Drugs Flashcards
Magnesium Sulfate
ACTION
depresses myoneural junctions, decreasing excitability of neural as
well as myocardial membranes. It is this depressant effect that is responsible for
depressing the central nervous system, potentially limiting seizure activity. The
depression of cardiac muscle activity is thought to be the mechanism by which
Magnesium Sulfate helps to control intractable V-Tach and other dysrhythmias
Pediatric Seizure
What do we wanna check for as early as possible?
and how can we treat it if necessary?
Check blood glucose level early, and treat appropriately.
o For blood glucose < 70,
-Administer D25W 2mL/kg for children < 8 years old
-Administer D50 2mL/kg for children > 8 years old (maximum 50mL or 25g)
in chest pain protocol, if Tachycardia (HR>100) present, we treat it with what?
Labetalol
5mg slow IV over 1-2 minutes.
may repeat in 5 minutes max of 20mg
Sodium Bicarbonate
CONTRAINDICATIONS
- metabolic and respiratory alkalosis
- hypocalcemia
- hypokalemia
Rocuronium
Zemuron
Onset of Action
and
Duration of Action
Onset
45-60 seconds
Duration
25-70 minutes
Sodium Bicarbonate
DOSAGE AND ADMINISTRATION
Adults:
and Peds
(RTT)
• 1 mEq/kg, IV/IO bolus
• May be repeated, after 10 minutes, at 0.5 mEq / kg
• 25 mEq IV/IO for pre-treatment in a crush injury, prior to the release of the
trapped extremity; these patients may require a second dose of 25 mEq if
symptomatic of hyperkalemia
Dextrose
DOSAGE AND ADMINISTRATION
Adults and Pedi
DOSAGE AND ADMINISTRATION
Adult:
• 25 grams IV slow
Pediatric:
• Preferentially use Dextrose 25% if age is <8 years old
• Refer to “Weight Based Resuscitation Tape” for pediatric dosing
For altered patients, whats the best course of action?
check the BGL first
Naloxalone 0.5mg IV/IM/IO/IN
Valium
Contraindications
CONTRAINDICATIONS
- Shock
- Coma
- Respiratory depression
- Substance abuse of CNS depressants
- Hypersensitivity to this medication
Haloperidol
Haldol
ACTION
antipsychotic.
known to have effect on dopaminergic and
seritonergic receptors.
Midazolam
Versed
CONTRAINDICATIONS
- known hypersensitivity to other benzodiazepines
- hypotension/shock
- respiratory distress
Adenosine
Contraindications
- Heart Blocks
- AFlutter/Afib
- VTach
- Wolff Parkinsons
- Asthma
Midazolam
Versed
DOSAGE / ADMINISTRATION
Adult:
Sedation after intubation or pre-treatment before cardioversion:
• 2 - 4 mg IV/IO
Fentanyl
DOSAGE AND ADMINISTRATION
Sedation in a patient with an advanced airway
Adult
Sedation in a patient with an advanced airway
Adult:
- 100 to 250 mcg IV, may repeat to a maximum cumulative dose of 250mcg
- Discuss with online medical control if additional doses are needed
Pediatric:
• Please use weight-based dosing, administered IV or IO
Midazolam
Versed
pedi
DOSAGE / ADMINISTRATION
Sedation after intubation or pre-treatment before cardioversion:
0.1 mg/kg IV/IO (max 2 mg)
Albuterol
Side Effects
Headache Drowsiness Vertigo Nausea Hypertension
In regards to Trauma, Pleural decompression for tension pneumothorax should only be performed
when all three of these criteria are present..???
If indicated, perform pleural
decompression at ___ intercostal space, ______ line.
-Severe respiratory distress with hypoxia
-Unilateral decreased or absent lung sounds (may see tracheal deviation away
from collapsed lung field)
-Evidence of hemodynamic compromise (shock, hypotension, tachycardia,
altered mental status)
decompression at 2nd intercostal space, midclavicular line.
