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Protocols Flashcards

(33 cards)

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1
Q

Adrenal insufficiency

A

Adrenal insufficiency

Adult:

  • Hydrocortisone 100mg
  • Methylprednisolone 125mg IV/IO/IM

Pediatric:

  • Hydrocortisone 2mg/kg
  • Methylprednisolone 2mg/kg IV/IO/IM
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2
Q

Alcohol Withdrawal

A

Alcohol Withdrawal

  • NS/LR 500ml
  • Lorazepam 1-2mg IV/IO/IM q5
  • Diazepam 5-10mg IV/IO/IM q5
  • Midazolam 2.5mg IV/IO or 5mg IM q5
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3
Q

Allergic Reaction / Anaphylaxis (Adult)

A

Allergic Reaction / Anaphylaxis (Adult)

  • Epi .3mg (1:1,000) IM
  • Albuterol 2.5mg neb. x4
  • Diphenhydramine 25 - 50mg IV/IO/IM
  • For hives: Famotidine 20mg IV/IO
  • Refractory anaphylaxis. Epinephrine 2-10mcg/min
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4
Q

Allergic Reaction / Anaphylaxis (Pedi)

A

Allergic Reaction / Anaphylaxis (Pedi)

<25 kg, 0.15mg epinephrine (1:1,000) IM
≥25 kg, 0.3mg epinephrine (1:1,000) IM
- Albuterol 2.5mg neb. x4
- Diphenhydramine 1mg/kg IV/IO/IM
- Refractory anaphylaxis. Epinephrine .1 - 2mcg/kg/min
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5
Q

Asthma / COPD / RAD (Adult)

A

Asthma / COPD / RAD (Adult)

  • DuoNeb
  • CPAP (MAX 10cm H2O)
  • Dexamethasone 10mg IV/IO
  • Methylprednisolone 125mg IV/IO
  • Epinephrine 0.3mg IM
  • Magnesium sulfate 2g in 100ml over 10 minutes
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6
Q

Asthma / COPD / RAD (Pedi)

A

Asthma / COPD / RAD (Pedi)

  • DuoNeb
  • CPAP
  • Dexamethasone 0.6mg/kg PO/IV/IM
  • Methylprednisolone 2mg/kg IV/IO/IM,
  • Epinephrine .01mg/kg IM. (<25kg MAX 0.15mg) (>25kg MAX 0.3mg)
  • Mag 40mg/kg in 100ml over 20 min

CROUP / BRONCHIOLITIS
- Racemic epinephrine 0.5ml of 2.25% OR Nebulized, 5mg (1:1,000) in 3ml NS.

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7
Q

Fever (Pedi > 3m old)

A

Fever (Pedi > 3m old)

Temperatures >101.5°F

  • Acetaminophen 15mg/kg PO per Chart.
  • Consider Catch up dose.

*Children should never take aspirin.

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8
Q

Hyper K

A

Hyper K

  • Calcium Chloride 1g IV
  • Albuterol 2.5mg
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9
Q

Hypoglycemia (Adult)

A

Hypoglycemia (Adult)

  • D10% IV/IO until glucose >60
  • Glucagon 1mg IM x2
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10
Q

Hypoglycemia (Pedi)

A

Hypoglycemia (Pedi)

  • D10% 5mL/kg IV/IO until glucose >60
  • Less than 20kg, glucagon 0.5mg IM
  • Greater than 20kg, glucagon 1mg IM
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11
Q

Nausea / Vomiting

A

Nausea / Vomiting

Adult:

  • NS/LR 500ml IV. Repeat 250ml
  • Ondansetron 4mg IV/IO/IM/PO
  • Metoclopramide 5–10mg IV/IO over 15 minutes or IM.

Pedi:

  • NS/LR 10 - 20ml/kg IV
  • Ondansetron 0.1mg/kg IV
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12
Q

Nerve Agents/ Organophosphate Poisoning (Adult)

A

Nerve Agents/ Organophosphate Poisoning (Adult)

  • After 3 DuoDote kits:
  • Atropine 2mg IV/IO/IM: 4mg q5: 8mg q5: etc.
  • Pralidozime 1g over 60min
  • (Benzo)
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13
Q

Nerve Agents / Organophosphate Poisoning (Pedi)

A

Nerve Agents / Organophosphate Poisoning (Pedi)

  • Atropine .05-.1mg/kg IV/IO/IM (MAX 5mg)
  • Pralidoxime 25mg/kg IV/IO
  • (Benzo)
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14
Q

Pain Management (Adult)

A

Pain Management (Adult)

  • Fentanyl 1mcg/kg IO/IV/IM/IN
  • Hydromorphone 0.5 - 1mg IV/IO/IM (MAX 4mg)
  • Morphine 0.1mg/kg IV/IO/IM
  • Ketamine 0.3mg/kg IV/IO/IM (Max 30mg)
  • Ketorolac 15mg IV/IO/IM,
  • Acetaminophen 1g IV/IO over 15 minutes. Or PO

Migraine:
- Metoclopramide 10mg IV/IO over 15 minutes or IM.

