Medication Doses Flashcards
Amiodarone - Cardiac Arrest
300mg after the 3rd shock
150mg after the 5th shock
CPR Interfering patient
Fentanyl 100mcg 1-2min (no max) If fentanyl ineffective: Ketamine 50-100mg 1-2min (no max) If no IV access: Fentanyl 200mcg or Ketamine 200mg IM
RSI - standard
Ketamine 1.5mg/kg (max 200mg)
If GCS >10 Midaz 5mg IV
Rocuronium 1mg/kg (max 100mg)
RSI - modified (ketamine contraindicated)
Fentanyl 100-200mcg
Midaz 5-10mg IV
Rocuronium 1mg/kg (max 100mg)
(If serotonin syndrome use a morph/midaz combination)
Narrow complex tachycardia (stable BP <90)
If BP < 90 or no reversion with valsalva
Adenosine 6mg - if no reversion after 2/60
Adenosine 12mg repeat once after 2/60
Narrow complex tachycardia (unstable - deteriorating rapidly)
Synchronised Cardioversion
Midaz 1-2mg
Fentanyl 50mcg
Cardioversion 150J repeat x 1
If unsuccessful change to anterior posterior and DCCS 200J
Wide complex tachycardia - stable
Amiodarone 5mg/kg (max 300mg) over 20/60 single dose
Wide complex tachycardia - unstable
Synchronised cardioversion
Midaz 1-2mg
Fentanyl 50mcg
DCCS 150J repeat x 1
If unsuccessful anterior/posterior position DCCS 200J
If successful or unsuccessful continue to run the amiodarone infusion
Inadequate Perfusion (cardiogenic) - no crackles
N/Saline 250ml IV repeat as required.
Inadequate Perfusion (cardiogenic) crackles or ext poor perfusion
Adrenaline Infusion
- commence @ 5mcg/min (5ml/hr) titration to achieve SBP 100mmHg (max 250mcg)
If no syringe pump.
- Adrenaline 10mcg IV @ 2/60
STEMI
Heparin 4000units. Repeat 1000units at 1hour
Tenectaplase
- <60kg 30mg 6000units 6ml
- 60-69kg 35mg 7000units 7mls
- 70-79kg 40mg 8000units 8mls
- 80-89kg 45mg 9000units 9mls
- 90-99kg 50mg 10000units 10mls
Morphine - pain relief
IV - Up to 5mg max 20mg
IM - 10mg repeat 5mg after 15min or frail/<60kg 0.1mg/kg no repeat.
Fentanyl - pain relief
IV - up to 50mcg max 200mcg
IN - 200mcg repeat 50mcg til 400mcg. If elderly/frail/<60kg 100mcg repeat 50mcg max 200mcg
IM - 100mcg repeat 50mcg after 15min or 1mcg/kg no repeat.
Ketamine - pain relief
IV - 10-20mg at 5-10min. Procedural pain relief 20-30mg at 2min until dissociation
Infusion - 0.1-0.3mg/kg/hr
IN - 75mg repeat 50mg at 20min no max or
- if frail/<60kg/elderly 50mg repeat 25mg at 20min no max
Headache
Prochlorperazine 12.5mg.
Paracetamol 1g
Fentanyl if pain >7 and still 15min away from hospital
Bradycardia - unstable
Atropine 600mcg
Atropine 1200mcg @ 3-5min if inadequate response.
Continue 600mcg if adequate response 3-5min as required max 3mg
Asthma - Mild/Mod
Salbutamol pMDI 4-12 doses at 20min intervals. 4 breaths between each puff
Asthma - severe
Salbutamol 10mg (5ml) repeat at 5min 5mg (2.5ml)
Ipratropium Bromide 500mcg once
Dexamethasone 8mg IV/oral
Asthma - Inadequate response to severe management
Adrenaline 500mcg IM repeat at 5-10min (max 1.5mg)
IV adrenaline if no response to IM or thunderstorm asthma consult
20mcg at 2min.
