Medications / Standard Orders

Question 1

Adenosine

Answer 1

Stable Narrow Complex SVT or Wide Complex Tachycardia:
6 mg RIVP followed immediately by a 20 cc NS bolus, and
12 mg RIVP followed immediately by a 20 cc NS bolus if the patient does not convert.
May be repeated one time.

Question 2

Albuterol

Answer 2

2.5 mg nebulized

May repeat 2 times.

Question 3

Albuterol MDI

Answer 3

4 puffs every 10 minutes for continued SOB and wheezing.

Question 4

Albuterol (Ped.)

Answer 4

2.5 mg nebulized

May repeat 2 times.

Question 5

Albuterol MDI (Ped.)

Answer 5

4 puffs every 10 minutes for continued SOB and wheezing.

Question 6

Aspirin

Answer 6

325 mg PO chewed (1 adult non-coated tablet) OR

4 chewable 81 mg tablets.

Question 7

Atropine

Answer 7

Symptomatic Bradycardia:
0.5 mg IV/IO.
May repeat every 5 minutes to a MAX of 3 mg or 0.04 mg/kg.
Organophosphate Poisoning:
2 mg Iv/IO.
Repeat every 5 minutes if patient remains symptomatic.

Question 8

Calcium Chloride

Answer 8

Calcium Channel Blocker Poisoning:
1 g IV/IO.
BASE ORDER ONLY.

Question 9

Dextrose

Answer 9

Dextrose 10% / 250 mL (D10W 25g) IV/IO Bolus.

Question 10

Dextrose (Ped.)

Answer 10

Hypoglycemia:
0 - 4 weeks with BGL <35.
4 weeks + with BGL <60.
Dextrose 10% / 250 mL (D10W 25g) IV/IO Bolus.
0.5 g/kg (5mL/kg).

Question 11

Benadryl

Answer 11

Allergic/Dystonic Reaction:
25 mg IV/IO
50 mg IM

Question 12

Benadryl (Ped.)

Answer 12

Allergic/Dystonic Reaction:
1 mg/kg IV/IO MAX 25 mg
2 mg/kg IM MAX 50 mg

Question 13

Dopamine

Answer 13

400 mg / 250 mL NS IV/IO.
5 - 20 mcg/kg/min.
Titrate to maintain signs of adequate tissue perfusion.

Question 14

Dopamine (Ped.)

Answer 14

9 - 14 years
400 mg / 250 mL NS IV/IO.
5 - 20 mcg/kg/min.
Titrate to maintain signs of adequate tissue perfusion.

Question 15

Epinephrine 1:1000

Answer 15

Severe Bronchospasm / Asthma / Allergic Reaction / Anaphylactic Shock:
0.3 mg IM.

Question 16

Epinephrine 1:1000 (Ped.)

Answer 16

Severe Bronchospasm / Asthma / Allergic Reaction / Anaphylactic Shock:
0.01 mg/kg IM.
MAX 0.3 mg.

Question 17

Epinephrine 1:10000

Answer 17

Persistent Severe Anaphylactic Shock:
0.1 mg SIVP/IO.
May repeat every 5 minutes, MAX 0.5 mg.
Cardiac Arrest:
1 mg IV/IO.

Question 18

Epinephrine 1:10000 (Ped.)

Answer 18

Anaphylactic Shock (No radial pulse / depressed LOC):
0.01 mg/kg IV/IO, MAX 0.1 mg PER DOSE.
May repeat to a TOTAL MAX of 0.5 mg.
Cardiac Arrest:
1 day - 8 years: 0.01 mg/kg IV/IO MAX 1 mg
9 - 14 years: 1 mg IV/IO
Newborn Care:
0.01 mg/kg IV/IO if HR < 60 after 1 min and hypoxia and hypothermia has been treated.
0.005 mg/kg IV/IO every 10 minutes for persistent hypotension.
BASE ORDER / RCF ONLY.
Post ROSC with Inadequate Perfusion:
1 day - 8 years: 0.5 mcg/kg/min IV/IO drip.

Question 19

Fentanyl

Answer 19

50 mcg IV/IO SIVP.
May repeat every 5 minutes.
MAX 200 mcg.
100 mcg IM/IN.
May repeat in 50 mcg doses every 10 minutes.
MAX 200 mcg.
*IM NOT APPROPRIATE FOR TCP*

Question 20

Fentanyl (Ped.)

Answer 20

0.5 mcg/kg IV/IO SIVP.
MAX 50 mcg.
May repeat every 5 minutes.
TOTAL MAX 100 mcg.
1 mcg/kg IM/IN.
MAX 100 mcg.
May repeat in IV dose every 10 minutes.
MAX 200 mcg.

Question 21

Oral Glucose

Answer 21

1 tube

Question 22

Oral Glucose (Ped.)

Answer 22

1 tube

Question 23

Glucagon

Answer 23

Hypoglycemia:
1 mg IM/SQ/IN 
Beta Blocker Poisoning:
1 mg IV/IO
BASE ORDER ONLY

Question 24

Glucagon (Ped.)