Methylprednisolone
SIDE EFFECTS
Nervousness
Dizziness
Headache
May raise serum glucose levels (hyperglycemia)
Assess all trauma patients for Trauma Alert criteria. If criteria are met, begin transport to
Trauma Center within ____ minutes of arrival on scene whenever possible
10
Hypotension/Shock (Non-Trauma)
Assess for _____ and signs of cardiogenic shock (auscultate for ___, ___ heart
sounds, assess for ___ and/or ___ edema).
o If absent:
Administer _______. May repeat as needed for continued
hypotension.
Consider _______mcg/kg/min IV
o If pulmonary edema present:
Consider starting with ______, and repeat
cautiously while monitoring respiratory status.
Administer ____mcg/kg/min IV
If BP improves consider ____ for treatment of pulmonary edema.
Assess for pulmonary edema and signs of cardiogenic shock (auscultate for rales, S3 heart
sound, assess for JVD and/or pedal edema).
o If absent:
Administer NS 500mL bolus. May repeat as needed for continued
hypotension.
Consider Dopamine 5-20mcg/kg/min IV
o If pulmonary edema present:
Consider starting with smaller fluid boluses (e.g. NS 250mL), and repeat
cautiously while monitoring respiratory status.
Administer Dopamine 5-20mcg/kg/min IV
Epinephrine
Action
ACTION
Epinephrine is an endogenous catecholamine with beta-1, beta-2 (bronchodilation and
vasoconstriction of skeletal muscle) and alpha 1 (peripheral vasoconstriction)
adrenergic effects. It has positive inotropic, chronotropic and dromotropic effects, along
with increased SVR, increased coronary and cerebral perfusion and increased
automaticity. It causes an increase in myocardial oxygen demand.
For Patients with crush injury or prolonged Administer _______ (maximum ____meq) just prior to
release of trapped extremity
• Administer _____ bolus
Administer Sodium Bicarbonate 1 mEq/kg slow IV push (maximum 25meq) just prior to
release of trapped extremity
• Administer normal saline 500mL bolus
Sodium Bicarbonate
ACTION
Sodium bicarbonate is an alkalizing agent, which causes blood pH to rise
Amiodarone
Other name?
Cordarone
Ondansetron
Zofran
SIDE EFFECTS
headache dizziness drowsiness fatigue weakness diarrhea abdominal pain constipation dry mouth extrapyramidal reactions
Ketamine
INDICATIONS
Indicated for induction in adults and children or management of agitated delirium
Organophospate poisoning treatment
may repeat how often and until when?
atropine 2mg IV
may repeat every 5 minutes until secretions subside.
Glascow Coma Scale
EVM - 3-15
4Eyes 5Verbal 6Motor
Eye Opening
None 1 = Even to supra-orbital pressure
To pain 2 = Pain from sternum/limb/supra-orbital pressure
To speech 3 = Non-specific response, not necessarily to command
Spontaneous 4 = Eyes open, not necessarily aware
Verbal Response
None 1 = No verbalization of any type
Incomprehensible
2 = Moans/groans, no speech
Inappropriate
3 = Intelligible, no sustained sentences
Confused
4 = Converses but confused, disoriented
Oriented
5 = Converses and oriented
Motor Response
None
1 = To any pain; limbs remain flaccid
Extension
2 = Shoulder adducted and shoulder and forearm internally
rotated
Flexor response
3 = Withdrawal response or assumption of hemiplegic posture
Withdrawal
4 = Arm withdraws to pain, shoulder abducts
Localizes pain 5 = Arm attempts to remove supra-orbital/chest pressure
Obeys commands
6 = Follows simple commands
Labetalol
CONTRAINDICATIONS
PRECAUTIONS
hypersensitivity to the medication • high degree AV block • cardiogenic shock • bradycardia • hypotension
PRECAUTIONS • heart failure • hepatic disease • diabetes • asthma
EtCO2 rating needing to be managed for patient with sever head trauma
at least 40
Epinephrine
Precations
PRECAUTIONS
- hyperthyroidism
- diabetes mellitus
- glaucoma
- may exacerbate angina, hypertension, SVT and CHF
- protect solution from intense light sources
- is unstable in alkaline solutions
Dopamine
PRECAUTIONS
PRECAUTIONS
• Can cause an increase in myocardial oxygen consumption thus worsening the
cardiac status of the patient. Should be carefully monitored.