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15
Q

Pain Management (Pedi)

A

Pain Management (Pedi)

  • Fentanyl 1mcg/kg IO/IV/IM/IN (MAX 100mcg)
  • 2nd Fentanyl .5mcg/kg (MAX 50mcg)
  • Morphine 0.1 mg/kg IV/IO/IM (MAX 5mg)
  • 2nd Morphine .05 mg/kg (MAX 2.5mg)
  • Acetaminophen 15mg/kg PO (MAX 1g)
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16
Q

Seizures (Adult)

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A

Seizures (Adult)

  • Midazolam 10mg IM (5mg if ≤39kg)
  • Midazolam 5mg IV/IO/IN
  • Lorazepam 4mg IV/IO/IM. (2mg if ≤39kg)
  • Diazepam 10mg IV/IO, then 2.5mg
  • Eclampsia
  • Magnesium sulfate, 4g IV/IO over 10 minutes.
17
Q

Seizures (Pedi)

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A

Seizures (Pedi)

  • Midazolam .2mg/kg IM/IN (MAX 8mg)
  • Midazolam .1mg/kg IV/IO (MAX 4mg)
  • Lorazepam .1mg/kg IV/IO/IM. (MAX 4mg)
  • Diazepam .2mg/kg IV/IO (MAX 10mg)
18
Q

Sepsis (Adult)

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A

Sepsis (Adult)

  • Two large IVs.
  • NS or LR 500 mL bolus to maintain BP >90 OR MAP >65 (MAX 4,000ml)
  • Norepinephrine 1 - 30mcg/min
  • Epinephrine 2 - 10 mcg/min
19
Q

Sepsis (Pedi)

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A

Sepsis (Pedi)

  • NS/LR 20mg/kg (MAX 60mL/kg)
  • Norepinephrine .1 - 2mcg/kg/min
  • Epinephrine infusion .1 - 2mcg/kg/min
20
Q

Shock

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A

Shock

ADULT:

  • NS/LR 250mL maintain BP >90 (MAX 2000ml)
  • Norepinephrine 1 - 30mcg/min
  • Epinephrine 2 - 10mcg/min

PEDIATRIC:
- NS/LR 20ml/kg (MAX 60ml/kg)

21
Q

Smoke Inhalation

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A

Smoke Inhalation

  • 02 100%
  • Hydroxocobalamin via Cyanokit x2
  • Epinephrine 5mg (1:1,000) in 3ml NS.
22
Q

Stroke

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A

Stroke

  • Elevate the head of the stretcher 30 degrees
  • On scene goal ≤15 min
  • 18g IV in the forearm / AC
23
Q

ACS

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A

ACS

  • Aspirin 324mg PO within last 24 hours
  • Nitro .4 SL with BP >100
  • Fentanyl 1mcg/kg (MAX 100mcg x3)
  • Morphine .1mg/kg (MAX 5mg x3)
24
Q

Bradycardia (Adult)

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A

Bradycardia (Adult)

  • NS 500ml
  • Atropine .5mg IV,IO
  • Pacing w/ benzo
  • Midazolam 2.5mg IV/IO or 5mg IM
  • Lorazepam 1mg IV/IO or 2mg IM
  • Diazepam 2mg IV/IO
  • Epi 2-10mcg/min

B blocker / calcium channel blocker OD:
- Glucagon 5mg IV/IO

Calcium channel blocker OD:

