Tactical Medicine Flashcards
Impaled ECW dart removal
-Dart to head, neck, hands, feet, or genitals must be stabilized and evaluated by physician.
-Barb extrication may be attempted once, as long as barb is not buried to the hub or in the above locations
-all patients receiving electrical intervention must be evaluated in ER
Pseudoephidrine (Sudafed)
OPERATIONAL
30 or 60 mg tablet
Decongestant
For nasal congestion/rhinorrhea
Contraindications: hypersensitivity, HTN
Side effect: insomnia
Dosage: 30-60 mg every 4-6 hours
Cetrizine (Zyrtec)
OPERATIONAL
10 mg tablet
Non-sedating antihistamine
For allergic symptoms
Contraindications: hypersensitivity
Precautions: HTN, liver/kidney disease
Side effects: dry mouth, urine retention
Dosage: 10 mg daily
Diphenhydramine (Benadryl)
NON-OPERATIONAL
25-50 mg tablets
Sedating antihistamine
For allergic symptoms
Contraindications: hypersensitivity
Precautions: HTN, liver/kidney disease
Side effects: dry mouth, urinary retention, somnolence
Dosage: 25-50 mg every 4-6 hours PER MD
Fexofenadine (Allegra)
OPERATIONAL
60 mg tablet
Non-sedating antihistamine
For allergic symptoms
Contraindications: hypersensitivity
Precautions: HTN
Side effects: dry mouth, urinary retention
Dosage: 60 mg once or twice daily
Oxymetazoline nasal spray (Afrin)
OPERATIONAL
Nasal spray 0.05%
Nasal vasoconstriction, decongestant
For rhinorrhea, sinus congestion, pain
Contraindications: hypersensitivity
Precautions: HTN
Side effects: minor nosebleed, often used to treat nosebleed
Dosage: 2x sprays per nare, 2-3 times a day
Antiacid (Mylanta or other)
OPERATIONAL
Liquid OTC
Antacid
For GI upset, GERD, PUD, gastritis, esophagitis
Contraindications: hypersensitivity
Precautions: some medications rely on acidic pH and should not be taken in combination
Interactions: Loose stool possible
Dosage: 15-45 mL every 4-8 hours
Cimetidine (Tagmet or other H2 blocker)
OPERATIONAL
200/300/400 mg tablet or 300 mg IV/IM
H2 blocker
For PUD, GERD, esophagitis, gastritis
Contraindications: hypersensitivity, other PPI use
Dosage: 300 mg IV/IM/PO every 6-8 hours, or 400 mg 2x daily
Loperamide (Imodium)
OPERATIONAL
2 mg tablet or 1 mg/5 mL suspension
Anti-diarrheal
For diarrhea
Contraindication: Known hypersensitivity, HTN, bloody diarrhea
Side effects: ENT Dryness
Dosage: 4 mg first dose, 2 mg each subsequent dose until stool formed, 16 mg max per day
5-HT3 Antagonist (Zofran)
OPERATIONAL
IV/IM injectable, tablets
Anti-emetic, anti-motion sickness
For nausea/vomiting
Contraindications: Hypersensitivity
Precautions: Long QT
Dosage: PER MD
Metoclopramide (Reglan)
NON-OPERATIONAL
10 mg IM/IV injectable
Anti-emetic, promotes GI motility
For nausea/vomiting
Contraindications: hypersensitivity
Precautions: Dystonic reaction risk (treat with diphenhydramine)
Side effects: sedation, dystonia
Dosage: 10-20 mg IV/IM/PO every 4 hours PER MD
Dimenhydrinate (Dramamine)
NON-OPERATIONAL
IM/IV injectable, 50 mg tablet
Anti-emetic, anti-motion sickness
For nausea/vomiting
Contraindications: hypersensitivity
Precautions/side effects: possible sedation
Dosage: 50-100 mg IM/IV/PO every 4 hours, PER MD
Meclizine (Antivert)
NON-OPERATIONAL
25-50 mg tablet
Anti-emetic, anti-motion sickness
For nausea/vomiting
Contraindications: Hypersensitivity
Precautions/side effects: possible sedation
25-50 mg PO every 4 hours PER MD
Scopolamine Transdermal
OPERATIONAL (if previously tolerated)
1 mg patch
anti-emetic, anti motion sickness
For nausea, vomiting, motion sickness prevention
Contraindications: hypersensitivity, angle closure glaucoma, hypersensitivity to belladonna alkaloids, seizures, urinary retention
Precautions: may cause sedation, disorientation underwater
Side effect: sedation
Interactions: use caution when taking potentially sedative drugs and anticholinergics
Dosage: 1 mg patch every 3 days, PER MD
Proparacaine or Tetracaine (Alcaine)
OPERATIONAL
Ocular anesthetic solution
Topical anesthetic
To facilitate eye exam, relieve eye pain
Contraindications: hypersensitivity
Precautions: Ensure eye protection from foreign objects after exam
Dosage: 1-2 drops per eye PER MD
Fluorescein Stain (with blue light)
OPERATIONAL
Single application strips
Dye to facilitate eye exam
For suspected eye injury
Contraindications: hypersensitivity
Dosage: one drop per eye
Eye irrigation solution
OPERATIONAL
100 mL, 200 mL bottles
To irrigate contaminants from the eye following exposure to foreign bodies or chemicals in the eye.
