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MIEMSS Protocol > Medication Cards > Flashcards

Medication Cards Flashcards

1
Q

Activated Charcoal (W/O sorbitol)

A

Adult and pediatric: 1 gram/Kg
Preparations: 25g in 125 mL
50g in 250 mL

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2
Q

Acetaminophen

A

> 2 y/o, in mild to moderate discomfort.
Contraindications: head injury, hypotension
Dosing: 2-4 y/o: 160 mg
5-12 y/o: two 160 mg doses
>13 y/o: four 160 mg doses (640)

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3
Q

Adenosine

A

Antagonized by theophylline, effects enhanced by digitalis, CCB, and Benzos.

Pediatric dosing: 0.1 mg/kg, followed by 0.2 mg/kg.
6mg/2mL

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4
Q

Albuterol

A

May repeat one time for bronchospasm. Ages <2 y/o, 1.25 mg neb.

Hyperkalemia: w/ medical direction
Adult: 20mg nebulized
Ped: single bronchospasm dose.
2.5 mg/2 mL

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5
Q

Amiodarone

A

VTach w/ pulse: 150 mg over 10 minutes in 50-100 mL. May repeat once.
Ped. w/ pulse: medical control order for 5 mg/kg over 20 minutes in 50-100 mL.

Ped. w/o pulse, 5 mg/kg push dose up to 300 mg May repeat twice up to 15 mg/kg
450 mg/9 mL

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6
Q

Atropine

A 
Relative contraindications:
     Glaucoma
     Suspected AMI or Ischemia
     Type II block or third degree block (med 
      control)
Adult: 0.5-1 mg every 5-10 min. Max dose 0.04 mg/kg
Ped: 0.02 mg/kg, max 0.5 mg. Repeat once
Organophosphate poisoning:
     2-4 mg every 5-10 min.
    Peds: 0.02 mg/kg every 5-10 min.
1 mg/10 mL
High Dose: 8mg/ 20 mL (3 or 5 mL syringe recommended)
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7
Q

Calcium Chloride

A

Also to reverse adverse reactions from magnesium sulfate administration.
Adult: 0.5-1 gm slow IV over 10 min., max 1 gm
Admin. 500mg slow IV for hypotension following diltiazem admin or mag. adverse effects.
Ped: 20 mg/kg slow IV, max 1 gram
Blood dose: 1 gram
1 g/10 mL

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8
Q

Dexamethasone

A

Adult: 10 mg
Ped: 0.5 mg/kg PO for asthma, max of 10mg
Croup, same dose PO/IV/IM.
10 mg/ 1 mL, 1 mL syringe recommended

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9
Q

Dextrose

A

if BGL <70 mg/dL, admin 25 grams of D50 until Pt has normal MS, BGL is 90, or repeat if necessary.
Ped: <28 days, if <40 mg/dL, admin 2 mL/kg of D10. Med control for 2nd dose
28 days to 18 years, if <70 mg/dL, 2-4 mL/kg, 2nd dose after med control.
50% Dextrose, 25g/50 mL

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10
Q

Diazepam

A

Cont.: head injury, caution in glaucoma
Adult seizure: 2.5-10 mg in 2.5 mg increments slow IVP, max 10 mg
Ped: 0.1 mg/kg in 2.5 mg increments slow IVP up to 5 mg. Rectal up to 0.2 mg/kg up to 10 mg

Nerve agent exposure: 10mg IM
Ped: 10 mg autoinjector or 0.1 mg/kg IM

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11
Q

Diltiazem

A

Symptomatic Afib and A flutter (HR 130+)
Contraindicated in peds.
Dosing: 0.25 mg/kg (max 20 mg) IV bolus over 2 mins. If no response, repeat in 15 minutes w/ .35 mg/kg (max dose 25 mg) over 2 mins.

If over 50 or with CHF, hypotension, or renal prob., initial bolus of 5-10 mg over 2 mins.
100 mg powder, dilute in 100 mL LR

Infusion allowed for IFT, no more than 15 mg/hr

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12
Q

Diphenhydramine

A

25-50 mg slow IVP or IM
Peds: 1 mg/kg slow IVP or IM
50 mg/ 1 mL

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13
Q

Epinephrine (arrest)

A

1 mg every 4 mins for a max of 4 mg. if after ROSC arrest occurs, max of 2 additional doses.
NOT for traumatic arrest.
Ped: 0.01 mg/kg every 4 mins, max of 4 mg. max of 2 additional doses after ROSC

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14
Q

Epinephrine (bradycardia)

A

1mg in 100 mL, 1 mL/min using 60 drop set. if SBP <90, obtain med. direction.
Ped: 0.01 mg/kg, repeat every 5 min.

