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Indication of albuterol
respiratory distress, specifically wheezing, bronchoconstriction due to asthma/ COPD
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contraindications to albuterol
allergy to / suspected pulmonary edema / (cautious with cardiac hx)
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Side effects of Albuterol
Increased HR / anxiety (discontinue treatment if HR increases 20bpm)
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Dosage / Route of Albuterol
2.5mg / 3ml nebulized with 6L O2
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Pediatric dosage for albuterol
2.5mg / 3ml **contact medical control for additional dosages**
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Indications for atrovent
respiratory distress specifically wheezing, bronchoconstriction due to asthma / COPD
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contraindications for atrovent
Glaucoma / allergy to soy/peanuts/atropine / < 2 y/o
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side effects of atrovent
dry mouth, headache, cough
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dosage / route for atrovent
0.5mg nebulized or premixed with albuterol in duo-neb
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Indication of ASA
chest pain / acute MI
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contraindications of ASA
Active Ulcer / Asthma medications / Allergy to ASA
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Side effects of ASA
GI bleeding
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Dosage / Route of ASA
4 81mg chewable tablets (324mg) oral
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Pediatric Atrovent
none <15 y/o
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indications Epi 1:1,000
anaphylaxis / status asthmaticus without relief from inhaled treatments
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Contraindications Epi 1:1,000
None
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Side effects of Epi 1:1,000
Tachydysrhythmias / HTN / anxiety
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Dosage / route Epi 1:1,000
0.3mg Epi-pen IM / 0.3mg SQ/IM
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Medical control Epi 1:1,000
- anaphylaxis/asthma: contact for additional dosage
- Asthma: >40 y/o / HR >160 / HTN / Cardiac Hx
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Pediatric Epi 1:1,000
0.01mg/Kg IM max single dose 0.3mg CMC for additional doses
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Indicaitons for Glucagon
hypoglycemia / bs <60 with ALOC & unable to establish IV
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Contraindications to glucagon
allergy to glucagon
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Side effects of glucagon
Nausea & vomiting
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Dosage / Route of glucagon
1mg reconstituted in 1ml sterile H2O IM
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Pediatric Glucagon
- <8 y/o 0.5mg IM
- >8 y/o 1mg IM
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Indications for Oral Glucose
hypoglycemia BS <60
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Contraindications of Oral Glucose
No Gag reflex
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Dosage / route
1 tube (24 grams - 31 grams) orally
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Indication of Narcan
Opiate overdose / ALOC suspected overdose
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Side Effects of Narcan
Vomiting/ withdrawal symptoms / agitation
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Dosage of Narcan
- 2mg/2ml slow IV / IM/ IN
- may repeat every 5 minutes as needed
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Pediatric Narcan
- decreased respiratory effort
- <20kg 0.1mg/kg
- >20kg 2mg
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Indication of Nitro
chest pain with suspected angina pectoris / acute MI / acute pulmonary edema
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contraindications of Nitro
BP <100 / sexual enhancement drugs
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Side effects of nitro
headhache / tachycardia / hypotension / syncope / N&V / facial flushing
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Dosage / Route of nitro
- 0.4mg SL tablet / metered dose spray
- Nitro Paste: 1gm / 1 inche topically (remove if bp drops <100)
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Indications for Lasix
acute pulmonary edema
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Contraindications of Lasix
dehydration / hypovolemia / pregnancy / hypotension
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Side effects of lasix
N&V / dizziness / headache / **cause pulmonary edema or tinnitis if pushed too fast**
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Dosage / Route of Lasix
40-80 mg SLOW IV push (over 2 minutes) *max 100mg* Call Medical control for orders
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Indication for lidocaine
Stable V-Tach with pulse / Wide complex tachycardia
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Contraindication to Lidocaine
Allergy to / bradycardia / 2nd or 3rd degree blocks
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Side effects of Lidocaine
CNS depression / hypotension / bradycardia / N&V / respiratory/cardiac arrest
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Dosage/ Route
- 1.0-1.5mg/kg IV
- 2nd dose 0.5-0.75 mg/kg
- total dose of 3mg
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Pediatric Lidocaine
refer to broselow tape
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Indication for Epi 1:10,000
Cardiac Arrest: VF/ Asystole / pulseless VT
