Flashcards in Drug Protocols Deck (57)
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1
Adrenaline Indications
Cardiac ArrestAnaphylaxis or severe allergic reactionSeere life-threatening bronchospasm OR silent chest (only able to speak in single works AND/OR silent chest AND/OR haemodynamic compromise AND/OR an ALOC)Bradycardia with poor perfusion (unresponsive to atropine AND/OR TCP)Croup (with stridor at rest)Shock unresponsive to adequate fluid resuscitation (excluding haemorhagic cause)
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Adrenaline DosagesAnaphylaxis OR severe allergic reaction
IM - ACP1, ACP2, CCP≥ 6 years - 300 microgrepeat at 5 minute intervals. No max dose< 6 years - 150 microgRepeat at 5 minute intervals. No max dose.IV/IO - CCP2 microg/kg (Single dose not to excede 50 microg)Repeat at 2 minute intervals. No max dose.NEB - ACP2, CCP5mg Single dose only
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Adrenaline DosagesSevere life-threatening bronchospasm OR silent chest
IM - ACP1, ACP2, CCP≥ 6 years - 300 microgrepeat at 5 minute intervals. No max dose< 6 years - 150 microgRepeat at 5 minute intervals. No max dose.IV/IO - CCP2 microg/kg (Single dose not to excede 50 microg)Repeat at 2 minute intervals. No max dose.
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Adrenaline DosagesCardiac Arrest
IV - ACP2, CCP≥ 10kg (≥ 1 year) - 10microg/kgRepeat at 3-5 minute intervals. No max dose.<10kg (<1 year) - 100 microgRepeat at 3-5 minute intervals. No max dose.
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Adrenaline DosagesCroup
NEB - ACP2, CCP5mg. Single Dose only.
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Adrenaline DosagesShock Unresponsive to adequate fluid resus
IV/IO - CCP2 microg/kg (Single dose not to excede 50 microg)Repeat at 2 min intervals. No max dose.
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Adrenaline DosagesBradycardia with poor perfusion
CONSULT!
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Amiodarone Paediatric Indications
Cardiac arrest (refractory VF or pulse-less VT)
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Amiodarone DosagesCardiac Arrest
IV/IO5mg/kgSlow push over 2 minutesSingle dose only
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Atropine Indications
Bradycardia (with poor perfusion)Envenomation (with increased parasympathetic activity)Hypersalivation (secondary to ketamine administration)Organophosphate toxicity (with cardiac AND/OR respiratory compromise)
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Atropine DosagesBradycardia
IV/IO - CCP20 microg/kg (Single dose not to exceed 600 microg) Repeat ONCE at 2 minutes.Total max dose 40 microg/kg
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Atropine DosagesEnvenomation and Organophosphate toxicity
IM/IV/IO - ECP, CCP (IO CCP only)20 microg/kg (Single dose not to exceed 600 microg)Repeat at 5 minute intervals. No Max dose.
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Atropine DosagesHypersalivation
IV - CCP20 microg/kg (single dose not to exceed 600 microg)Single dose only
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Calcium Gluconate Paediatric Indications
Suspected Hyperkalaemic cardiac arrestSevere HyperkalaemiaCalcium Gluconate Blocker toxicityHypotension associated with Magnesium infusion (that fails to respond to IV fluid therapy)
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Calcium Gluconate DosagesAll indications
IV/IO - CCP0.5 mL/kg (or 50 mg/kg)Slow push over 2-5 minutes.Repeated once at 10 minutes.
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Ceftriaxone Indications
Suspected meningococal septicaemia (with a non-blanching petechial and/or purpuric rash)
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Ceftriaxone Dosages
IM - ACP1, ACP2, CCP50 mg/kg (rounded up to the nearest 5kg)Reconstitute in 3.6mL water for ingection.IV/IO - ACP2, CCP (IO CCP ONLY)50 mg/kg (rounded up to the nearest 5kg)Reconstitute in 9.6mL water for ingection.
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Fentanyl Indications
Significant PainSedation (for maintenance of established ETT)
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Fentanyl DosagesSignificant Pain
NAS - ACP2, CCP≥ 1 year (CCP 6 months) - 1.5 microg/kgRepeat at 1 microg/kg at 10 minutes.< 1 year (CCP 6 months) - CONSULTIM - ACP2, CCP≥ 1 year - 1-2 microg/kg (CCP 2 microg)Single max dose 50 microgTotal max dose 2 microg/kg< 1 year - CONSULTIV - ACP2, CCP≥ 1 year - 1microg/kgSingle max dose 25 microgRepeat at 0.5 microg/kg (max 25 microg) at 5 minutes.Total max dose 2 microg/kg. (CCP - no max dose)< 1 year - CONSULT
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Fentanyl DosagesSedation
IV/IO - CCP≥ 1 year - 1 microg/kgSingle max dose 25 microgConsider administration with midazolam. No max dose.<1 year - Consult
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Glucagon Indications
Symptomatic hypoglycaemia (with inability to self-administer oral glucose)
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Glucagon Dosages
> 25 kg - 1 mg single dose only.≤ 25 kg - 0.5 mg single dose only.
