP.

  1. 3mg IM
    1: 1000
    * Base hospital order for pt >40 and or BP >180*
42
Q

When do we not give nitro

A

When pt taking PDE-5 inhibotors within last 48 hours.
-for ED or pulmonary HTN
.Slidenafil, tadalafil, vardenafil/viagra, cialis, levitra

43
Q

Respiratory Distress - Dopamine

  • when to use
  • dose
  • consideration*
A

Use of SBP constently <90
10mcg/kg/min
*must have base hospital order

44
Q

Nerve Agent - Mild Exposure -

Medications -Dose Routes

A

Mark 1 - admin 1 atropine (2mg) auto-injector IM, and 1- 2-PAM (600mg) auto Injector IM……or

DuoDote: Admin one Auto injector (Atropine 2.1mg and 2-Pam 600mg …..or

Attroppine 2mmg IV/IIM

45
Q

Nerve Agent- Moderate Exposure

Medications / dose / route

A

Mark 1 : admin 2- Atropine (4mg) and two - 2-Pam (1200mg) auto injector IM……or

DuoDote:Admin two Auto Injectors (Atropine 4.2mg & 2 pam 1200 mg….or

Atropine 4mg

46
Q

Nerve Agent Severe Exposure-

Medications/ dose/ route

A

Mark 1: Admin 3 Atropine (6mg) and 3 2-Pam (1800mg) auto injectors IM….or

DuoDote: Admin 3 Auto-Injectors (Atropine 6.3mg and 2-Pam 1800mg) or….

Atropine 6mg IV/IM

47
Q

Nerve Agent - Diazepam
-when to use
dose
*special dosing

A

Severe nerve agent exposure with seizure activity
-treat per protocol or……
When made available by deployment of a CDC Chempack- if supplied as diazepam 10mg/2ml auto injector - admin dose IM may repeat X2

If supplied as vial 5-10mg IVP or 10mg IM. May repeat x2 to max dose 30mg.

Further dosing requires BHO.

48
Q 
Haz Mat - Organophosphate - Atropine
When to use...
Dose
Route 
Repeat
A

When copious secretions
2mg IV push
Repeat every 3-5min

49
Q 
Chest Pain - Nitro 
dose/route
Repeat
BP must be \_\_\_\_ 
*precaution*
A

0.4mg SL
repeat every 5 min
Titrate to pain as long as BP >90
*precaution to pt taking PDE-5 inhibitors

50
Q

Chest Pain - Aspirin
dose
if taking concurrent anticoagulation therapy

A

320mg PO

Concurrent anticoagulation therapy is not a contraindication.

51
Q

Cardiac Arrest - Epi

Dose
Repeat

A

1mg

repeat 3-5min

52
Q

Cardiac Arrest - Amiodarone
Dose
Repeat

A

300mg

repeat 150mg

53
Q

Cardiac Arrest - Dopamine

  • When to use
  • Dose
A

Post Resuscitation SBP <90 with base hospital order

10mcg/kg/min

54
Q

Decreased Sensorium - Dextrose
Dose/concentration
Level when to give
Repeat

A

50% - 12gm

blood sugar < 60

55
Q

Decreased Sensorium- Glucagon

-Dose/Route

A

1 unit IM

if blood sugar <60

56
Q

Decreased Sensorium - Dextrose IO
Dose / Concentration
When to use

A

BGL < 60 or decreased responsiveness continues for more then 5 minutes after admin of Glucagon.

57
Q

Decreased Sensorium- Narcan

  • Dose
  • Route
A

Preferred routes are IV/IN. Can be given IM
Dose 1-6mg IV push, IN, IM
Titrate to adequate respiratory status
IN should be given 1mg at a time

58
Q

Decreased Sensorium - Versed

  • Dose
  • max
A
  1. 1mg/kg max 6mg SLOW IVP
    - give in 2mg increments - titrate to seizure control.

If no IV access- 0.1mg/kg IM (max dose 6mg) in single IM injection…may be split into 2 sites if not significant muscle mass….or may be given IN

59
Q

Decreased Sensorium- Diazepam

When to use
Dose

A

May substitute Diazepam when there is a shortage of Versed.
5-10 mg IVP to control seizures.
If no IV access, 10mg IM. May repeat once. Max dose 20mg.

60
Q

Restraint- Versed IV
Dose
Max

A

0.1mg/kg (max dose 6mg)
Slow IVP
Give in 2 mg increments titrate to reduction in agitation

61
Q

Restraint - IM Versed
Dose
Max

A

0.1mg/kg max dose 6mg in single IM injection

62
Q

Restraint - Versed IN

A

0.1mg/kg
max dose 6mg
One half dose in each nare.

63
Q

Nausea/Vomiting
Dose
Route
Repeat

A

4mg PO/SL/IM/IV/IO

For IV or IO Ondansetron admin slowly over 1 min to prevent syncope

For persistent vomiting may repeat X1 for a max dose of 8mg

Sac Metro Protocols (30 decks)

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