PARAMEDIC Flashcards
ACETAMINOPHEN
TYLENOL
Pain
Dose:1300 mg PO
ADENOSINE
SVT
Provided:6 mg x4
Adult: 6mg, 2nd 12mg
Fast push
AFRIN (Oxymetazoline)
Nosebleed
Provided: 0.05 spray bottle
Dose: 4 sprays each nostril
ALBUTEROL
wheezing, broncospasm, anaphylaxis, hyperkalemia
Provided: 2.5mg nebx4
Adult: 2.5mg
Ped: 5mg
AMIODARONE
antidysrhythmic
Provided: 150 mgx3
Dose:300mg, 2nd 150mg IV/IO
ASPIRIN
pain, anti-inflammatory, anti-platelet, anti-pyretic
Dose: 324mg=4-81mg chewed tablets
ATROPINE
anticholinergic
Increases cardiac output
Provided: 1mg vial x2
Dose: 1 mg IV q3-5min max:3mg
After 1st dose prepare to pace
ATROVENT (IPRATROPIUM)
Asthma/COPD
Provided: 0.5mg neb
Adult: 0.50 neb
Ped: 0.25 neb
CONTRA: PEANUT ALLERGY
BENADRYL (DIPHENHYDRAMINE)
allergic reaction, anaphylaxis
Provided: 50 mg vial
Dose:25-50mg PO. 50mg IV
CALCIUM CHLORIDE
Mineral/Electrolyte
Hyperkalemia, hypercalcemia , calcium channel blocker toxicity, hypermagnesemia
Provided: 1 gram vial
Dose: 1 gram slow IV push
OB MAG TOX: 500mg IV
PED: 10-20mg/kg IV SLOW over
10-15 minutes max: 1 gram
CEFAZOLIN (ANCEF)
antibiotic
Open fracture
Provided: 1 gram vial
Dose: 1gram IV/IO in 2 ML NS
CONTRA: HYPERSENSITIVITY TO CEPHALOSPORIN ANTIBIOTIC DRUGS, PENICILLIN OR BETA-LACTAMS
D-10
Carbohydrate, hypertonic solution. Hypoglycemia
Provided: 500mL bag premix
Adult: 10 gr IV
Ped: 5mL/kg IV
DEXAMETHASONE
(DECADRON)
corticosteroid, anti-inflammatory, croup, bronchospasm,high altitude cerebral edema, allergic reaction
Provided: 4mg vialx2
Dose: adult 8mg IV/IM
ped:0.5 mg/kg IV/IM MAX 8mg
DIPHENHYDRAMIN (BENADRYL)
antihistamine, allergic reaction, acute extrapyramidal reactions
Provided: 50mg vial
Dose: 50mg IV
ped: 1mg/kg
max 25mg IV/IM
DOPAMINE (INTROPIN)
sypathommetic
Hypotension W/O hypovalemia, bradycardia following Atropine
Provided: 1600 mcg/mL, 250 mL bag premix
Dose: 5-20 mcg/kg/min IV
Ped: same as adult
EPINEPHRINE (ADRENALIN)
Sypathomimetic
Anaphylaxis, cardiac arrest, PEA, V-fib & V-tach w/o pulse unresponsive to defib, bradycardia when pacing and Atropine fail, bronchial asthma
Provided: 1mg/10mL - 1mg= 1:10,000 prefill x3, cardic down IV bolus Dose: 1mg every 3-5 min. Cardiac symptoms, 1-20 mcg/min bradycardia, 1-20 mcg/min IV hypotension
1mg/mL 30 mg vial 1mg/1000ml bag=1mcg mL
1:1000 Allergic reaction dose: 0.3 mg IM Pts =>30kg
IM 0.5mg 1:1000 asthma/COPD
1:1000 should never be given IV
FENTANYL (SUBLIMAZE)
opioid analgesic
Pain
Provided: 100mcg/2mL vialx3
Dose: 1-2 mcg/kg IV/IN q10min max 300mcg for pain, or 50-100 mcg for pain, cardiac CP & sedation, IV for RSI.
PED: 1mcg/kg IV/IM max 300 mcg for pain, sedation: 1-2 mcg/kg IV/IN q5 min.
max 300mcg, 2-5 mcg/kg IV for RSI,
FUROSEMIDE (LASIX)
loop diuretic
CHF, pulmonary edema
Dose: 40mg IV or double pt’s usual dose
Glucagon
Pancreatic hormone
Beta blocker OD,
Provided: 1 mg kit
Dose: 1 mg IM if IV unsuccessful
PED: 50mcg/kg IV/IM Beta-blocker OD
HYPOGLYCEMIA: <20kg 0.5 mg IM, >20kg 1mg IM if IV unsuccessful
HALOPERIDOL LACTATE (HALDOL)
antipsychotic, neuroleptic
Psychotic episodes, emergency sedation for psychosis
Provided: 5mg vial
Dose: <70YO 5mg IV or 10mg IM. =or>70 2mg IV or 5mg IM
-ONLY ONCE
CONTRA:CNS DEPRESSION, COMA, HYPERSENS, PREGNANCY, LIVER OR CARDIC DISORDER
IPRATROPIUM (ATROVENT)
anticholinergic, bronchodilator
Asthma, bronchospasm, COPD exacerbation, excessive mucus
Provided: 0.5mg
1st dose mix one 0.5mg atrovent & 2.5 Albuterol
Contra: peanut allergy
Ketamine (Ketalar)
Dissociative anesthetic
BEHAVIOR: can cause aggression*1mg/kg IV, **Preferred IV DRIP:
0.25mg/kg IV in 100mL bag
(60 drop set, wide open about 10 min.) Seizures resistant to benzos
LIDOCAINE (XYLOCAINE)
Antidysrhythmic, local anesthetic, primarily opens sodium channels
Suppresses PVCs, cardiac arrest from V-tach or V-fib, stable monomorphic VT w/ preserved ventricular function, wide complex Tach, ventricular ectopy w/MI, 2nd & 3rd degree heart block in absence of pacemaker
Dose: 1st dose 1-1.5mg/kg
2nd 0.5-0.75 mg/kg
Magnesium Sulfate
Electrolyte, anticonvulsant
Seizures, eclampsia (but not 2 hrs before delivery), cardiac arrest only in torsades (2 grams/5 min IV), hypomagnesemia, digitalis toxicity dysrhthymia, QTc >0.48 administer 2 grams over 20min.