Contraindications: hypersensitivity
Dosage: Irrigate until pH of 7.4 is achieved.
Erythromycin ophthalmic ointment
OPERATIONAL
0.5% ointment
Macrolide antibiotic
For infectious exposure per MD
Contraindications: Hypersensitivity to penicillins
Topical only
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD
pH paper
OPERATIONAL
Rolls or pre-cut strips
Measures baseline pH during decon./irrigation
Following exposure to foreign body or chemical to eye or skin
Contraindications: hypersensitivity
Precautions: not for penetrating eye injury
Dosage: (1) 1-2 inch strip PER MD
Ciprofloxacin
OPERATIONAL
150/500/750 mg tablets, 400 mg IVPB, 250 or 500/5 suspension
2nd gen quinolone antimicrobial agent
Indicated PER MD for infectious exposure
Contraindications: hypersensitivity
Side effects: GI upset, nausea/vomiting, diarrhea, yeast infection
Dosage: PER MD
Triple antibiotic ointment (Bacitracin/Polymyxin/Neomycin)
OPERATIONAL
Topical ointment
Polypeptide antibiotic
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity
Topical use only
Side effects: Local irritation, GI upset
Dosage: Apply to scrapes, burns, wounds prior to sterile dressing
Amoxicillin/clavulanate (Augmentin)
OPERATIONAL
875 or 125 mg tablets
Beta-lactamase inhibitors
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD
Cefazolin (Ancef)
NON-OPERATIONAL
0.5-2 grams IM/IV
1st gen Cephalosporin antimicrobial agent
indicated PER MD for trauma applications with delayed transport and infectious exposures
Contraindications: hypersensitivity to PCN or Cephalosporins
Side effects: GI upset, nausea/vomiting, diarrhea, yeast infection
Dosage: PER MD
Clindamycin (Cleocin)
OPERATIONAL
150-300 mg tablets, reconstituted liquid 75 mg/5 mL
Antibiotic
For suspected pharyngitis or respiratory infection, cellulitis
Contraindications: hypersensitivity to clindamycin
Side effects: diarrhea
Dosage: Pediatric: 10 mg/kg every 8 hours
Adult: 300 mg every 8 hours
Trimethoprim/Sulfadiazine (Bactrim)
OPERATIONAL
DS Tablet
Sulfonamide antibiotic
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity
Precautions: Liver/kidney disease, anemia, thrombocytopenia
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD
Azithromycin (Zithromax)
OPERATIONAL
250 mg tablet
Macrolide antibiotic
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity to penicillin
Precautions: liver/kidney disease
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD
Doxycycline
OPERATIONAL
100 mg tablet
Tetracycline antibiotic
Indicated PER MD for infectious exposures
Contraindications: Known hypersensitivity to tetracyclines, PREGNANCY
Precautions: liver/kidney disease, photoreactivity rash
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD
Mupirocin topical ointment (Bactroban)
OPERATIONAL
2% topical ointment
Other antibiotic
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity
Precautions: avoid eyes, limit prolonged use
Side effects: Local irritation, GI discomfort
Dosage: PER MD
Emtricitabine and tenofovir (Truvada)
OPERATIONAL
Tablet containing tenofovir DF 300 mg, emtricitabine 200 mg
Anti-retroviral
Indicated PER MD for infectious exposures
Contraindications: hypersensitivity
Precautions: liver/kidney disease
Side effects: GI upset, nausea/vomiting, diarrhea
Dosage: PER MD
Prednisone (PO)
OPERATIONAL
PO, (1/5/10/20/50 mg) tablets
Corticosteroid, anti-inflammatory
For allergic reaction, auto immune condition, PER MD
Contraindications: hypersensitivity
Precautions: PUD/GERD/GI bleed Hx.
Side effects: GI upset, nausea
Dosage: 40 mg to 60 mg once daily PER MD
Dexamethasone (Decadron)
OPERATIONAL
PO or IV/IM, tablets
Corticosteroid, anti-inflammatory
For allergic reaction, auto-immune condition, PER MD
Contraindications: hypersensitivity
Precautions: PUD/GERD/GI bleed Hx.
Side effects: GI upset, nausea
Dosage: 10 mg once daily, PER MD
Acetaminophen (PO)
OPERATIONAL
Tablet: 325 and 500 mg
Pain medication
For mild-moderate pain
Contraindications: hypersensitivity, liver disease, PUD/GERD/GI bleed Hx.