• Use with caution in cardiogenic shock with accompanying CHF.
Opioid overdose symptoms
treatment
Respiratory depression, altered mentation (somnolence), possibly decreased blood pressure,
pinpoint pupils, possibly cardiac arrest
Treat with Naloxone 0.5mg via IV/IO/IM/IN route (whichever is easiest
Adenosine
Other name for it?
Adenocard
For regular, wide complex tachycardias (most likely ______________),
administer _______mg over ___ minutes.
Follow by maintenance infusion of __mg/min for __hrs
For regular, wide complex tachycardias (most likely ventricular tachycardia),
administer Amiodarone 150mg over 10 minutes.
Follow by maintenance infusion of 1mg/min for 6hrs
Naloxone
Narcan
DOSAGE AND ADMINISTRATION
Adults:
• 0.5mg IV, IO, IM, IN (whichever is easiest) – may be dosed as a single 2mg dose
or may be given in increments of 0.5mg up to four times, depending on the
protocol and patient’s clinical presentation
• For severe respiratory depression (<6 breaths per minute) administer 2 mg.
Benadryl
Precautions
PRECAUTIONS
• Use caution in pregnant patients
• Benadryl may have additive effects when used with other CNS depressant
medications
Calcium Channel Blockers and Beta Blockers overdose symptoms
and overdose treatment?
bradycardia, hypotension, heart blocks, hypoglycemia, and pre-syncope or
altered mental status
calcium chloride
1G slow IV
Etomidate
COMPLICATIONS
COMPLICATIONS
• Anticipate that the patient will awaken rapidly and be left without residual
analgesia.
• Medicate with additional narcotics and neuromuscular blockers, as needed.
Benadryl
Indications
INDICATIONS
- anaphylaxis
- extrapyramidal reaction to phenothiazine medications
- mild to moderate allergic reactions
Midazolam
Versed
SIDE EFFECTS agitation drowsiness excess sedation apnea/respiratory depression bronchospasm coughing nausea and vomiting
agitation drowsiness
excess sedation apnea/respiratory depression
bronchospasm coughing
nausea and vomiting
Nitroglycerin
INDICATIONS
• Ischemic chest pain
• Hypertension
• Acute pulmonary edema which may be secondary to another process such as
congestive heart failure
Cardizem
SIDE EFFECTS / ADVERSE EFFECTS
SIDE EFFECTS / ADVERSE EFFECTS
epistaxis dyspnea dysrhythmias CHF peripheral edema bradycardia chest pain hypotension palpitations syncope tachycardia nausea / vomiting flushing diaphoresis urticaria hyperglycemia muscle cramps paresthesia / tremor
Fentanyl
DOSAGE AND ADMINISTRATION
Pain Control
Pedi
Pain Control
Pediatric:
• 0.5 mcg/kg, IV push slowly over 1-2 minutes, not to exceed 100 mcg.
• 1.5mcg/kg via mucosal atomization device if IV access unsuccessful or not
otherwise needed.
• May repeat every 5 minutes to a total of three doses or a maximum cumulative dose of 250 mcg
• Recheck a pain score & vitals including a HR, RR, and BP between doses
ABDOMINAL PAIN ALS: • Male > \_\_; female >\_\_ (cardiac until proven otherwise). • Female age \_\_-\_\_ who has fainted or has systolic BP
ABDOMINAL PAIN ALS: • Male > 30; female > 45 (cardiac until proven otherwise). • Female age 12-50 who has fainted or has systolic BP <90 (ectopic) • Not alert (not at normal baseline) • VS not normal for age and size
Cardizem
Contraindications
CONTRAINDICATIONS
Hypersensitivity Sick Sinus Syndrome
2nd or 3rd degree AV block Hypotension (<90 mmHg systolic)
Recent myocardial infarction Pulmonary congestion
Wolff-Parkinson-White syndrome (WPW)
Aspirin
Dosage
324mg PO
4 baby aspirin
Adenosine
Action?