MICA
If no response to IM
50-100mcg IV at 2-5min if infusion not available or whilst infusion being set up
Infusion 2-15mcg/min (2-15ml/hr)
COPD
Salbutamol 10mg repeat 5mg at 5min
Ipratropium Bromide 500mcg
Dexamethasone 8mg
MICA
Severe resp distress and RR >24
CPAP @ 7.5cm H20 increase to 10cm if nil improvement
Upper Airway Obstruction
5 back blows moving to 5 chest thrust repeat.
Unconscious manually remove obstruction. Commence chest compressions if unable to remove.
Upper Airway Obstruction - all other stridor
Adrenaline 5mg Nebulised. Consult for further
Dexamethasone 8mg IV/IM
Nausea and Vomiting - Adult
Ondasertron 8mg IV or 4mg oral. Repeat 4mg once after 10min.
IM can be administered using 4mg. If severe a further 4mg can be given.
The preferred treatment for N+V in pregnant patients with signs of dehydration is fluid rehydration
Hypoglycaemia
Responding to commands:
- 15g oral glucose (max 30g)
Not responding to commands or glucose ineffective:
- Dextrose 10% 15g (150ml) IV 10ml N/Saline flush before and after.
- After 5-10min no return to normal further 10g (100ml) titration to effect.
- If IV unable IM glucagon 1IU.
Hyperglycaemia
N/Saline 20ml/kg IV titration to perfusion.
Consider antiemetic.
Seizures - adult
- Midazolam 10mg IM repeat 10mg after 10min
- Elderly/frail/<60kg Midaz 5mg repeat 5mg after 5min
- IV Midaz 5mg
- Elderly/Frail/<60kg 2mg
No response after 5min
- 2-5mg IV repeat after 2-5min (Max 30mg with IM+IV)
- elderly/frail/<60kg 2mg IV repeat at 2-5min
- Consult for further
- Endotracheal intubation if no improvement
Anaphylaxis - Adult
Adrenaline 500mcg IM repeat @ 5/60
Oxygen 15lt NRB
- Stridor
Adrenaline 5mg nebulised consult for further - Bronchospasm
Salbutamol 5mg neb or pMDI 4-12 repeat at 20min.
Ipratropium bromide 500mcg.
Dexamethasone 8mg IV/oral - BP <90
N/Saline 20ml/kg (max 40ml/kg) - Inadequate response with hx of heart failure or taking beta blockers
Glucagon 1mg IV/IM repeat once at 5min
Inadequate response after 2 doses of IM
Adrenaline infusion 5mcg/min increase 5mcg @ 2/60
Extremely poor perfusion or impending cardiac arrest
Adrenaline 10mcg at 2/60. Or if poor response
Adrenaline 50-100mcg IV as required
Inadequate Perfusion (non-cardiogenic/Non-hypovolaemic)
Inadequate or extremely poor perfusion and chest clear:
- N/Saline 20ml/kg over 30min
No change:
- Adrenaline infusion 5mcg/min (5ml/hr) increase 5mcg @ 2/60
- If no infusion available 10mcg @ 2/60
- If poor response 50-100mcg as required.
Meningococcal Septicaemia - Adult
1g Ceftriaxone
IV dilute with 9.5ml water administered over 2min
IM dilute with 3.5ml lidocaine into upper lateral thigh.
Heroin OD - Adult
Naloxone 1-6mg-2mg IM single dose only
Opioid OD other
Naloxone 100mcg IV. Repeat every 2/60 until pt self ventilating (max 2mg)
Draw up into 5ml syringe with 3ml N/saline = 100mcg/ml
If no IV
400mcg IM single dose.
TCA OD
Sodium Bicarbonate 8.4% 100ml IV given over 3/60. Repeat 100ml after 10/60. Consult for further.
Consider ETT if pt GCS<10 after mx
RR - 20-24
Fi02 - 100%
ETC02 - 20-25mmHg
A more alkaline environment will de-activate the medication.
