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1
Q

RSI meds for adult

A 
Etomidate 0.3 mg/kg
Succinylcholine 2mg/kg
Rocuronium 1mg/kg
In rapid succession 
Propofol 2 mg/kg
Ketamine 1mg/kg
Vecuromium 0.1 mg/kg
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2
Q

What RSI drug would you NOT use if your pt was hyperkalemic, has a burn/crush injury, spinal cord injury or a myopathy?

A

Succinylcholine. You would want to use rocuronium 1mg/kg

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3
Q

For RSI if you have no succs or roc what drug would you use?

A

Vecuromium 0.1 mg/kg

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4
Q

For a hypotensive pt what drug would you use in RSI?

A

Ketamine 2mg/kg

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5
Q

For RSI if you have NO etom and pt bp good what drug would you use?

A

Diprivan 2mg/kg

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6
Q

RSI atropine dose for pt <8 yrs old?

A

Atropine 0.02 mg/kg

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7
Q

For RSI you want to pre-oxygenate w/NRB for 1-3 min and have NC on how many liters/min?

A

5

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8
Q

What is mallampati score?

A

Classification of ease of intubation.
Class 1: full visualization of tonsils, uvula, n soft palate
Class 2: visual of hard n soft palate n upper portion of tonsils n uvula.
Class 3: only soft n hard palate n base of uvula visible.
Class 4: only hard palate visible.

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9
Q

Airway assessment

LEMON

A 
Look
Evaluate 3-3-2
Mallampati
Obstruction
Neck mobility
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10
Q

What does LEMON stand for?

A 
Look
Evaluate (3-3-2, mouth opening 3        finger widths, norm mandible dimension, notch of thyroid cartilage 2 finger breadths below hyoid bone)
Mallampati 
Obstruction
Neck mobility
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11
Q

For RSI; in the septic pt you would use what drug in place of etomidate?

A

Ketamine 2mg/kg

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12
Q

What drug in RSI would you want to promedicate with for an actual or potential head injury pt?

A

Fentanyl 3-5 mcg/kg ivp

Lidocaine 1.5 mg/kg ivp

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13
Q

Allergic reaction..what drugs would you use?

A

Benadryl 50 mg ivp/im
Albuterol 5mg
NS bolus up to 2L
EPINEPHRINE (1:1,000) 0.3mg or 0.3 ml IM

If severe life threatening and IM not working; mix 10 ml of 1:10,000 (1mg) in 1L of NS start at 60 ml/hr and increase by 60 ml/hr every min

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14
Q

Drugs to use for combative pt?

A

Ativan (lorazepam) 1-2 mg IVP
Versed (midazolam) 2 mg IVP/IM
Ketamine (ketalar) 5 mg/kg IM or 1-2 mg/kg I’VE

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15
Q

COPD/asthma, bronchospasm..what meds would you give?

A 
Albuterol 5mg
Atrovent (ipratropium bromide) 0.5mg
Epinephrine (if life threatening) 0.3 mg (0.3 ml) of 1;1,000 IM (avoid if heart dx tachyarrhythmias or age >50
Solu-medrol 125 mg IVP
Epi aerosol 5 ml (or racemic epi 0.5ml)
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16
Q

Bradycardia

A

Atropine 0.5 mg IVP
Dopamine 5-20mcg/kg/min if pacing is ineffective

Epinephrine gtt 2-10 mcg/min

Transcutaneous pace for type 2 second degree or 3rd degree av block

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17
Q

Chest pain

A

Asa 81 mg
Nitro gtt 5 mcg/min titrate 5-10 mcg/min q 3 min
Fentanyl 50 mcg IV

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18
Q

Tachycardia >150 unstable

A

Immediate synchronized cardioversion w/ 150 joules

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19
Q

Tachycardia wide qrs

A

Adenosine (adenocard) 6mg

Amiodarone (cardarone) 150 mg IV over 10 min, repeat 150mg IV over 10min

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20
Q

Tachycardia narrow qrs

A

Vagal maneuver

Adenosine (adenocard) 6mg rapid push, may repeat 12 mg dose once

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21
Q

Tachycardia afib/flutter

A

Diltizem (cardizem) 0.25 mg/kg IVP over 2 min
May repeat 0.35 mg/kg in 15 min
Maintenance 5-15 mg/hr gtt

If unresponsive Amiodarone 150mg IVP over 10min

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22
Q

CHF

A

Cpap
Nitro 50 mcg/min titrate 5-10 mcg/min q 3 min up to 200 mcg keep sbp >100
Lasix (furosemide) 0.5-1.0 mg/kg IVP