Provided: 1gram vialx2
METOPROLOL (LOPRESSOR)
beta blocker
SVT, A-FIB, A-FLUTTER,
Provided: 5 mg vialx2
Dose: 5mg/2 min IV mix in 10 ml syringe. Repeat q5 max 15mg
Contra: SBP<100, BRADYCARDIA, 2&3 DEGREE HEART BLOCK, CHF, DECREASED CARDIC OUTPUT.
-Used for hypertensive crisis
MIDAZOLAM (Versed)
Benzodiazipine
Premedication for intubation or cardioversion 1-2 mg IV/IM/IN, SEIZURE 5MG IV/IM/IN, Sedation for behavior or hypertensive crisis w/cocaine/meth toxicity: 5mg IV/IM/IN repeat 1X after 5 MIN
Naloxone (Narcan)
Opioid antagonist
Coma of unknown origin, Narcotic OD
PROVIDED: 4MG VIAL
DOSE: 0.04 MG IV titrate to desired response. 0.4 MG IN MAX 2MG Pedi: 0.4mg-2mg IN, 0.1 mg/kg IV/IN
CONTRA: INTUBATED PT, MEPERIDINE SEIZURES
Make diluted narcan: 10ml syringe of NS, empty out 1 mL replace with (0.4 mg) 1mL of Narcan in same syringe. Concentration = 0.04 mg/mL.
NITROGLYCERINE (NITROSTAT)
Vasodilator
Ischemic CP, CHF, AMI, hypertensive emergency
Contra: vol. Depleation,sbp<100 or 30 below baseline, head injury, HR <50, HR >100, RIGHT MI, HEAD BLEED, USE OF VIAGRA, Cialis ect..SEXUAL ENHANCEMENT DRUGS 24-48 HRS
DOSE: 0.4 mg SL up to 3X q5MIN,
HR <60 & SBP >120 THEN: 5 mcg/min IV
MAX 100 mcg/min
ONDANSETRON (ZOFRAN)
antiemetic
Nausia, vomiting
Provided: 4mg vialx2, 4mg ODT X2 DOSE: 4mg IV/IM/IN up to 3x = 12mg max
OXYMETAZOLINE (AFRIN)
Nasal decongestant, sympathomimetic
For nasal decongestion or epitaxis
Contra: closed angle gloucoma, HTN, CAD, CAV
DOSE: 4 SPRAYS EACH NOSTRIL
SODIUM BICARBONATE
ph buffer, alkalizing agent, Electrolyte supplement
Tricyclic antidepressant OD, METABOLIC ACIDOSIS, PROLONGED DOWN TIME, HYPERKALEMIA, DKA, RABDOMYOSIS
50 mEq IV
contra: hypokalemia, alkalosis, hypernatremia, severe pulmonary edema
TXA (TRANSEXCEMIC ACID)
Antifibrinolytic, hemostatic agent
For trauma & post partum
Contra: GI bleed
Adult: contra >3hr after injury, give amount provided, 1 gram in 100mL bag WO/10 MIN.
Pedi: >1 YO 15mg/kg in 50 mL NS/10 min.
Labetalol
dual alpha (α1) and beta (β1/β2) adrenergic receptor blocker
20mg/2min. q10min increments of 2nd20/3rd40/4th80/5th80
How many mcg in 1 mg?
1000 mcg
How many mcg in 0.1mg?
100 mcg
How many mg in 1 gr?
1000 mg
How many mcg in 0.01 mg
10 mcg
How many mcg in 0.001 mg
1 mcg
1 Gram
1000 mg
1 gr
1,000,000 mcg (1million)
Tachycardia with a pulse
Narrow complex
Stable=vagal-reg?-Adenisine 6mg, 12mg fast -Labatalol 20mg/2min-call med control
Unstable=AMS, HYPOTENSION,(signs of shock) HR INCREASE, BP DECREASE, PALE, SWEATY, WEAK PULSE ALL THESE CARDIOVERT reg50-100j irreg120-200j
Tachycardia with a pulse
Wide complex
Signs of shock=cardiovert
No=Lidocaiane 1mg/kg repeat x1
Consider: Adenosine 150mg/10min
Mag. Sulfate 2gr/5min for Torsades
