SWOhioProtocol

Question 1

Weight Based Drug Calculations

Answer 1

Find Weight in Kg
Multiply weight by dose in mg
Take dose in mg divided by concentration per ml, this is the dose in ml.

12kg Pt needs 5mg/kg of 150mg/3ml amiodarone.
12x5=60. We need 60mg.
Amiodarone is 50mg/1ml
60 divided by 50 is 1.2. we need to draw up 1.2ml of amiodarone.

Question 2

3% Saline

Answer 2

Head/ Spinal Trauma

Head or spinal trauma w/coma & unilateral or bilateral blown pupils, posturing, or decline in GCS during transport >2 points.

500ml 3% saline

Question 3

APGAR

Answer 3

————– 0 points —- 1 point —— 2 points
Activity —- Absent —- Arms and legs flexed —- Active Movement
Pulse —— Absent —— Below 100bpm—– Over 100bpm
Grimace —– Flaccid —– Some flexion of extremities— Active motion
Appearance– Blue, Pale — Body pink, extremities blue— Completely Pink
Respiration— Absent —- Slow, irregular —– Vigorous cry

Question 4

Pediatric Bradycardia
0-3 y/o: HR< 100bpm
3-9 y/o: HR< 60bpm
9-16 y/o: HR< 50bpm

Answer 4

Pt must be symptomatic. Don’t just treat a number
Start with 100% O2 and BVM
If after ventilation HR is below 60 in newborn or child, perform Chest Compressions

Epi 1:10,000 .01mg/kg (.1ml/kg) IV/IO repeat every 3-5min if Bradycardia persists

If bradycardia persist… Atropine .02mg/kg (min .1mg, max .5mg) IV/IO

Question 5

Push Dose Epi

Answer 5

5-20mcg every 2-5 min
.5-2ml of a 10mcg/ml solution every 2-5min

To mix- Take a 10ml syringe with 9ml of NS. Using a stopcock, draw up 1ml of Epi .1mg/ml cardiac Epi. You now have 10mls of Epi 10mcg/ml

Question 6

Prednisone

Answer 6

Asthma

60mg PO

Question 7

Diphenhydramine
(Benadryl)

Answer 7

Allergic Reactions, Anaphylaxis

25-50mg IV/IM

Question 8

Epinephrine 1mg/1ml (1:1,000)

Answer 8

Anaphylaxis: .3ml IM repeat 5-15min as needed

Asthma with impeding respiratory failure: .3ml IM

Question 9

Pulseless V-tach/ V-fib D-fib energy level

Answer 9

360 joules for all shocks

Question 10

Adenosine

Answer 10

Stable SVT
6mg rapid IV push with 10ml flush

2nd dose- 12mg Rapid IV push with 10ml flush

Question 11

Methylprednisolone
(Solu-medrol)

Answer 11

Asthma
125mg IV or PO

Adrenal Insufficiency
125mg IM/IV/IO

Question 12

D10
(Dextrose 10%)

Answer 12

Hypoglycemia
6.25-25g IV-IO
(62.5-250ml)

Question 13

Tranexamic Acid (TXA)
(conditions for use and dose)

Answer 13

A.) Evidence of significant blunt or penetrating trauma
B.) Evidence or concern for severe internal or external bleeding
C.) Hemodynamic instability. Sustained BP<90 or <100 for >75y/o

1g in 100ml of .9% NS, infuse over 10min IV/IO

Question 14

Fentanyl

Answer 14

25-100mcg IV/IO/IN/IM
Repeated every 5min as needed or 15min for IM

Question 15

Amiodarone

Answer 15

Pulseless V-tach/V-fib
300mg IV/IO 1st dose
150mg IV/IO 2nd dose

Stable Pulsed V-tach
150mg in 100ml NS over 10min IV/IO. Mau be repeated after 3-5min.
contraindicated for stable V-tach during pregnancy or while breastfeeding

Question 16

Sodium Bicarbonate

Answer 16

Hyperkalemia: 1mEq/kg IV/IO

Cardiac Arrest: 1mEq/kg IV/IO

Prolonged Extrication >60min: 50mEq in 1L NS over 1hr. Immediately prior to extrication; 1mEq/kg bolus IV

Sodium Channel Blocker OD (tricyclic antidepressants and Benadryl): for prolonged QRS, Hypotension, V-tach 1mEq/kg IV/IO

Question 17

Ondansetron

Answer 17

4mg IV/IO/IM
or
PO Tablets

Question 18

IV Drip Rate Math

Answer 18

                         Time (in min)

Question 19

Nitroglycerin

Answer 19

Chest Pain
.4mg sublingual 3-5min / max 3 doses if SBP is >100

CHF
.4mg mild symptoms (HR<100, SBP 100-150, RR<25, O2 >94%)

.8mg severe symptoms ( HR>100, SBP>150, RR>25, O2 <94%)

Question 20

Albuterol

Answer 20

Asthma/COPD or wheezing in Allergic Reactions

2.5mg Nebulized

Question 21

Calcium Gluconate

Answer 21

Hyperkalemia

1gram mixed in 100ml of NS IV/IO

Question 22

Atropine

Answer 22

Bradycardia

1mg IV/IO repeat every 3-5min. Max of 3mg

Question 23

Aspirin

Answer 23

Chest Pain

324mg PO

Question 24

Magnesium Sulfate

Answer 24

Torsade de Pointes:
2g IV/IO diluted in atleast 10ml of NS over 10min

Asthma with impeding respiratory failure:
2g IV/IO diluted in 100ml NS over 20min (after epi administration)

Eclampsia/Preeclampsia:
4-6g IV in 100ml NS over 20min

Question 25

Lidocaine

Answer 25

Pain associated with IOs:
After slowly administer 1-2ml (20-40mg) 2% before flushing saline

Question 26

Glucagon

Answer 26

Hypoglycemia:
1mg IM

Refractory anaphylaxis Pt on Beta Blocker:
1mg IM/IV

Question 27

Epinephrine .1mg/1ml
(1:10)

Answer 27

Cardiac Arrest:
1mg (1mg/10ml) IV/IO every 3-5min

Question 28

Pediatric Albuterol

Answer 28

Asthma/Wheezing:
<30kg 2.5mg

> 30kg 5mg

Question 29

Pediatric Diphenhydramine
(Benadryl)

Answer 29

Allergic Reactions, Anaphylaxis
1mg/kg IV/IM/PO (max of 50mg)

Question 30

Pediatric Pulseless V-Fib/V-Tach