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Albuterol Sulfate - Proventil
Adult:
- - Broncho-constriction/wheezing/hyperkalemia
- 2.5mg in 3mL NSS
- Administered nebulized with 5-8LPM of 02
Pediatric:
- - Broncho-constriction/wheezing/hyperkalemia
- 2.5mg in 3mL NSS
- Administered nebulized with 5-8LPM of 02
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Atropine - Atropine
Adult:
- - All cardiac indications
- 0.5 to 1.0mg IVP q 3-5 min up to max 3mg or 0.04 mg/kg rapidly
- Alternatively it can be given via ETT at 2.0 to 2.5x IV dosage
- - Organophosphate poisoning
- 1-2mg q 5min
Pediatric:
- All cardiac indications - Max 0.04mg/kg - min dose 0.1mg
- 0.02 mg/kg IVP
- Alternatively can be given ETT at 2.0 to 2.5X IV dose
- - Organophosphate poisoning
- 0.05mg/kg IV q. 10-20 min
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Bumetanide - Bumex
Adult:
- - Diuretic
- 0.5 - 2.0mg IV Push given over 2 minutes q 2-3 hours
- Note - 1mg of Bumex = 40mg of Lasix
- Max dose 10mg per day
Pediatric:
- Not recommended for pediatric patients
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Diazepam - Valium
Adult:
- Seizures - 5mg IV push SLOWLY
- - Cocaine overdose/Acute agitation
- 5-10mg IVpush SLOWLY
Pediatric:
- Seizures - 0.1mg/kg IV push
- 0.5mg/kg PR
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Diphenhydramine - Benadryl
Adult:
- Allergic reaction/Dystonic response - 25-50mg IV push or deep IM
Pediatric:
- All indications - 1mg/kg IV push or IM
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Dexamethasone Sodium Phosphate - Decadron
Adult:
- All indications - 10mg IV push or IM
Pediatric:
- Croup - 0.6mg/kg IM or IV
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Epinephrine - Adrenalin
Adult:
- Anaphylaxis - 0.3 - 0.5mg SC (1:1000 Concentration)
- - Asthma
- 0.3 - 0.5mg SC (1:1000 Concentration)
- - Cardiac Arrest
- 1mg IV push (1:10,000 Concentration) q 3-5 min
- 2.0X to 2.5X IV dose for ETT administration (mix 2.0-2.5mg in 10ml of NSS)
- - Bradycardia
- 1-10mcg/min IV Drip; 1mg to 500mL
Pediatric:
- Cardiac Arrest - 0.01mg/kg IV Push (1:10,000 concentration) q. 3-5min
- - Anaphylaxis
- 0.01 mg/kg IV Push (1:10,000 concentration)
- 0.01 mg/kg SC (1:1,000 concentration)
- - Bradycardia
- 0.01 mg/kg IV push x1 dose only (1:10,000 concentration)
- Max dose of 1mg
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Furosemide - Lasix
Adult:
- Acute pulmonary edema (BP > 120 systolic) - 20mg IVP - standing orders
- 1.0mg/kg IV push slowly
Pediatric:
- Pulmonary edema/Hypertension - 1mg/kg IV push q 6-12 hrs
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Ipratropium Bromide - Atrovent
Adult/Pediatric:
- 0.5mg in 2.5ml NSS - 0.02% solution
- Nebulized with 6-8 liters of 02
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Levalbuterol - Xopenex
Adult:
- Broncho-constriction/wheezing - 1.25mg in 3ml NSS for more severe wheezing (acute setting)
- Administered nebulized with 5-8 LPM of 02
- - Other doses
- 0.63mg in 3ml NSS for moderate wheezing (home therapy)
Pediatric:
1.25mg in 3ml NSS for more severe wheezing (acute setting) - 0.31mg in 3ml NSS for pediatric patients (home therapy)
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Lorazepam - Ativan
Adult:
- Seizure/sedation/relieve anxiety - IV injection - 1.0mg to 2.0mg
- IM injection - 2.0mg up to 4.0mg
Pediatric:
Seizures - 0.05 - 0.1mg/kg IV push
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Magnesium Sulfate - Magnesium Sulfate
Adult:
- Alive Dose - Torsades de Pointes - VTach - 1-2g IV drip over 5-15 minutes (BP dependant)
- - Dead Dose - Recurrent or refractory v-fib / pulseless VTach / Torsades
- 1-2g IVP
- -Asthma
- 2g IV drip given over 20 minutes
- -Pre-eclampsia/eclampsia
- 2-4g IV given over 3-5 minutes
Pediatric:
None available
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Methylprednisolone - Solu-Medrol
Adult:
Anaphylaxis, Asthma - 125mg IV Push
Pediatric:
- Anaphylaxis, Asthma - 2mg/kg dose IV Push
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Midazolam Hydrochloride - Versed
Adult:
- Pre-intubation/Sedation - 0.1mg/kg IV Push
- Typical dose 5mg-10mg IV Push
- - Seizures when no IV access is avail
- 2-5mg IM
- -Induction Agent
- 0.2mg/kg IV push - 7-10mg avg. adult
Pediatric:
- Seizures without IV access - 0.1mg/kg IM
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Morphine Sulfate - Morphine
Adult:
- Pain (MI, sickle cell and other) - 2-5mg IV Push q. 5 minutes until desired effects
- - Pain (Burns)
- 5-10mg IV Push q. 5 minutes until desired effects
- Often high dose morphine is required for pain relief
Pediatric:
- Pain (all indications) - 0.1mg/kg IV Push
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Naloxone - Narcan
Adult:
- Opiate overdose - 0.4 - 2.0mg IM/IV/SC/Inter-Nasal
Pediatric:
- Opiate reversal (0-5 years old or <20kg) - 0.1 mg/kg IV/SC/ETT q. 3 minutes until response
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Nitroglycerin - Nitrostat, Nitrospan, Nitrodisc, Nitrodur, Tridil
Adult:
- All indications: - 0.4mg (2% solution) SL spray administer on mucus membranes of mouth (under toungue)
- 0.4mg (1/150grains) SL tablet q. 3-5 minutes
- 1-2 inches as on ointment/paste - apply to skin without hair - avoid self exposure
- 10-20mcg/min IV drip mixed 50-100 mg in 250mL
- Increase by 5-10mcg/min q. 5-10 minutes until desired response
Pediatric:
No prehospital administration recommended
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Terbutaline - Brethine
Adult:
- Asthma/Bronchospasm/Premature labor - 0.25mg SQ to start, wait 15 min repeat if necessary
Pediatric:
Not recommended for pediatrics in pre-hospital setting.
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