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15
Q

Epinephrine (Anaphylaxis/asthma)

A

Administer 0.5 mg every 5 min up to 3 doses. If condition does not improve, use epi drip.
Ped: 0.15 mg in 0.15 mL if less than 5 y/o. Repeat every 5 minutes for a max of 3 doses. Then begin infusion.
Croup: 2.5 mL 1:1,000 nebulized. Consider second dose.

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16
Q

Epinephrine (shock)

A

Adult: 1mg in 100 mL, 1 mL/min in 60 drop set. Can admin 250mL bolus prior (2L if septic). if BP is <90 sys, begin drip. Check BP every 5 min. If BP is less than 90 sys or 65 MAP, increase to 2 mL/min. If goals are not met, med consult. Neuro shock pressures are 110 sys, 85 MAP.

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17
Q

Epi drip doses for Peds.

A 
Less than 10 kg: 6 drops min
10-19: 12 drops min
20-29: 18 drops min
30-39: 24 drops min
40-49: 30 drops min
Double if no response observed in 5 min.
patients under 10, calculate min. systolic as 70+2x age. If goal is not met in 10 min, contact ped. base station.
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18
Q

Fentanyl

A

Adult: 1 mcg/kg up to 200 mcg, reassess in 5-10 mins. can administer 2nd dose. medical direction for additional doses.
Peds: Same dosage
250 mcg/5 mL
Dilute with 5 mL NS, creates 250 mcg in 10 mL

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19
Q

Glucagon

A

Hypoglycemia: 1mg IM/IN, med consult up to 3 mg
28 days-4 y/o, 0.5 mg, med consult up to 3 mg.

Beta blocker OD:
Med control: adult 1mg IVP every 5 min.
28 days- 4 y/o: 0.5 mg IVP every 5 min

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20
Q

Haldol

A 
Cont: CNS depression/injury
          children <5 y/o
          adverse effect: extrapyramidal reaction Admin diphenhydramine to relieve these symptoms.
18-69: 5 mg IV
69+: 2.5 mg IV
5-12: 0.05 mg/kg IM or IV, max 2.5 mg
13-18: 2.5-5 mg IM or IV
5 mg/ 1 mL
21
Q

Ketamine (pain management)

A

Adverse effects: laryngospasm w/ rapid
admin.
Adult: 0.2 mg/kg over 2 minutes, max. 20 mg. Reassess in 5-10 min, then re-administer same dose.
0.5 mg/kg IN/IM, reassess in 15 min, then second dose.
Ped: same as adult dose
200 mg/ 20 mL
for PM, use a 3 mL syringe, 30 mL for RSI.
Now allowed for use when transcutaneous pacing

22
Q

Ketamine (excited delirium)

A

Adult: Administer 1 mg/kg IV, max dose 100 mg. If agitation persists, 2.5 mg midazolam.
IM: 4 mg/kg up to 400 mg. consider 5mg versed IM. Additional 4 mg/kg IM with med control.
Ped: same dosing, max of 200 mg.
500 mg/5 mL

23
Q

Ketamine (CPR awareness and bucking)

A

CPR induced awareness:
Adult: 1 mg/kg
Ped: med consult

Bucking: 2mg/kg over 1 minute, may repeat w/ 1 mg/kg IVP every 10-15 min as needed, max of 3 doses.

24
Q

Ketorolac

A

Adult: 15mg IV, no repeat. 30 mg IM, no repeat
Ped: 2-18: 0.5 mg/kg IV or 1 mg/kg IM

25
Q

Lactated Ringers

A

Adults: max 2L w/o medical direction
Peds: initial bolus of 20mg/kg, 10 mg/kg for volume sensitive children. May administer second 20mL/kg bolus before consulting med direction

26
Q

Lidocaine

A 
IO: 20-40 mg, consult for peds. 
Nasal anathesia (>13) 2 ml per nare. do not exceed 3 mg/kg throughout patient.

2%: 100mg/5 mL
4%: 160 mg/4 mL (2 mL each nare)
Jelly 2%: 5 mL/ tube

27
Q

Magnesium Sulfate

A

Eclamptic seizures: 4 grams in 50-100 mL over 10 minutes.
Refractory VT/VF or Torsades: 1-2 grams over 2 mins
Bronchospasm: 1-2 grams in 20-100 mL over 10 minutes

Ped: Brohchospasm: 50 mg/kg in 50-100 mL over 10-20 min.
Torsades: 25 mg/kg to a max of 2 grams over 2 minutes.
5g/10 mL recommended, 10 mL syringe
A

28
Q

Midazolam (seizure)