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23
Q

Hypoglycemia

A

D50 25grams repeat in 10 prn

Glucagon 1mg IM

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24
Q

Hyperglycemia

A

BS. >300 w/change in LOC, increased resp

250 ml NS bolus

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25
Heat emergency
NS 500 ml bolus | Ativan (lorazepam) 1-2 mg for shivering prn
26
What meds would u use for a K greater then 7, or >5.5 w/ EKG changes..loss of P wave, widening QRS, tall peaked T waves, or arrhythmias..weakness or paralysis?
``` Ca Gluconate 10ml of 10% in 5 min(do not use if dig tox) NA bicarbonate 50 meq (no if chf) Insulin 10units IVP Glucose 25 G IVP Consider albuterol 5mg/5ml nebs ```
27
HTN >200/120
Ntg gtt 10 mcg/min titrate q 3 min Nicardipine (cardene) bolus 5mg/hr increase by 2.5 mg q 5-15 min max 15 mg/hr..when bp improved, quick ween to 3 mg/hr Labetalol (trandate) 10-20 mg IVP q5-10 min max 150 mg
28
OD..what drugs and dose?
Narcan (naloxone) 0.4 mg IV/im/in Tricyclics 8.4%NA bicarbonate Organophosphate atropine
29
Pain mgmt meds
Diludid 0.5-1 mg IV/IM q10 min Fentanyl (sublimaze) 1mcg/kg q5 (no more then 100mcg per dose) MS up to 4mg q5
30
Sedation
Versed (midazolam) 2-5mg | Ativan (lorazepam) 1-2 mg
31
Cardioversion sedation meds?
Fentanyl (sublimaze)1mcg/kg And Etomidate (amidate) 0.1 mg/kg Immediately prior if pt awake
32
Sedation for intubated pt?
``` Ativan (lorazepam) 1-2 mg Versed (midazolam) 2-5 mg Fentanyl (sublimaze) 1mcg/kg q5min Propofol (Diprivan) 20-40mg bolus q2min...gtt 5-50 mcg/kg/min Ketamine (ketalar) 1mg/kg over 1min ```
33
Seizure meds?
Check BS Versed (midazolam) 0.1 mg/kg max dose of 5 mg Ativan (lorazepam) 2mg q10 slow push
34
Non-traumatic shock meds?
250 NS bolus prn Dopamine 5-20 mcg/kg/min Dobutamine 2-20 mcg/kg/min Sepsis: norepinephrine (levophed) 0.5-12 mcg/min
35
N/V?
Zofran (ondansetron) 4mg NS bolus 250 ml Reglan (metoclopride) 10mg IVP/IM Benadryl (diphenhydramine) 25 mg IVP for restlessness
36
Adenocard (adenosine)..what's it for and adult dose?
Narrow tachycardia 6 mg rapid IVP then 12 mg rapid IVP x1 prn
37
Albuterol (Proventil)..what's it for and adult dose?
Allergic reaction, bronchospasm, wheezing | 5mg nebs, repeat prn
38
Amiodarone (cordarone)..what's it for and adult dose?
Antiarrhythmic..wide tachycardia 300mg IVP n repeat 150 mg-arrhythmias 150 mg IVP over 10 min-tachycardia
39
Amiodarone kit...what's it for and how is it dosed?
Antiarrhythmic n wide tachycardia 1mg/min
40
Atropine...what's it for and adult dose?
Asystole, PEA, 1mg IVP q 3-5 min Symptomatic bradycardia 0.5 mg q3-5 min
41
Atrovent (ipratropium)..what's it for and the adult dose?
Bronchospasm or wheezing | 0.5 mg nebs
42
Benadryl (diphenhydramine) what's it for and the adult dose?
Allergic reaction and anaphylaxis 50mg IVP/IM Akathisa (restlessness) 25 mg IVP
43
Calcium Gluconate..,what's it used for and the adult dose?
Hyperkalemia 10 ml of 10% IVP over 5 min
44
Dextrose (D50W)..what's it for and the adult dose?
Glucose <70 | 25gm IVP
45
Dilaudid (hydromorphone HCL)...adult dose and what's it for?
Pain mgmt 0.5-1 mg IVP q10 min >65 yo..0.5 mg IVP q10
46
Diltiazem 25mg/ml (cardizem)...what's it for and adult dose?
Tarcardia 0.25 mg/kg IV over 2 min May repeat 0.35 mg/kg in 15 min
47
Diltiazem 125mg/25ml (cardizem)...gtt.. | What's it for and adult dose?
Tachycardia | 5-15 mg/hr titrate for hr
48
Dopamine (intropin)...what's it for and the adult dose?
Shock..non-traumatic, n bradycardia 5-20 mcg/kg/min Keep bp >100
49
Dobutamine...what's it for and adult dose?
Non-traumatic shock 2.5-20 mck/kg/min Titrate keep bp >100
50
Epinephrine (1:1000, 1:10,000)..what's it for and the adult dose?