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Glucose 10% Indications
Symptomatic hypoglycaemia (with inability to self-administer oral glucose)
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Glucose 10% Dosages
IV/IO - ACP2, CCP (IO CCP only)0.25 g/kg (2.5mL/kg)Repeat at 1mL/kg boluses every 5 minutes until BGL < 4.0 mmol/L
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Glucose gel Indications
Symptomatic hypoglycaemia (with ability to self-administer oral glucose)
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Glucose Gel Dosages
PO - ACP1, ACP2, CCP≥ 2 years - 15gRepeat once at 15 minutes if BGL <4 mmol/LTotal max dose 30g
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Glyceryl Trinitrate Paediatric Indications
Autonomic Dysreflexia (SBP > 160 mmHg)Irukandji Syndrome (SBP > 160 mmHg)
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GTN DosagesAll inidcations
Sublingual - ACP2, CCPCONSULT
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Hydrocortisone Indications
Moderate or Severe AsthmaSevere allergic reaction OR anaphylaxis (requiring adrenaline (epinepherine) administration)Symptomatic adrenal insufficiency
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Hydrocortisone DosagesModerate or Severe AsthmaSevere allergic reaction OR anaphylaxis
IM/IV - ECP (with consult), CCP5mg/kg Single dose only. Not to exceed 100mg)IV single dose only
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Ipratropium Bromide Indications
Moderate OR severe bronchospasm
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Ipratropium Bromide Dosages
NEB - ACP1, ACP2, CCP≥ 2 years - 250 microg. Single dose
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Ketamine Paediatric Indications
- Severe traumatic pain (following 0.2mg-0.2mg/kg morphne or 1-2 microg/kg fentanyl) associated with: - fracture reduction and splinting - multiple or significant fractures requiring facilitated extrication - Patients with splinted fractures requirign ongoing narcortic analgesia for transport requirements)Induction of anasethesia- Severe traumatic pain associated with burns- Ongoing traumatic pain unresponsive to narcotics (following 0.2-0.3 mg/kg morphine OR 2-3 microg/kg fentanyl)
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Ketamine DosagesSevere traumatic pain associated with burns
IV - CCPCONSULT
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Ketamine DosagesOngoing traumatic painSevere traumatic pain
IV - CCP> 1 year - 100microg/kg (0.1mg/kg)Repeate every 2-3 minutesTotal max dose 1mg/kg
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Ketamine DosagesInduction of anaesthesia
IV/IO - ECCP0.25-2mg/kgSingle dose onlyTotal max dose 100mg
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Magnesium Sulphate Indications
Irukandji SyndromeSever Life-threatening asthmaTorsades de PointesBox jellyfish envenomation
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Magnesium Sulphate DosagesIrukandji syndrome and Box jellyfish envenomation
IV - E.ACP2, CCP0.1 mmol/kg over 15 minutes (rounded p to nearest 0.5 mmol). Single max dose 5 mmolRepeat once at 10 minutesTotal max 10 mmol.
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Magnesium Sulphate DosagesTorsades de Pointes
IV/IO - CCP0.1 mmol/kg over 10 minutes (round up to nearest 0.5 mmol)Single dose not to exceed 5 mmolRepeat once at 10 minutesTotal max dose 10 mmol
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Magnesium Sulphate DosagesSevere life-threatening asthma
IV/IO - CCP0.1 mmol/kg over 10 minutes (round up to nearest 0.5 mmol)Single dose not to exceed 5 mmol
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Midazolam Indications
Generalized seizures/focal seizures (GCS < 12)SedationAcuute behavioural disturbance (with SAT score at 2 or >)
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Midazolam DosagesGeneralized Seizures/focal seizures
NAS - ACP2, CCP200 microg/kgSingle dose not to exceed 5mg.Repeat at half the initial dose at 10 minutes (max 0.25mg)Total Max 10mgIM - ACP2, CCP200 microg/kgSingle dose not to exceed 5mg.Repeat at half the initial dose at 10 minutes (max 0.25mg)Total Max 10mgIV/IO - CCP100mcg/kgSingle dose not to exceed 2.5mgRepeat at 5 min intervalsTotal max dose 10mg
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Midazolam DosagesSedation
IV/IO - CCPUp to 100 microg/kgSingle dose not to exceed 2.5mgRepeat at 3-5 minute intervalsTotal max dose 5mg
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Midazolam DosagesAcute Behavioural disurbance
IM (only if IV access not acheiveable)≥ 8 years - 200 microg/kgSingle dose only. Max 5mgIV - CCP≥ 8 years - 100 microg/kgSingle dose only. Max 2.5mg
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Naloxone Indications
Respiratory depression (secondary to administration of narcotic drugs)
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Naloxone Dosages
IM - ACP2, CCP20 microg/kgSingle dose only. Not toe xceed 800 microg.
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Ondansetron Indications
Nausea AND/Or vomiting
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Ondansetron Dosages
IM - ACP1≥ 5 years - 2mgSingle dose onlyIM - ACP2, CCP≥ 3 years - 100 microg/kgsingle dose only, not to exceed 4mgIV - ACP2, CCP≥ 3 years - 100 microg/kgsingle dose only, not to exceed 4mgSlow push over 2-3 minutes
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Paracetamol Indications
Minor painFever (causing distress)
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Paracetamol Dosages
PO - ACP1, ACP2, CCP≥ 1 month - 15mg/kgSingle dose only
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Promethazine Paediatric Indications
Symptomatic rash/moderate allergic reactions
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Promethazine Dosages
IV - ECP (CONSULT), CCP≥ 2 years - 250 microg/kgSingle dose only. Not to exceed 12.5mgSlow push over 1 minutes
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Salbutamol Indications
BronchospamsSuspected hyperkalaemia (with QRS widening AND/OR dissociation)
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Salbutamol DosagesBronchospasm
NEB - ACP1, ACP2, CCP≥ 2 years - 5mgRepeated PRNNo max doseIV - CCP≥ 2 years - 5microg/kgSingle dose not to exceed 250 microg.Repeat once at 10 mintues
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Salbutamol DosagesSuspected hyperkalaemia
NEB - CCP5mg - Single dose only
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Sodium Bicarbonate Paediatric Indications
Cardiac ArrestSuspected hyperkalaemiaSignificant injury with potential for crush injury
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