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1

RSI meds for adult

Etomidate 0.3 mg/kg
Succinylcholine 2mg/kg
Rocuronium 1mg/kg
In rapid succession
Propofol 2 mg/kg
Ketamine 1mg/kg
Vecuromium 0.1 mg/kg

2

What RSI drug would you NOT use if your pt was hyperkalemic, has a burn/crush injury, spinal cord injury or a myopathy?

Succinylcholine. You would want to use rocuronium 1mg/kg

3

For RSI if you have no succs or roc what drug would you use?

Vecuromium 0.1 mg/kg

4

For a hypotensive pt what drug would you use in RSI?

Ketamine 2mg/kg

5

For RSI if you have NO etom and pt bp good what drug would you use?

Diprivan 2mg/kg

6

RSI atropine dose for pt <8 yrs old?

Atropine 0.02 mg/kg

7

For RSI you want to pre-oxygenate w/NRB for 1-3 min and have NC on how many liters/min?

5

8

What is mallampati score?

Classification of ease of intubation.
Class 1: full visualization of tonsils, uvula, n soft palate
Class 2: visual of hard n soft palate n upper portion of tonsils n uvula.
Class 3: only soft n hard palate n base of uvula visible.
Class 4: only hard palate visible.

9

Airway assessment
LEMON

Look
Evaluate 3-3-2
Mallampati
Obstruction
Neck mobility

10

What does LEMON stand for?

Look
Evaluate (3-3-2, mouth opening 3 finger widths, norm mandible dimension, notch of thyroid cartilage 2 finger breadths below hyoid bone)
Mallampati
Obstruction
Neck mobility

11

For RSI; in the septic pt you would use what drug in place of etomidate?

Ketamine 2mg/kg

12

What drug in RSI would you want to promedicate with for an actual or potential head injury pt?

Fentanyl 3-5 mcg/kg ivp
Lidocaine 1.5 mg/kg ivp

13

Allergic reaction..what drugs would you use?

Benadryl 50 mg ivp/im
Albuterol 5mg
NS bolus up to 2L
EPINEPHRINE (1:1,000) 0.3mg or 0.3 ml IM

If severe life threatening and IM not working; mix 10 ml of 1:10,000 (1mg) in 1L of NS start at 60 ml/hr and increase by 60 ml/hr every min

14

Drugs to use for combative pt?

Ativan (lorazepam) 1-2 mg IVP
Versed (midazolam) 2 mg IVP/IM
Ketamine (ketalar) 5 mg/kg IM or 1-2 mg/kg I'VE

15

COPD/asthma, bronchospasm..what meds would you give?

Albuterol 5mg
Atrovent (ipratropium bromide) 0.5mg
Epinephrine (if life threatening) 0.3 mg (0.3 ml) of 1;1,000 IM (avoid if heart dx tachyarrhythmias or age >50
Solu-medrol 125 mg IVP
Epi aerosol 5 ml (or racemic epi 0.5ml)

16

Bradycardia

Atropine 0.5 mg IVP
Dopamine 5-20mcg/kg/min if pacing is ineffective

Epinephrine gtt 2-10 mcg/min

Transcutaneous pace for type 2 second degree or 3rd degree av block

17

Chest pain

Asa 81 mg
Nitro gtt 5 mcg/min titrate 5-10 mcg/min q 3 min
Fentanyl 50 mcg IV

18

Tachycardia >150 unstable

Immediate synchronized cardioversion w/ 150 joules

19

Tachycardia wide qrs

Adenosine (adenocard) 6mg
Amiodarone (cardarone) 150 mg IV over 10 min, repeat 150mg IV over 10min

20

Tachycardia narrow qrs

Vagal maneuver
Adenosine (adenocard) 6mg rapid push, may repeat 12 mg dose once

21

Tachycardia afib/flutter

Diltizem (cardizem) 0.25 mg/kg IVP over 2 min
May repeat 0.35 mg/kg in 15 min
Maintenance 5-15 mg/hr gtt

If unresponsive Amiodarone 150mg IVP over 10min

22

CHF

Cpap
Nitro 50 mcg/min titrate 5-10 mcg/min q 3 min up to 200 mcg keep sbp >100
Lasix (furosemide) 0.5-1.0 mg/kg IVP

23

Hypoglycemia

D50 25grams repeat in 10 prn
Glucagon 1mg IM

24

Hyperglycemia

BS. >300 w/change in LOC, increased resp
250 ml NS bolus

25

Heat emergency

NS 500 ml bolus
Ativan (lorazepam) 1-2 mg for shivering prn

26

What meds would u use for a K greater then 7, or >5.5 w/ EKG changes..loss of P wave, widening QRS, tall peaked T waves, or arrhythmias..weakness or paralysis?