Slows the conduction through the AV Node.
Blocks re-entrant pathways in SVT
Remember that ___% of geriatric syncope is cardiac dysrhythmia based
25
For all other cases of symptomatic hypertension with SBP > ___ and diastolic BP > ____,
administer _____mg IV push over ___ minutes. May repeat x ___ in ____ minutes if BP is
unchanged.
Goal is to lower blood pressure no more than ___% initially.
o this drug is contraindicated in cases of _________. Use caution in patients with
history of _____ disease or recent (
For all other cases of symptomatic hypertension with SBP > 220 and diastolic BP > 120,
administer Labetalol 10mg IV push over 1-2 minutes. May repeat x 1 in 10 minutes if BP is
unchanged. Goal is to lower blood pressure no more than 25% initially.
o Labetalol is contraindicated in cases of bradycardia. Use caution in patients with
history of reactive airway disease or recent (<48hrs) cocaine use
Methylprednisolone
CONTRAINDICATIONS
• Known hypersensitivity to methylprednisolone sodium succinate
• Systemic fungal infections
USE WITH CAUTION
• Known tuberculosis infection
• Patients who have received steroids within the past 12 hours
Synchronized Cardioversion
Joules
Supraventricular tachycardia or atrial flutter
50 to100 J
Succinylcholine
Anectine
Via IV- Time to complete paralysis?
Duration?
effects fade time?
Via IM - time to paralysis?
duration?
IV injection, complete paralysis is obtained within 1 minute and persists
for approximately 2 – 4 minutes
• Effects start to fade within 4 - 10 minutes
IM effects start within 3 minutes and the duration can be from 10 – 30 minutes
6 criteria for termination of cardiac arrest
Pulseless, apneic, and no other signs of life present
o Lack of pupillary reflexes and spontaneous movement
o Asystole or agonal rhythm <20bpm on cardiac monitor and multiple lead EKG
o Patients who become pulseless after severe traumatic injury when transport to the
nearest ED cannot be accomplished within 15min (i.e. prolonged extrications)
provided that all other signs of life are absent and transport has not been initiated
o Perform needle decompression of the chest prior to declaring termination, as tension
pneumothorax is a potentially reversible cause of cardiac arrest in these patients
o Place call to Online Medical Control for discussion prior to termination of
resuscitation
Methylprednisolone
Solumedrol
ACTION
Methylprednisolone is a potent anti-inflammatory glucocorticoid, a type of steroid. Its
anti-inflammatory effect is used to control conditions of severe inflammation such as
anaphylaxis and severe allergic reactions, exacerbations of COPD and asthma, and
other diseases. Onset of effect can occur within an hour of administration, and last for
nearly twelve hours.
Fentanyl
DOSAGE AND ADMINISTRATION
Pain Control
Adult
Pain Control
Adult:
• 50 - 100 mcg, IV push slowly over 1-2 minutes, or IM injection, may repeat every
5 minutes to a total of three doses or a maximum cumulative dose of 250 mcg
• Recheck a pain score & vitals including a HR, RR, and BP between doses
Nitroglycerin
SIDE EFFECTS
transient headache diaphoresis
hypotension syncope
nausea and vomiting tachycardia
Dextrose
Action
ACTION
Dextrose is a carbohydrate (monosaccharide) in a hypertonic solution which, when
given intravenously, increases blood glucose levels.
Labetalol
DOSAGE AND ADMINISTRATION
Adult:
Symptomatic Hypertension
10 mg IV over 1-2 minutes
• May be repeated in 10 minutes, if no significant change in blood pressure
• The goal is to lower the blood pressure, but not by more than 25%
Consider possibility of ______ as etiology of wide-complex tachycardia
(especially in dialysis patients), and treat with _____ @ ___ IV/IO if
suspected
Consider possibility of hyperkalemia as etiology of wide-complex tachycardia
(especially in dialysis patients), and treat with Calcium chloride 1G IV/IO if
suspected
Ondansetron
Zofran
CONTRAINDICATIONS
• hypersensitivity
Pediatric Vomiting and Diarrhea
UPC
Utilize IV protocol if s/s of hypovolemia, give ___?