A

0.1 mg/kg in 2 mg increments slow IVP over 1-2 min, max dose of 5 mg. If IV unavail, IM/IN. additional doses require med control unless suspected nerve agent.
Ped: same dose, but 0.2 mg/kg IN/IM
10mg/2mL, use 1 or 3 mL syringe

29
Q

Midazolam (chem. restraint, bucking tube)

A 
Chem. restraint:
18-69: 5mg IV/IM
69+ 2.5 mg IV/IM
Ped. not indicated
Bucking tube:
Adult: 0.05 mg/kg slow IVP over 1-2 min. Max. 5 mg
Ped: same dose
30
Q

Morphine Sulphate

A

Adult: 0.1 mg/kg to a max of 20 mg, reassess in 5-10 mins, may administer 0.1 mg/kg up to to mg.
Pediatric: Same initial dose, second dose 0.05 mg/kg, max additional dose of 10mg
Peds. CHF: 0.1 mg/kg slow IVP/IM (1-2 mg/min) max dose 5 mg

31
Q

Naloxone

A

Adult: 0.4-2mg IVP/IO or 4 mg in one nare.
Peds: Administer 0.1 mg/kg IVP/IO or 4 mg in one nare. May be repeated as required.

32
Q

Nitroglycerin

A

Peds require medical consult
Chest pain: 0.4 mg SL may be repeated 2x at 3-5 minute intervals.
Med consult for additional doses.
Pulmonary edema/CHF: Low dose: same as AMI protocol
High dose: Administer 0.4 mg SL and 1 inch of nitro paste. Administer 1 dose NTG 0.8 mg SL, continue 0.8mg dosing to achieve 20% reduction in SBP.

33
Q

Ondansetron

A

Adult: 8mg slow IV over 2-5 minutes or 4-8 mg IM, or 8mg ODT. May repeat once w/o medical direction.
Ped: 28 days to 12 y/o: 0.1 mg/kg slow IVP over 2-5 min.
13-18: same as adult.
4mg/2 mL

34
Q

Sodium bicarbonate

A

Adult: 1 mEq/kg IVP bolus initially, with 0.5 mEq/kg at 10 minute intervals
Ped: Same initial dose, diluted 1:1 with LR if <1 y/o.
Hyperkalemia:
Adult: 50 mEq slow over 5 min, then drip 100 mEq in 1L LR over 30-60 min.
Ped: 1 mEq/kg IV over 5 minute, dilute 1:1 with LR if <1 y/o.
50 mEq/50 mL recommended 60 mL

35
Q

Etomidate (RSI)

A

0.3 mg/kg over 30-60 seconds, 0.15 mg/kg if hypovolemic.

40 mg/ 20 mL, 30mL syringe

36
Q

Etomidate (VDP)

A

0.3 mg/kg, then 0.15 mg/kg, then 0.15 mg/kg all over 30-60 seconds.

37
Q

Succinylcholine

A

1.5 mg/kg (max 200) rapid IV push

200mg/10 mL

38
Q

Terbutaline

A

0.25 mg IM, repeat once after 15 minutes, max of 0.5 mg IM

1 mg/mL

39
Q

Vecuronium

A

RSI: 0.1 mg/kg, if inadequate after 2-3 minutes, 0.05 mg/kg

VDP: 0.05 mg/kg (max 10 mg) may repeat once in 2-3 minutes

10mg powder, add 10 mL NS

40
Q

1.0 Air Q (blue)

A

4-7 kg

41
Q

1.5 Air Q (green)

A

7-17 kg

42
Q

2.0 Air Q (orange)

A

17-30 kg

43
Q

2.5 Air Q (Yellow)

A

30-50 kg

44
Q

3.5 Air Q (red)

A

50-70 kg

45
Q

4.5 Air Q (purple)

A

70-100 kg

46
Q

Cyanokit

A

Hydroxoxobalamin
Draw blood prior to admin.
5g over 10-15 minutes

70 mg/kg over 10-15 min for ped.

47
Q

Tranexamic Acid

A

SBP less than 90 due to traumatic injury (within 1 hour) OR post partum hemorrhage within 1 hour, SBP less than 90, HR greater than 110, despite uterine massage.

Contraindications: <15 YO
Greater than 1 hr after incident
Hx. of thrombotic disease

1 gram in 100 mL over 10 minutes.

48
Q

Norepinephrine

A

0.05-2 mcg/kg/min
Begin infusion at 0.1 mcg/kg/min and proceed
Titrate up 0.1 mcg/kg/min every 2 minutes to attain target BP

Contraindications: Pulseless or less than 18 YO

49
Q

Ketamine Drip

A

Administer 1 VDP ketamine dose beforehand,
1-2 mg/kg/hr
High concentration dose of Ketamine in 100 mL bag

MIEMSS Protocol (6 decks)

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