2020 Paramedic Update

650mg PO

• -fever > 100.4
• -pain relief

15mg/kg PO

• -<4yo
• -GCS <= 14
• -known allergy
• -intoxication
• -pregnancy

• 15mg in 100ml bag over 5min
• 25mg IN

Repeat 1x prn after 15min

• .3mg/kg in 100ml bag over 5min
• .5mg/kg IN

Repeat 1x prn after 15min

• -Trauma w/ hemorrhage
• -within 3hrs if injury
• -SBP<90 and/or HR>110
• -tachy >120bpm w/ signs of hypoperfusion
• -Pts >65yo w/ SBP<110
• -postpartum hemorrhage >500ml within 24hrs I’d delivery
• -epistaxis uncontrolled by BLS

• -known hypersens
• -suspected MI, stroke, or PE
• -injury >3hrs old
• -pts <14yo

1g in 100ml bag over 10min (110gtt/min)

-Epistaxis - 1ml per nare IN, clamp nostrils, repeat 1x after 5min prn

• -Asystole
• -PEA
• -Anaphylaxis
• -Bronchospasm
• -bradycardia
• -hypoperfusion

2-8mcg drip

• -.3mg 1:1000 q20min I’d needed
• -severe cases - 2-8mcg drip OR 0.5ml push dose

.3mg 1:1000 OR 2-8mcg/min drip

Push dose 0.5ml q1-5min

OR

Drip 2-8mcg/min

.1-1mcg/kg/min drip

-.01mg/kg 1:1000 IM max .3mg

• -severe .2-1mcg/kg drip
• OR
• -1ml push dose q2min to SBP 70mmHg age 1-10, 90mmHg >10yo

.01mg/kg 1:1000 IM, repeat q20min prn

• .1-1mcg/kg/min drip
• OR
• 1ml push dose q3-5min

.5mg 1:10000 nebulized

.1-1mcg/kg/min drip

Take 1:10000 preload and waste 9ml

Draw up 9ml NS

• -Bradycardia - sedation beyond initial dose for TCP
• -Ped ROSC - Epi infusion
• -seizures - verses after 1st 2 doses
• -tachy w/ pulse peds - lido if unresp to cardiovert
• -shock - fluid bolus
• -epistaxis - TXA Admin
• -delirium - versed beyond initial dose
• -Combative - versed beyond initial dose

-Peds - 1mg/kg, repeat in 10min prn

• -Adult - 250ml to maintain SBP > 80
• -ped - 5ml/kg to maintain SBP > 70, 80

• -1st - 6mg Adenosine mixed in 18ml NS in 20ml syringe
• -2nd & 3rd - 12mg mixed with 16ml NS in 20ml syringe

.1mg/kg mixed with NS to equal 10ml

.2ml/kg mixed w/ NS to equal 10ml

VF / VT

1-1.5mg/kg first, .5-.75mg/kg 2nd / 3rd... max 3mg/kg

-1st dose of lido given at 2nd shock