• Check ___?
For blood glucose < 8 ___, administer ___ @______ for children < ___ years old
Administer ___ @ ___ for children > 8 years old (maximum __mL or __ G)
• For symptomatic nausea/vomiting, administer _____.
o Administer ___mg/kg IV (max __mg) for children <40kg.
o Administer __mg ODT or IV for children > 40kg (oral route preferred if patient
does not require IV for other reason)
Utilize IV protocol if signs or symptoms of hypovolemia, and give NS 20cc/kg bolus
• Check blood glucose level
For blood glucose < 60, administer D25 2mL/kg for children < 8 years old.
Administer D50 2mL/kg for children > 8 years old (maximum 50mL or 25G)
• For symptomatic nausea/vomiting, administer ondansetron.
o Administer 0.1mg/kg IV (max 4mg) for children <40kg.
Administer Zofran 4mg ODT or IV for children > 40kg (oral route preferred if patient
does not require IV for other reason)
What are the 6 controlled substances?
Lorazepam Diazepam Midazolam Fentanyl Ketamine Etomidate
Succinylcholine
Anectine
DOSAGE AND ADMINISTRATION
Adult:
Peds (RTT)
• 1.5 mg/kg IV/IO push
• In extreme circumstances: deep IM injection of 3 - 4 mg/kg; total dose not to
exceed 150 mg, however paralytics should ideally be given with IV access
What drug can we administer prior to cardioversion and at what dose?
Midazolam
Versed
1-2mg IV/IN
If hypertensive patient complains of ____, obtain____ and treat per protocol.
o What should be first line antihypertensive and analgesic agent in this group
If patient complains of chest pain, obtain 12-lead EKG and treat per Chest Pain Protocol.
o Nitroglycerine should be first line antihypertensive and analgesic agent in this group
Patients with crush injury or prolonged extrication are at risk for developing _____
Patients with crush injury or prolonged extrication are at risk for developing rhabdomyolysis
Epinepherine
DOSAGE AND ADMINISTRATION
Cardiac Arrest
Adult/Pedi
Cardiac arrest:
Adult
- 1 mg IV / IO of Epinephrine (1:10,000) push every 3-5 minutes
- Can be given via ET tube at 2 - 2.5 times the normal dose diluted in 10ml of NS
Pediatric
• Epinephrine (1:10,000) 0.01 mg/kg IV or IO every 3-5 minutes
Initial recommended dose is dependent on rhythm
- Narrow, regular:
- Narrow, irregular:
- Wide, regular:
- Wide, irregular:
Narrow, regular: 50-100J
Narrow, irregular: 120-200J
Wide, regular: 100J
Wide, irregular: defibrillation dose (NOT synchronized)
Etomidate
PRECAUTIONS
PRECAUTIONS
• Patients with renal or hepatic insufficiency
Atropine
CONTRAINDICATIONS
CONTRAINDICATIONS
tachycardia
• narrow angle glaucoma
• myasthenia gravis
Atropine
SIDE EFFECTS
palpitations tachycardia
headache vertigo
dry mouth blurred vision
urinary retentio
Calcium Chloride
DOSAGE AND ADMINISTRATION
Adult and Pedi
Hyperkalemia
Hyperkalemia:
Adult:
• 1 gram, IV/IO
Pediatric:
• 20 mg/kg, IV/IO, maximum dose 1 gram
• Refer to “Weight Based Resuscitation Tape” for pediatric dosing.
Treatment For chemical burns
remove clothing and brush off any visible dry chemicals or powder.
flush with water or NS for 10-15 minutes
Sepsis alert will be instituted for patients meeting the following 2 criteria?