Side effects: GI upset
Dosage: 650-1000 mg/ 6 hours
Ibuprofen (Motrin/Advil)
OPERATIONAL
200 mg tablet (OTC), 100 mg/5 mL suspension, 600 and 800 mg tablets
NSAID
For mild to moderate pain
Contraindications: hypersensitivity, renal insufficiency, PUD/GERD/GI bleed Hx
Precautions: do not use with other NSAIDs, caution steroid use
Side effects: GI upset, nausea, GI bleed risk
Dosage: 400-600 mg/4-6 hours
600-800 mg/6-8 hours
Naproxen (Aleve/Naprosyn) PO
OPERATIONAL
Tablet: 220/375/500 mg
NSAID
For mild to moderate pain
Contraindications: hypersensitivity, renal insufficiency, PUD/GERD/GI bleed Hx
Precautions: do not use with other NSAIDs, caution steroid use
Side effects: GI upset, nausea, GI bleed risk
Dosage: 220-500 mg every 12 hours
Tramadol (Ultram) PO
OPERATIONAL (with no side effects)
50 and 100 mg tablets
Pain medication
For moderate to moderately severe pain
Contraindications: hypersensitivity, seizure disorder, SSRI/TCA/MAOI use, renal/hepatic insufficiency (adjust dose)
Precautions: use care with opiate use
Side effects: dizziness/nausea
Interactions: antidepressants, antipsychotics, warfarin, digoxin, tegretol, quinidine
Dosage: 50-100 mg every 4-6 hours, 400 mg/day max
Lidocaine (transdermal or IM/SQ)
OPERATIONAL
1% (10 mg/mL) ampule/vial
Injectable anesthetic
For local pain/injury
Contraindications: hypersensitivity
Precautions: should not exceed 4 mg/kg or 300 mg
Side effects: seizure, lightheadedness, tinnitus
Dosage: topical application at site of dental pain
Fentanyl Transmucosal (PO)
NON-OPERATIONAL
Lozenge/lollipop 800 mcg
Opioid analgesic
For severe pain/injury
Contraindications: hypersensitivity
Precautions: Controlled substance. Patient should not bite or chew lozenge, let it dissolve slowly
Side effects: Patient must be monitored for CNS depression
Dosage: Oral application for patient directed analgesia, patient should remove the lollipop once pain is controlled.
Clove Oil (topical for dental analgesia)
OPERATIONAL
Topical liquid (OTC)
Topical dental anesthetic
For dental pain/injury
Contraindications: hypersensitivity
Precautions: Penetrating trauma, open intra-oral wounds
Dosage: topical application to the site of dental pain
Ketorolac (Toradol)
OPERATIONAL
30 mg/mL IV/IM
NSAID
For mild/moderate pain
Contraindications: hypersensitivity, renal insufficiency, PUD/GERD/GI bleed Hx.
Precautions: Do not use with NSAIDs, caution with steroid use
Side effects: GI upset/nausea, GI bleed risk
Dosage: 15-30 mg IM/IV every 6-8 hours
Caffeine (No-Doz)
OPERATIONAL
200 mg tablet
Enhances alertness
For caffeine withdrawal headache, to facilitate functioning with limited rest periods
Contraindications: hypersensitivity
Side effects: insomnia
Dosage: 200 mg every 3-4 hours as needed
Zalepon (Sonata)
NON-OPERATIONAL (4x hours after administration)
10 mg capsule
Anxiolytic/hypnotic, shorted t-1/2 of agents available
For facilitating rest during non-operational periods in prolonged deployment/transportation, minimum of 4 hours required (6 hours preferred)
Contraindications: hypersensitivity, unsecure location, lack of assured 4-hour non-operational period
Precautions: may not drive/operate machinery/ use weapons for at least 4 hours
Side effects: sedation
Interactions: Alcohol/other sedatives potentiate effect
Dosage: 10-20 mg with assured 4 hour non-operational block, APPROVED BY MD
Modafinil (Provigil)
OPERATIONAL
200 mg tablet
Enhances alertness/concentration
For facilitating functioning with limited rest periods
Contraindications: hypersensitivity
Side effects: Insomnia, mild BP elevation
Dosage: 200 mg once daily
Cyanoacrylate adhesive (Dermabond)
OPERATIONAL
Single use ampule
Tissue adhesive
For minor trauma
Contraindication: hypersensitivity
Precautions: avoid near eyes
Side effect: transient local discomfort
Dosage: as required for wound closure, 2-4 layered applications
Topical hemostatic dressing
NON-OPERATIONAL
Individual use packages
Promotes blood clotting
For hemorrhage
Contraindications: hypersensitivity
Precautions: standard universal precautions for wound care
Dosage: Single or multiple dressings applied to a bleeding wound
Steri-strips
OPERATIONAL
Individual use packages
Facilitates closure of wounds
For superficial wounds
Contraindications: hypersensitivity to adhesive
Precautions: standard universal precautions for wound care
Dosage: single or multiple dressings applied for wound closure
Staples
OPERATIONAL
Individual use staple dispensers
Facilitates closure of wounds
Contraindications: contaminated wounds, wounds with foreign material
Precautions: standard universal precautions for wound care
Dosage: single or multiple dressings applied for wound closure PER MD
Albuterol MDI
NON-OPERATIONAL (without MD consult)
0.83 mcg MDI
Bronchodilator
For respiratory distress/bronchospasm
Contraindications: hypersensitivity
Precautions: standard universal precautions for respiratory patient
Dosage: (2) puffs, may be repeated 2 additional times. Additional doses PER MD
