Treatment Plans - Adult

Question 1

Describe ACP treatments for Beta-blocker overdose. Include dosages and timing for all medications

Answer 1

• Atropine: 0.6mg IV push q.2-4min to a MAX of 3.0mg
• Epinephrine: 10mcg IV push q.2-4min to target peri-arrest hypotension
• Epinephrine: 2-10mcg/min infusion to target bradycardia and hypotension (note that higher rates may be needed)
• Glucagon: 5mg IV slow push (single dose)
• Transcutaneous pacing: start at 60bpm and titrate energy to mechanical capture +10%
• Other adjunctive therapies (ex: midazolam for seizure control, intubation, arrythmia management, etc.)

Question 2

Describe ACP treatments for Calcium channel blocker overdose. Include dosages and timing for all medications

Answer 2

• Atropine: 0.6mg IV push q.2-4min to a MAX of 3.0mg
• Consult CLINICALL prior to initiating further therapy!
• Calcium chloride 1-2g IV over 10 minutes. Always give calcium prior to epinephrine in cases of CCB toxicity
• Epinephrine: 10mcg IV push q.2-4min to target peri-arrest hypotension
• Epinephrine: 2-10mcg/min infusion to target bradycardia and hypotension (note that higher rates may be needed)
• Glucagon: 5mg IV slow push (single dose)
• Transcutaneous pacing: start at 60bpm and titrate energy to mechanical capture +10% (not listed in CPGs)
• Other adjunctive therapies (ex: midazolam for seizure control, intubation, arrythmia management, etc.)

Question 3

Asthma/bronchoconstriction

Answer 3

Salbutamol
* 4 x 100 mcg via metered dose inhaler; repeat as required

Ipratropium
* 160 mcg via metered-dose inhaler (8 x 20 mcg sprays)

Epinephrine
* 0.5 mg IM every 5-20 minutes
* 50-100 mcg IV/IO; may repeat as necessary (pre-arrest)

Magnesium Sulfate
* 2 g IV over 20 minutes
* add to 50mL bag with 10gtt/mL secondary set at 1gtt/2s

Question 4

COPD

Answer 4

Salbutamol
* 4 x 100 mcg via metered dose inhaler; repeat as required

Ipratropium
* 160 mcg via metered-dose inhaler (8 x 20 mcg sprays)

target SpO2 = 88-92%