- Suspected infection
2. Two or more of the following: • Temperature (100.4° F) OR < (96.8° F) • Respiratory Rate > 20 breaths/min • Heart Rate > 90 beats/min • ETCO2 ≤ 25
Dopamine
DOSAGE AND ADMINISTRATION:
Hypotension/shock refractory to fluid resuscitation
and
Bradycardia w/ a pulse
Adult
Hypotension/shock refractory to fluid resuscitation
Adult:
Infusion rate 5-20 mcg/kg/min IV and titrate for response.
Bradycardia with a pulse
Adult
• Infusion rate 2-20 mcg/kg/min IV and titrate for response.
Epinepherine
DOSAGE AND ADMINISTRATION
Anaphylaxis:
Anaphylaxis:
Adult:
• 0.3mg of Epinephrine 1:1,000 via intramuscular injection
• May repeat if signs and symptoms of shock persist after the initial dose
• If patient appears to be nearing cardiac arrest or develops cardiac arrest, give
1mg IV of 1:10,000 epinephrine
Pediatric:
• Per weight-based tape, inject the 1:1,000 epinephrine intramuscularly
• May repeat if signs and symptoms of shock persist after the initial dose
• If patient develops cardiac arrest, give 1:10,000 epinephrine IV per weight-based
tape dosing
Dopamine
Action
ACTION
Dopamine is an endogenous catecholamine, which is a precursor to norepinephrine.
Primarily acts upon alpha-1 and beta-1 receptors. Low dose ranges <2mcg/kg/min
results in vasodilation of the renal, mesenteric and cerebral arteries. Dose ranges of 2-
10 mcg/kg/min cause beta stimulation which results in increased cardiac output with
minimal changes in SVR or preload. Dose ranges of 10-20 mcg/kg/min result in alpha
response with vasoconstriction of the renal, mesenteric and peripheral vasculature.
Calcium Chloride
Action
ACTION
Calcium chloride is an essential electrolyte for functional integrity of the nervous and
muscular system, cardiac contractility and coagulation of blood.
Adenosine
Indications
Treatment of SVT
All trauma patients who present with multi-systems trauma will be transported as
soon as possible with the transport goal being____ minutes or less
10
Albuterol
Indications?
Contraindications?
Indications
Bronchospasms
Asthma-COPD
Contraindications
Hypertension
Synchronized Cardioversion
sedation
Medication and Dose
consider sedation with
Midazolam/Versed
1 - 2 mg IV
treatment for patients with epistaxis
Firmly pinch the bridge of the nose for at least 10 minutes
with the head tilted forward facing down
Albuterol
Adult
Pediatric
Both are 2.5mg in 3-6ml
hypothermia is regarded as temp below ____degrees?
95
Synchronized Cardioversion
Joules
Ventricular Tachycardia
100J
Disadvantage of using Bougie Tube
Can only be used with a __ endotracheal tube or larger
6.0
which drugs can be given in the ET tube?
when delivered in an ET tube, what is the amended dose?
Epi
Narcan
Atropine
for ET tube, admin 2-2.5 times the IV dose diluted in 5-10ml or NS
Pediatric Pain Control
Drugs for pain management
Fentanyl 0.5mcg/kg IV (maximum dose 100mcg), slow IV push
May repeat every 5 minutes, to a maximum of 3 doses
May be administered via MAD Intranasal dose is 1.5mcg/kg
(maximum dose 100mcg)
For thermal burns, cover with ____ or sterile
dressings
o <10% TBSA?
o >10% TBSA, ?
o Leave blisters intact
cover with burn sheet or sterile dressings o <10% TBSA, wet dressings with normal saline o >10% TBSA, 1L bolus NS o Leave blisters intact
Succinylcholine
SIDE EFFECTS
Hypotension Tachycardia
Hypertension Cardiac arrest
Ventricular dysrhythmias Brief elevation of serum potassium
Bradycardia, especially with a repeat dose and in children under 5 years old
Increased intracranial, intraocular and intragastric pressure
Malignant hyperthermia (rare but life-threatening complication)
in trauma, If BP < ___, administer boluses of NS at ___mL until BP > ___
If BP < 90, administer boluses of NS at 250mL until BP > 90
Calcium Chloride
Calcium Channel Blocker Overdose/Toxicity:
Adult
1 gram, IV/IO slowly
Pediatric:
- 20 mg/kg (0.2 ml/kg), IV/IO slowly
- Refer to “Weight Based Resuscitation Tape” for pediatric dosing.