Vfib, pulseless VT, PEA, asystole, asthma, anaphylaxis, shock Card arrest: 1mg of 1:10,000 q3-5min Anaphylaxis/asthma.. 0.3 mg 1:1000 sq/im q5-10 min x2 Severe; 1:10,000 (1 ml IV) Epi gtt: 2-10 mcg/min
51
Etomidate..when do we use it and adult dose?
RSI, 0.3 mg/kg IV Sedation, 0.1 mg/kg for cardioversion
52
Fentanyl (sublimaze)..what's it for and adult dose?
Pain, airway, sedation | 1mcg/kg IVP q5 min..(max single dose 100 mcg)
53
Glucagon..what's it for and adult dose?
Glucose <70 and no IV site | 1 mg IM, repeat in 20 min
54
Haloperidol (haldol)...what's it for and adult dose?
Combative pt | 10 mg IVP
55
When would we use insulin and what adult dose?
Hyperkalemia 10 units of reg. IV
56
Ketamine (ketalar)..what's it for and adult dose?
Sedation Induction 2mg/kg IV over 1 min Sedation 1mg/kg IV over 1min
57
Labetalol (trandate)..what's the dose and what's it for?
Hypertension 10-20 mg q5-10 min IVP Max dose 150 mg
58
Lasix (furosemide) ..what's the adult dose and what's it for ?
CHF/pulm edema | 0.5-1.0 mg/kg IV
59
Lidocaine 2% (xylocaine)...what's the adult dose and what's it for?
RSI (consider), arrhythmia: 1-1.5 mg/kg IV EZ IO insertion; 40-60 mg IO slowly before fluid bolus
60
Lidocaine 1% (xylocaine)...what's it for and adult dose?
Local anesthesia; prn up to 4.5 mg/kg
61
Lorazepam (Ativan)..what's the adult dose and what's it for?
Behavioral, heat emergency, seizure, sedation; 1-2 mg IVP
62
Magnesium sulfate..what's it for and the adult dose?
Torsades de pointes...1-2 gm IV
63
Morphine sulfate..what's it for adult dose?
Pain, sedation, airway; 4mg IV q5 min prn Geriatric; up to 2 mg IV q5min prn
64
Narcan (naloxone)..what's it for and adult dose?
Narc OD | 0.4 mg IV may repeat up to 2 mg
65
Nicardipine (cardene)...what's it dot and adult dose?
Hypertension | Begin 5 mg/hr titrate q5-10 min 2.5 mg up to max of 15 mg/hr. when goal bp reached change to 3 mg/hr
66
Nitroglycerin (tridil)..what's it for and the adult dose?
CHF; begin w/ 10 mcg/min, titrate to 50 mcg /min keeping bp >100 CP; begin at 5 mcg/min, titrate by 5mcg/min q5 min
67
Nitro spray..what's it for and adult dose?
CP or pulm edema; 0.4 sl q5 min keep sbp >100
68
Norepinephrine (levophed)..when do we use it and what's the dose?
Septic shock | 0.5 mcg/min titrate up to 30 mcg/min
69
Oxytocin (pitocin)..what's it for and what's the dose?
OB emergencies, postpartum hemorrhage | 10 units
70
Plavix (clopidogrel)..what's it for and dose?
CP w/ allergy to asa; 300 mg
71
Procainamide (pronestyl)..what's it for and adult dose?
Antiarrhythmic; 15mg/kg @ 20-30 mg/min to a total loading dose of 1000 mg
72
Propofol (Diprivan)..what's it for and adult dose?
Sedation..bolus of 2mg/kg and gtt 5-50 mck/kg/min
73
Reglan (metoclopride)..whats it for and adult dose?
N/V; 10 mg IV/IM
74
Rocuronium bromide (zemuron)..what's it for and adult dose?
Neuromuscular relaxant.. 1mg/kg IV Defasiculating (muscle twitching) dose 0.1 mg/kg IV
75
Nitroprusside..adult dose and use?
Acute CHF | 0.3 mcg/kg/min
76
Sodium bicarbonate 8.4%...what's it for and adult dose?
Prolonged cardiac arrest, hyperkalemia; 1meq/kg IV
77
Solu-medrol..what's it for and adult dose?
Bronchospasm (asthma/copd) 125mg IV
78
Succinylcholine (anectine)..adult dose and use?
``` Neuromuscular relaxant (short term) 2mg/kg IV ```
79
Valium (diazepam)..use and adult dose?
Sedation, airway, | Up to 5 mg IV may repeat as needed
80
Vecuronium (norcuron)..adult dose and use?
Neuromuscular relaxant: 0.1 mg/kg IV Defasciulating (twitching) dose; 0.01 mg/kg IV
81
Versed (midazolam)..use and adult dose?
Sedation, airway, burns, seizures; 2mg IV increments up to 10mg 2-5 mg IV q10 severe burn discomfort
82
Zofran (ondansetron)..use and adult dose?
Vomiting; 4 mg IV slow 2-5 min Or 4mg oral disintegrating tab (ODT)

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