11010 Medication - Standard Orders

Front 1

Acetaminophen (Tylenol) - Adult (ALS)

Back 1

For mild to moderate pain scales 1-5 or in moderate to severe pain where other medications are contraindicated or deferred.

Tylenol, 1 gm IV/IO infusion over fifteen (15) minutes. Single dose only

Front 2

Acetaminophen (Tylenol) - Pediatric (ALS)

Back 2

For mild to moderate pain scales 1-5 or in moderate to severe pain where other medications are contraindicated or deferred.

2 years to 14 years:

Tylenol, 15mg/kg to a max of 1000mg or 1 gm IV/IO infusion over fifteen (15) minutes . Single dose only.

Front 3

Adenosine (Adenocard) - Adult (ALS)

Back 3

Stable Narrow-Complex SVT or Wide Complex Tachycardia:

Adenosine, 6 mg rapid IVP followed immediately by 20 cc NS bolus

and Adenosine, 12 mg rapid IVO followed immediately by 20 cc NS bolus if patient does not convert.

May repeat one (1) time.

Front 4

Albuterol (Proventil) - Aerosolized Solution - Adult (LALS, ALS)

Back 4

Albuterol, 2.5 mg nebulized, may repeat two (2) times.

Front 5

Albuterol (Proventil) Metered-Dose Inhaler - Adult (LALS, ALS)

Back 5

Albuterol MDI, four (4) puffs every 10 minutes for continued shortness of breath and wheezing.

Front 6

Albuterol (Proventil) - Pediatric (LALS, ALS)

Back 6

Albuterol, 2.5 mg nebulized, may repeat two (2) times.

Front 7

Albuterol (Proventil) Metered-Dose Inhaler (MDI) - Pediatric (LALS, ALS)

Back 7

Albuterol MDI, Four (4) puffs every 10 minutes for continued shortness of breath and wheezing.

Front 8

Aspirin, chewable (LALS, ALS)

Back 8

Aspirin, 325 mg PO chewed (one (1) Adult non-enteric coated Aspirin) or four (4) chewable 81 mg Aspirin

Front 9

Atropine (ALS) - Adult

Back 9

Atropine, 1 mg IV/IO. May repeat every five (5) minutes up to a maximum of 3 mg or 0.04 mg/kg.

Front 10

Atropine (ALS) - Adult

Organophosphate poisoning:

Back 10

Organophosphate Poisioning:

Atropine, 2 mg IV/IO, repeat at 2 mg increments every five (5) minutes if patient remains symptomatic

Front 11

Atropine - Pediatric (ALS)

Back 11

Organophosphate Posioning - Pediatrics less than 14 years of age:

Atropine, 0.05 mg/kg IV/IO not to exceed adult dose of 2 mg, repeat at 0.1 mg/kg increments every five (5) minutes if patient remains symptomatic.

Front 12

Calcium Chloride - Adult (ALS)

Calcium Chloride Blocker Poisonings

Back 12

Base Hospital Order Only

Calcium Chloride, 1 mg (10 ml of a 10% solution) IV/IO.

Front 13

Calcium Chloride - Adult (ALS)

Cardiac Arrest

Back 13

Base Hospital Order Only

For Cardiac Arrest with suspected hypocalcemia, hyperkalemia, hypermagnesemia, or calcium channel blocker poisoning:

Calcium Chloride, 1 gm (10 ml of a 10% solution) IV/IO.

Front 14

Calcium Chloride - Adult (ALS)

ESRD

Back 14

Base Hospital Order Only

for end stage renal disease (ESRD) patients on dialysis with suspected hyperkalemia and hemodynamic instability with documented sinus bradycardia, 3rd degree AV block, 2nd degree type II AV block, slow junctions and ventricular escape rhythms, or slow atrial fibrillation

Calcium Chloride, 1 mg (10 ml of a 10% solution) IV/IO

Front 15

Calcium Chloride - Pediatric (ALS)

Back 15

Base Hospital Order Only

Calcium Chloride Blocker Poisonings

Calcium Chloride, 20 mg/kg IV/IO over five (5) minutes.

Front 16

Dextrose - Adult (LALS, ALS)

Back 16

Hypoglycemia - Adult with blood glucose less than 80 mg/dL

Dextrose 10% / 250 ml (D10W 25 gm) IV/IO Bolus

Front 17

Dextrose - Pediatric (LALS, ALS)

Back 17

Hypoglycemia - Neonates (0 - 4 weeks) with blood glucose less than 35 mg/dL or Pediatric patients (more than 4 weeks) with glucose less than 60 mg/dL:

Dextrose, 10% / 250 ml (D10W 25 gm) 0.5 gm/kg (5 ml/kg) IV/IO

Front 18

Diphenhydramine (Benadryl) - Adult (ALS)

Back 18

Diphenhydramine, 25 mg IV/IO

Diphenhydramine, 50 mg IM

Front 19

Diphenhydramine (Benadryl) - Pediatric (ALS)

Back 19

Allergic Reaction:

2 years to 14 years

Diphenhydramine, 1 mg/kg slow IV/IO, not to exceed adult dose of 25 mg

or

Diphenhydramine, 2 mg/kg IM, not to exceed adult dose of 50 mg IM