Answer 24

Hypoglycemia:
0.025 mg/kg IM/IN.
May repeat 1 time after 20 minutes.
TOTAL MAX 1 mg.

Question 25

Atrovent

Answer 25

0.5 mg nebulized. | One dose only.

Question 26

Atrovent (Ped.)

Answer 26

1 day - 1 year: 0.25 mg nebulized. 1 - 14 years: 0.5 mg nebulized. One dose only.

Question 27

Lidocaine

Answer 27

``` Intubation: 1.5 mg/kg IV/IO VT/VF: 1.5 mg/kg IV/IO May administer additional 0.75 mg/kg IV/IO. May repeat once after 5 - 10 minutes. Infusion: 2 mg/min IV/IO Drip VT / Wide Complex Tachycardia with Pulses: 1.5 mg/kg IV/IO May administer additional 0.75 mg/kg IV/IO. May repeat once after 5 - 10 minutes. Initiate Infusion: 2 mg/min IV/IO Drip ```

Question 28

Lidocaine (Ped.)

Answer 28

``` Intubation: 1.5 mg/kg IV/IO. Cardiac Arrest: 1.0 mg/kg IV/IO. May repeat at 0.5 mg/kg after 5 minutes. MAX 3 mg/kg. ```

Question 29

2% Lidocaine

Answer 29

Pain with IO Infusion: .5 mg/kg IO. MAX 40 mg.

Question 30

Magnesium Sulfate

Answer 30

``` Polymorphic VT: 2 g IV/IO bolus over 5 minutes. Eclampsia: 4 g IV/IO SIVP over 3 - 4 minutes. Maintenance Drip: 10 mg/min IV/IO. ```

Question 31

Midazolam

Answer 31

``` Seizure: 2.5 mg IV/IO/IN. May repeat in 5 minutes. 5 mg IM. May repeat in 10 minutes. MAX of 3 doses, any combination of routes. Pacing / Cardioversion: 2 mg SIVP/IO/IN ```

Question 32

Midazolam (Ped.)

Answer 32

``` Seizure: 0.1 mg/kg IV/IO, MAX 2.5 mg May repeat in 5 minutes. 0.2 mg/kg IM/IN, MAX 5 mg. May repeat in 10 minutes. MAX of 3 doses, any combination of routes. ```

Question 33

Narcan

Answer 33

0.5 mg IV/IO/IM/IN. May repeat every 2-3 minutes. MAX 10 mg.

Question 34

Narcan (Ped.)

Answer 34

1 day - 8 years: 0.1 mg/kg IV/IO/IM/IN 9 - 14 years: 0.5 mg IV/IO/IM/IN. May repeat every 2-3 minutes. MAX 10 mg.

Question 35

Nitroglycerin

Answer 35

0.4 mg SL. | May repeat every 3 minutes with adequate perfusion.

Question 36

Zofran

Answer 36

Nausea / Vomiting: 4 mg SIVP/IO/ODT. 4 - 8 years: MAX 4 mg. 9+ years: MAX 12 mg.

Question 37

Oxygen

Answer 37

General: Titrate to maintain SPO2 of 94% or greater. COPD: Titrate to maintain SPO2 of 91% or greater.

Question 38

Phenylephrine

Answer 38

0.5 mg IN. | May be repeated 1 time prior to second NTI attempt.

Question 39

Sodium Bicarbonate

Answer 39

TCA Poisoning: 1 mEq/kg IV/IO. BASE ORDER ONLY.

Question 40

Normal Saline (Non-trauma)

Answer 40

``` Bradycardia: 300 mL IV/IO Bolus, may repeat. Tachycardia: 300 mL IV/IO Bolus PEA/Asystole: 300 mL IV/IO Bolus, may repeat. Nontraumatic Hypovolemia: 500 mL IV/IO Bolus, may repeat 1 time. Burns: Unstable: 250 mL IV/IO Bolus, may repeat to a MAX of 1000 mL. Stable: 500 mL/hour IV/IO drip. ```

Question 41

Normal Saline (Non-trauma) (Ped.)

Answer 41

Hypovolemia: | 20 mL/kg IV/IO Bolus, may repeat 1 time for tachycardia, change in pulses, limb temperature change, or ALOC.

Question 42

Normal Saline (Trauma)

Answer 42

Blunt- Unstable: IV/IO open until stable, MAX 2000 mL. Stable: IV/IO TKO. Penetrating- Unstable: IV/IO 500 mL Bolus. One dose only. Stable: IV/IO TKO. Closed Head Injury- Unstable: IV/IO 250 mL Bolus, may repeat 1 time. Stable: IV/IO TKO.

Question 43

Normal Saline (Trauma) (Ped.)

Answer 43

Unstable: 20 mL/kg IV/IO Bolus, may repeat once. Stable: IV/IO TKO.