  • Calcium Chloride 1g IV/IO
  • Calcium Gluconate 2g IV/IO
25
Bradycardia (Pedi)
Bradycardia (Pedi) *CPR if heart rate is <60 bpm - Epinephrine .01mg/kg IV/IO (1:10,000) (MAX .3mg) - Atropine .02mg/kg IV/IO (MAX .5mg) - Pacing w/ benzo - Midazolam .05mg/kg IV/IO/IN - Lorazepam .05mg/kg IV/IO - Diazepam .05mg/kg IV/IO B blocker / calcium channel blocker OD: - Glucagon .05mg/kg (MAX 5mg) Calcium channel blocker OD: - Calcium Chloride 20mg/kg IV/IO - Calcium Gluconate 100mg/kg IV/IO
26
Cardiac Arrest (Adult)
Cardiac Arrest (Adult) - 2min CPR - OPA/NPA - NRB / BVM 1 breath every 10 - Pads (Check Rhythm) SHOCK 200j - 2 min CPR - IV - (Check Rhythm) SHOCK 300j - 2 min CPR - EPI 1mg (1:10,000) - (Check Rhythm) SHOCK 360j - 2 min CPR - BVM or Advanced Airway - (Check Rhythm) SHOCK 360j - 2 min CPR - EPI 1mg (1:10,000) * For VF / VTACH - 300mg Amiodarone - 150mg Amiodarone - 1.5mg/kg Lidocaine - .75mg/kg Lidocaine q5 * For Torsades - Mag 25-50mg/kg (MAX 2g)
27
Cardiac Arrest (Pedi)
Cardiac Arrest (Adult) - 2min CPR - OPA/NPA - NRB / BVM 1 breath every 10 - Pads on (Check Rhythm) SHOCK 2j/kg - 2 min CPR - IV and EPI .01mg/kg (1:10,000) q3-5 - (Check Rhythm) SHOCK 4j/kg - 2 min CPR - (Check Rhythm) SHOCK 4j/kg - 2 min CPR - BVM or Advanced Airway - (Check Rhythm) SHOCK 4j/kg - 2 min CPR * For VF / VTACH (After second shock) - Amiodarone 5mg/kg (MAX 300mg) - Lidocaine 1mg/kg (MAX 100mg) * For Torsades - Mag 25-50mg/kg (MAX 2g)
28
CHF / Pulmonary Edema
CHF / Pulmonary Edema - O2 - CPAP 10cm H2O - Nitroglycerin .4-.8mg SL q5 - Nitroglycerin IV/IO 50 mcg/min, increase 50 mcg/min every 3-5 min
29
Tachycardia (Adult)
Tachycardia (Adult) Unstable = Sync Cardioversion ``` SVT = - Vagal Maneuver - Adenosine 6mg IV/IO - Adenosine 12mg IV/IO (May repeat successful dose) ``` RAPID A-FIB / A-FLUTTER = - Diltiazem .25mg/kg IV/IO - Diltiazem .35mg/kg IV/IO - Metoprolol 5mg IV/IO V-TACH = - (Consider) Adenosine 6mg IV/IO - (Consider) Adenosine 12mg IV/IO - Amiodarone 150mg IV/IO over 10 min - Lidocaine 1 - 1.5mg/kg IV/IO - Lidocaine 3mg/kg IV/IO TORSADES = - Mag 1-2g IV/IO over 5 min.
30
Tachycardia (Pedi)
Tachycardia (Pedi) Unstable = Sync Cardioversion - 1 j/kg - 2 j/kg SVT = - Adenosine .1mg/kg IV/IO (MAX 6mg) - Adenosine .2mg/kg IV/IO (MAX 12mg) WCT / V-Tach - Contact med control - Amiodarone 5mg/kg IV/IO over 20 min
31
Burns (Adult)
Burns (Adult) - If 2nd degree burns <10% body surface area, consider wet dressings (room temp) >20% Burned - Transport <1h = NS 500ml/hr - Transport >1h = NS 1-2ml/kg x %burn / 8.
32
Burns (Pedi)
Burns (Pedi) - If 2nd degree burns <10% body surface area, consider wet dressings (room temp) >20% Burned - Transport <1h = - <2 yo NS 100ml/hr - 2-5 yo NS 125ml/hr - 5-15 yo NS 250ml/hr - Transport >1h = NS 2ml/kg x %burn / 8.
33
Restraints
Restraints ADULT: Midazolam 5mg IM/IN or 2.5mg IV/IO, may repeat once in 5 minutes;OR Lorazepam 2 mg IM or 1 mg IV/IO, may repeat once in 5 minutes; OR Diazepam 2 mg IV/IO (preferred route), may repeat once in 5 minutes; OR Diazepam 5 mg IM, may repeat once in 20 minutes Ketamine (preferred) 4 mg/kg IM (round to nearest 50mg), max single dose 500mg. May administer additional 100mg ketamine IM in 5-10 minutes; OR If vascular access, may alternatively administer 1 mg/kg ketamine IV/IO over 2 minutes. May administer additional 0.5-1mg/kg IV/IO in 5 minutes (max total 2mg/kg ) PEDI: Ketamine (preferred) 4 mg/kg IM, maximum single dose 150mg. If vascular access, may alternatively administer 1 mg/kg (max 40mg) slow IV/IO over at least 2 minutes; OR Midazolam 0.1 mg/kg IM/IN/IV/IO (max 2mg), may repeat once in 5 minutes; OR Lorazepam 0.1 mg/kg IM/IV/IO (max 2mg), may repeat once in 5 minutes; OR Diazepam 0.1 mg/kg IV/IO (preferred route, max 2mg), may repeat once in 5 minutes; OR 0.1 mg/kg IM (max 5mg), may repeat once in 20 minutes

Paramedic (2 decks)

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