Chapter 18 Flashcards
Six Rights of Medication Administration
- Right Patient
- Right Medication
- Right Dose
- Right Time
- Right Route
- Right Documentation
TRAMP-ED
Rights of Medication Administration
- T = Time
- R = Route
- A = Amount (Dose)
- M = Medication
- P = Patient
- E = Expiration
- D = Documentation
Routes of Administration (ROAs)
- Oral (PO)
- Buccal
- Sublingual (SL)
- Inhalation
- Intranasal (IN)
- Intraosseous (IO)
- Intramuscular (IM)
- Subcutaneous (SubQ)
- Intravenous (IV)
- Endotracheal (ET)
Pharmacodynamics (PD)
The study of the effects of medications on the body.
Pharmacokinetics (PK)
The study of the absorption and elimination of medications into/from the body.
Pharmacokinetics is extremely patient-specific.
Administered Medications
- Aspirin
- Oxygen
- Narcan
- Activated Charcoal (Anti-Char)
- Oral Glucose
- Epi-Pen
- Albuterol
Assisted Medications
- Nitroglycerin (Nitro)
- Inhaler
- Epi-Pen
Aspirin
- Dose: 324mg
- MOA: Anticoagulant
- Route: Oral
Adequate Breathing
- Adults: 12–20
- Children: 15–30
- Infants: 25–50
Units = Breaths/Minute
Adequate Artificial Ventilation
- Adults: 10–12
- Children/Infants: 12–20
Units = Ventilations/Minute
Indications for C-PAP
- Pulse Oximetry = < 90%
- Respiration Rate = > 25
- Use of Accessory Muscles for Respirations
Indications/Containdications of Aspirin
Indications:
* Cardiac-Associated Chest Pain
Contraindications:
* Asthma
* Recent Trauma
* Gastrointestinal Bleeding
* Noncardiac-Associated Chest Pain
Oral Glucose
- Dose = 15 g
- MOA = Increase Blood Sugar Level
- Route = Buccal
Indications/Contraindications of Oral Glucose
Indications:
* Altered Mental Status (AMS)
* History of Diabetes
* Suspected Hypoglycemia
Contraindications:
* Inability to Follow Simple Commands
* Inability to Protect Airway
Oxygen
- Dose = 12–15 LPM (Non-Rebreather) or 2–6 LPM (Nasal Cannula)
- MOA = Provides High Oxygen Concentration to Inhaled Air
- Route = Inhalation
Unit = LPM = Liters/Minute
Indications/Contraindications of Oxygen
Indications:
* Respiratory Distress
* Suspected Shock
Contraindications:
* NONE for Emergency Use
Activated Charcoal (AntiChar)
- Dose = 25–50 g (Adult) or 12.5–25 g (Pediatric)
- MOA = Binds to Ingested (Toxic) Particulates
- Route = Oral
- The dose of Activated Charcoal should be roughly 1 gram per 1 kilogram of the patient.
- Medical Command must be contacted prior to administration of AntiChar.
Indications/Contraindications of Activated Charcoal
Indications:
* Ingestion of Toxin/Poison
Contraindications:
* Inability to Swallow
* Inability to Follow Simple Commands
* Inability to Protect Airway
* Ingestion of Caustic Substance
* Non-Ingestion Exposure to Toxin/Poison
Albuterol (Brochnodilator Inhaler)
- Dose = 2 Puffs (Inhaler) or 2.5 mg (Albuterol)
- MOA = Causes Brochodilation
- Route = Inhalation
Indications/Contraindications of Albuterol
Indications:
* Respiratory Distress
* Signs of Bronchoconstriction (e.g. Wheezing)
Contraindications:
* Respiratory Distress not Caused by Bronchoconstriction
Nitroglycerin
- Dose = 0.4 mg (1 Spray)
- MOA = Dilates Coronary Arteries
- Route = Sublingual
- Dilation of coronary arteries functions to reduce the workload of the heart (and thus reduce the body’s O2 demand).
- Medical Command must be contacted for additional doses of Nitroglycerin.
Indications/Contraindications of Nitroglycerin
Indications:
* Cardiac-Associated Chest Pain
Contraindications:
* Noncardiac-Associated Chest Pain
* Recent ED Drug Use (Within 48–72 Hours)
* Systolic BP = < 100
* Recent Intake of Nitroglycerin
ED = Erectile Dysfunction
Naloxone (Narcan)
- Dose = 2.0 mg
- MOA = Reverses Effects of Narcotics
- Route = Intranasal
Effects of narcotics include depressed level of consciousness and respiratory depression.
Indications/Contraindications of Naloxone (Narcan)
Indications:
* Suspected Narcotic (Opoid) Overdose
* Coma-Like State (with Unknown Cause)
Contraindications:
* Patient is Breathing Adequately
* Patient is Able to Maintain Airway
Narcan is used to regain the patient’s adequate respiratory effort ONLY.