Ca Gluconate 10ml of 10% in 5 min(do not use if dig tox)
NA bicarbonate 50 meq (no if chf)
Insulin 10units IVP
Glucose 25 G IVP
Consider albuterol 5mg/5ml nebs

27

HTN >200/120

Ntg gtt 10 mcg/min titrate q 3 min

Nicardipine (cardene) bolus 5mg/hr increase by 2.5 mg q 5-15 min max 15 mg/hr..when bp improved, quick ween to 3 mg/hr

Labetalol (trandate) 10-20 mg IVP q5-10 min max 150 mg

28

OD..what drugs and dose?

Narcan (naloxone) 0.4 mg IV/im/in

Tricyclics 8.4%NA bicarbonate
Organophosphate atropine

29

Pain mgmt meds

Diludid 0.5-1 mg IV/IM q10 min
Fentanyl (sublimaze) 1mcg/kg q5 (no more then 100mcg per dose)

MS up to 4mg q5

30

Sedation

Versed (midazolam) 2-5mg
Ativan (lorazepam) 1-2 mg

31

Cardioversion sedation meds?

Fentanyl (sublimaze)1mcg/kg
And
Etomidate (amidate) 0.1 mg/kg
Immediately prior if pt awake

32

Sedation for intubated pt?

Ativan (lorazepam) 1-2 mg
Versed (midazolam) 2-5 mg
Fentanyl (sublimaze) 1mcg/kg q5min
Propofol (Diprivan) 20-40mg bolus q2min...gtt 5-50 mcg/kg/min
Ketamine (ketalar) 1mg/kg over 1min

33

Seizure meds?

Check BS
Versed (midazolam) 0.1 mg/kg max dose of 5 mg
Ativan (lorazepam) 2mg q10 slow push

34

Non-traumatic shock meds?

250 NS bolus prn
Dopamine 5-20 mcg/kg/min
Dobutamine 2-20 mcg/kg/min

Sepsis: norepinephrine (levophed) 0.5-12 mcg/min

35

N/V?

Zofran (ondansetron) 4mg
NS bolus 250 ml
Reglan (metoclopride) 10mg IVP/IM
Benadryl (diphenhydramine) 25 mg IVP for restlessness

36

Adenocard (adenosine)..what's it for and adult dose?

Narrow tachycardia
6 mg rapid IVP then
12 mg rapid IVP x1 prn

37

Albuterol (Proventil)..what's it for and adult dose?

Allergic reaction, bronchospasm, wheezing
5mg nebs, repeat prn

38

Amiodarone (cordarone)..what's it for and adult dose?

Antiarrhythmic..wide tachycardia
300mg IVP n repeat 150 mg-arrhythmias

150 mg IVP over 10 min-tachycardia

39

Amiodarone kit...what's it for and how is it dosed?

Antiarrhythmic n wide tachycardia

1mg/min

40

Atropine...what's it for and adult dose?

Asystole, PEA, 1mg IVP q 3-5 min

Symptomatic bradycardia 0.5 mg q3-5 min

41

Atrovent (ipratropium)..what's it for and the adult dose?

Bronchospasm or wheezing
0.5 mg nebs

42

Benadryl (diphenhydramine) what's it for and the adult dose?

Allergic reaction and anaphylaxis 50mg IVP/IM

Akathisa (restlessness) 25 mg IVP

43

Calcium Gluconate..,what's it used for and the adult dose?

Hyperkalemia 10 ml of 10% IVP over 5 min

44

Dextrose (D50W)..what's it for and the adult dose?

Glucose <70
25gm IVP

45

Dilaudid (hydromorphone HCL)...adult dose and what's it for?

Pain mgmt
0.5-1 mg IVP q10 min
>65 yo..0.5 mg IVP q10

46

Diltiazem 25mg/ml (cardizem)...what's it for and adult dose?

Tarcardia
0.25 mg/kg IV over 2 min
May repeat 0.35 mg/kg in 15 min

47

Diltiazem 125mg/25ml (cardizem)...gtt..
What's it for and adult dose?

Tachycardia
5-15 mg/hr titrate for hr

48

Dopamine (intropin)...what's it for and the adult dose?

Shock..non-traumatic, n bradycardia
5-20 mcg/kg/min
Keep bp >100

49

Dobutamine...what's it for and adult dose?

Non-traumatic shock
2.5-20 mck/kg/min
Titrate keep bp >100

50

Epinephrine (1:1000, 1:10,000)..what's it for and the adult dose?

Vfib, pulseless VT, PEA, asystole, asthma, anaphylaxis, shock

Card arrest: 1mg of 1:10,000 q3-5min

Anaphylaxis/asthma.. 0.3 mg 1:1000 sq/im q5-10 min x2
Severe; 1:10,000 (1 ml IV)

Epi gtt: 2-10 mcg/min

51

Etomidate..when do we use it and adult dose?