If preeclampsia is present (___/___)BP, administer ________mg IVP every ___minutes until SBP
If preeclampsia is present (160/110), administer Labetalol 10mg IVP every 10minutes until SBP <
130 and DBP < 100.
o Contraindicated if HR < 60
o Use with caution in patients with history of asthma
If suspected CVA, whats proper protocol?
Check BGL first
Establish when symptoms began to determine if window of stroke alert
IV access
FAST-ED
Keep head of stretcher 30-45 degrees
dont treat BP >220 of suspected CVA
Sodium Bicarbonate
SIDE EFFECTS
- metabolic alkalosis
- seizures
- electrolyte imbalance
Cardizem
Precautions
PRECAUTIONS
- patients with renal or hepatic insufficiency or CHF
- geriatric patients
- pregnancy, lactation or children
- history of serious ventricular dysrhythmias
Daily Glucometer Checks
Once the solutions and test strips have been opened they are good for __
days.
90 days
For crushing trauma,
Administer _____ mEq ___ IV push just prior to release of trapped
extremity
• Administer normal saline ___mL bolus
For crushing trauma,
Administer Sodium Bicarbonate 25 mEq slow IV push just prior to release of trapped
extremity
• Administer normal saline 500mL bolus
Fentanyl
Alternate Name
Sublimaze
Benadryl
Alternate name
Diphenhydramine
For behavioral/Agitated delerium, admin which drugs?
If patient has dystonic reactions, then what?
Midazolam 5-10 mg IV
May also be given 5 and 5 in each nostril.
Haloperidol
5mg IV/IM
may repeat once in 10 minutes
Ketamine
2mg/kg IM/IV
Dystonic reactions are treated with
Diphenhydramine
1mg/kg
or 25-50mg
may repeat once after 10 minutes
Dextrose
Indications
INDICATIONS
- hypoglycemia
- altered levels of consciousness
- coma or seizure of unknown etiology
Amiodarone Drop ROSC
recurrent Vfib
150mg IV over 10 minutes
Relationship between CO2 and respiratory rate (RR):
↑ RR= ↓CO2 =
↓ RR= ↑CO2 =
Normal range of ETCO2 is __-__ mmHg
↑ RR= ↓CO2 =HYPER-ventilation (ETCO2 <35) → respiratory alkalosis
↓ RR= ↑CO2 = HYPO-ventilation (ETCO2 >45) → respiratory acidosis
Normal range of ETCO2 is 35-45 mmHg
12 Lead Placement and Lead Groups
SALI
Septal
V1 and V2
Anterior
V3 and V4
Lateral
I, V5, V6, and aVL
Inferior
II, III, and aVF
V1 Right parasternum 4th ICS V2 Left parasternum 4ICS V3 In between V2 and v4 V4 Left Midclavicular 5th ICS V5 In between V4 and V6 V6 Left Midaxillary
Fentanyl
Precautions
USE WITH PRECAUTION
- Head injury
- COPD history
- Respiratory difficulty
Cardizem
Action
ACTION
Diltiazem is a calcium channel blocker which inhibits transport of calcium into
myocardial and vascular smooth muscle cells resulting in inhibition of excitationcontraction
coupling and subsequent contraction. It causes systemic vasodilation with
resultant decrease in blood pressure and coronary vasodilation
Naloxone
Narcan
DOSAGE AND ADMINISTRATION
Pediatric:
- 0.1 mg/kg IV, IO, IM, IN
* Refer to “Weight Based Resuscitation Tape” for pediatric dosing.