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Dosage / route Epi 1:10,000
1mg IV every 3-5 minutes
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Pediatric Epi 1:10,000
0.01 mg/kg IV (refer to broselow tape)
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Indications for D50
hypoglycemia
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Contraindications of D50
caution to watch for infiltration
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Dosage / Route of D50
25 g / 50ml IV *consider IO if unable to establish IV*
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Pediatric D50
- >8 y/o D50 1-2ml/kg
- 1-8 y/o D25 2-4ml/kg
- <1 y/o D12.5 4ml/kg
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Indications of Benadryl
Alergic reaction / rash
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Contraindications of benadryl
asthma
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Side Effects of Benedryl
hypotension / headache / sedation / palpitations
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Dosage / Route Benadryl
25-50 mg IV/ IM slow
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Pediatric Benadryl
1mg / kg slow IV
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Indication of Morphine
pain / chest pain / acute pulmonary edema
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Contraindication of Morphine
allergy to / BP <90 / head injury / undiagnosed abd. pain / respiratory depression
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Side effects of morphine
respiratory depression / hypotension / N&V
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Dosage / Route Morphine
- up to 5mg slow IV/IM
- CMC for additional orders
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Pediatric Morphine
Burns **CMC** 0.05mg/kg - 0.1mg/kg IV
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Indication for Adenocard
Narrow comples SVT
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Contraindications for Adenocard
Allergy to / 2nd & 3rd degree blocks / asthma
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Side effects of adenocard
shortness of breath / facial flushing / bronchospasms / dysrhythmias
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Dosage / Route adenocard
6mg / 12mg / 12 mg IV slam fould by flush (IV site AC)
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Pediatric Adenocard
- CMC refer to broselow tape
- 0.1mg/kg 1st dose (max 6mg)
- 0.2mg/kg 2nd/3rd dose (max 12mg)
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Indications of Valium
Witnessed seizure / premedication for pacing/cardioversion / psychological emergencies / medicated intubation for respiratory distress
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Contraindications of Valium
Allergy to / shock / coma / depressed vital signs / pregnancy / respiratory depression
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Dosage / Route of Valium
- Seizure/Premedication/Psych: up to 5mg IV CMC for additional
- Medicated intubation: up to 10mg IV
- Elderly pt: use smallest effective dose
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Pediatric Valium
- witnessed seizure 0.1mg/kg - 0.3mg/kg slow IV every 15 mins.
- <5 y/o max total 5mg
- >5 y/o max 10mg
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Indications of zofran
nausea & vomiting
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contraindications of zofran
allergy to
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side effects of zofran
headache / dizziness
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Dosage / Route of zofran
4mg IV (slow)
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Indications of Atropine
Asystole / symptomatic bradycardia / organophosphate poisoning
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Dosage/Route of Atropine
- Asystole: 1mg IVP every 3-5 mins Max 3mg
- Bradycardia: CMC 0.5-1mg IVP every 3-5 mins max 3mg
- Organophosphate poisoning: 2mg every 3-5 min maintain HR 70bpm
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Pediatric Atropine
0.02mg/kg min dose 0.1mg max 0.5mg
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Indication of Toradol
pain rated <5; back/flank pain
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contraindications to Toradol
alergy to toradol/ASA/NSAIDs; renal impairment; bleeding disorders; 2 weeks before/after surgery; brestfeeding/pregnancy; pt on coumadin; head injury
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Side effects of Toradol
irritation to area/vein; nausea; hypotension
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Dosage/Route of Toradol
- 60mg IM >65 y/o& <110lbs decrease dose to 30mg IM
- 15-30mg SLOW IV
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Indication of fentanyl
pain not relieved by morphine; pts with allergy to morphine
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Contraindications of fentanyl
allergy to; <=2y/o; do not push fast, leads to respiratory depression
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Side Effects of Fentanyl
MANY; respiratory depression; laryngospasm; N/V; thorasic rigidity
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Dosage / Route of Fentanyl
- 50mcg IV slow / IM
- decrease dose to 25mcg for elderly
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Indications for Sodium Bicarb
ASA / Tricyclic antidepressant
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Side Effects of Sodium bicarb
metabolic alkalosis; kypokalemia; fluid overload watch for infiltration; push VERY slow to reduce chance of cerebral dysfunction, seizure, peripheral tissue hypoxia, & lactic acidosis
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Dosage / Rate of Sodium bicarb
50mEq/IV VERY SLOW
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