RSI, 0.3 mg/kg IV

Sedation, 0.1 mg/kg for cardioversion

52

Fentanyl (sublimaze)..what's it for and adult dose?

Pain, airway, sedation
1mcg/kg IVP q5 min..(max single dose 100 mcg)

53

Glucagon..what's it for and adult dose?

Glucose <70 and no IV site
1 mg IM, repeat in 20 min

54

Haloperidol (haldol)...what's it for and adult dose?

Combative pt
10 mg IVP

55

When would we use insulin and what adult dose?

Hyperkalemia 10 units of reg. IV

56

Ketamine (ketalar)..what's it for and adult dose?

Sedation
Induction 2mg/kg IV over 1 min
Sedation 1mg/kg IV over 1min

57

Labetalol (trandate)..what's the dose and what's it for?

Hypertension
10-20 mg q5-10 min IVP
Max dose 150 mg

58

Lasix (furosemide) ..what's the adult dose and what's it for ?

CHF/pulm edema
0.5-1.0 mg/kg IV

59

Lidocaine 2% (xylocaine)...what's the adult dose and what's it for?

RSI (consider), arrhythmia: 1-1.5 mg/kg IV

EZ IO insertion; 40-60 mg IO slowly before fluid bolus

60

Lidocaine 1% (xylocaine)...what's it for and adult dose?

Local anesthesia; prn up to 4.5 mg/kg

61

Lorazepam (Ativan)..what's the adult dose and what's it for?

Behavioral, heat emergency, seizure, sedation; 1-2 mg IVP

62

Magnesium sulfate..what's it for and the adult dose?

Torsades de pointes...1-2 gm IV

63

Morphine sulfate..what's it for adult dose?

Pain, sedation, airway;
4mg IV q5 min prn
Geriatric; up to 2 mg IV q5min prn

64

Narcan (naloxone)..what's it for and adult dose?

Narc OD
0.4 mg IV may repeat up to 2 mg

65

Nicardipine (cardene)...what's it dot and adult dose?

Hypertension
Begin 5 mg/hr titrate q5-10 min 2.5 mg up to max of 15 mg/hr. when goal bp reached change to 3 mg/hr

66

Nitroglycerin (tridil)..what's it for and the adult dose?

CHF; begin w/ 10 mcg/min, titrate to 50 mcg /min keeping bp >100

CP; begin at 5 mcg/min, titrate by 5mcg/min q5 min

67

Nitro spray..what's it for and adult dose?

CP or pulm edema; 0.4 sl q5 min keep sbp >100

68

Norepinephrine (levophed)..when do we use it and what's the dose?

Septic shock
0.5 mcg/min titrate up to 30 mcg/min

69

Oxytocin (pitocin)..what's it for and what's the dose?

OB emergencies, postpartum hemorrhage
10 units

70

Plavix (clopidogrel)..what's it for and dose?

CP w/ allergy to asa; 300 mg

71

Procainamide (pronestyl)..what's it for and adult dose?

Antiarrhythmic; 15mg/kg @ 20-30 mg/min to a total loading dose of 1000 mg

72

Propofol (Diprivan)..what's it for and adult dose?

Sedation..bolus of 2mg/kg and gtt 5-50 mck/kg/min

73

Reglan (metoclopride)..whats it for and adult dose?

N/V; 10 mg IV/IM

74

Rocuronium bromide (zemuron)..what's it for and adult dose?

Neuromuscular relaxant..
1mg/kg IV

Defasiculating (muscle twitching) dose 0.1 mg/kg IV

75

Nitroprusside..adult dose and use?

Acute CHF
0.3 mcg/kg/min

76

Sodium bicarbonate 8.4%...what's it for and adult dose?

Prolonged cardiac arrest, hyperkalemia; 1meq/kg IV

77

Solu-medrol..what's it for and adult dose?

Bronchospasm (asthma/copd) 125mg IV

78

Succinylcholine (anectine)..adult dose and use?

Neuromuscular relaxant (short term)
2mg/kg IV

79

Valium (diazepam)..use and adult dose?

Sedation, airway,
Up to 5 mg IV may repeat as needed

80

Vecuronium (norcuron)..adult dose and use?

Neuromuscular relaxant: 0.1 mg/kg IV

Defasciulating (twitching) dose; 0.01 mg/kg IV

81

Versed (midazolam)..use and adult dose?

Sedation, airway, burns, seizures;
2mg IV increments up to 10mg

2-5 mg IV q10 severe burn
discomfort

82

Zofran (ondansetron)..use and adult dose?

Vomiting; 4 mg IV slow 2-5 min
Or
4mg oral disintegrating tab (ODT)