Contra Costa County Ems Drug Dosage Protocols

Front 1

Adenosine:

Indication, doseages, & contraindications

Back 1

Indication: SVT

Dosages:

1st dose 6 milligrams followed by a 20 milliliter rapid flush

2nd dose 12 milligrams followed by a 20 milliliter flush

Contraindications: asthma, hypersensitivity and wolf Parkinsons white

Front 2

Albeterol:

Indication, doseages, & contraindications

Back 2

Indication: bronchospasm or crush injury / hyperkalemia

Dosages:

5 milligrams in 6 milliliters normal saline nebulised for asthma PRN

5 milligrams in 60 milliliters normal saline nebulized for hyperkalemia / crush injury continuous

Contraindications: MAO inhibitors the antidepressants (Nardil & Parnate)

Front 3

Amiodarone:

Indications, doseages ,and contraindications

Back 3

Indication 1: pulseless ventricular fibrillation/ ventricular tachycardia

Dosages 1: 300 milligram IV or iovilus, repeat 150 milligram bolus if rhythm persists.

Indication 2: stable ventricular tachycardia.

Dosage 2: 150 milligrams IV infusion or slow IV push over 10 minutes 15 milligrams / minute

Contraindications: hypotension

Front 4

Aspirin: indication dosages and contraindications

Back 4

indication: chest pain - suspected ACS

dosage four 81 milligram tablets

contraindications: allergy to aspirin or salicylate

Front 5

Atropine indications dosages and contraindications

Back 5

heart blocks.

Dosage 1: 0.5 milligrams iv or io every 3 to 5 minutes up to a max of 3 milligrams.

Indication 1: symptomatic bradycardia ( not used in wide qrs second and third degree heart blocks.Dosage 1: 0.5 milligrams iv or io every 3 to 5 minutes up to a max of 3 milligrams.Indication 2: organophosphate poisoning. dosages 2: 1 -2 milligrams IV or IO repeat every 3 to 5 minutes as needed to decrease symptoms

Indication 2: organophosphate poisoning.

dosages 2: 1 -2 milligrams IV or IO repeat every 3 to 5 minutes as needed to decrease symptoms

Front 6

Calcium chloride: indications dosages and contraindications

Back 6

Indication 1: hyperkalemia in cardiac arrest.

dosages 1: 500 milligrams IV or IO slowly may repeat in 5 to 10 minutes.

indication 2: hyperkalemia / crush injury

Dosages:1 gram IV or IO slowly over 60 seconds.

indication 3: hydrofluoric acid toxicity.

dosages: 500 milligrams IV or iOS slowly.

Contraindications: use cautiously in all patients on digitalis avoid rapid administration which can cause cardiac arrest.

Front 7

Dextrose 10%: indications dosages and contraindications

Back 7

Indication: hypoglycemia.

dosages: 10 grams initially in 100 milliliters if glucose remains below 60 give an additional 15 grams in a hundred and fifty milliliters.

Front 8

Benadryl: indications dosages and contraindications.

Back 8

Indication 1: allergy / hives - itching.

Indication 2: dystonic reaction.

Dosages: 25 to 50 milligrams IV or I

Consider lower dosage if taken prior

Front 9

Epinephrine 1: 10000: indications dosages and contraindications

Back 9

Indication 1 : cardiac arrest

Dosage: 1mg IV or IO.

Indication 2 : anaphylaxis

Dosage : 0.1mg IV max prn dosage is 0.5mg

Only use if IM epi fails.

Front 10

Epinephrine 1: 1000: indications dosages and contraindications.

Back 10

Indication 1: allergic reactions / anaphylactic shock

dosage: 0.3-0.5 milligrams IM use lower dose in smaller or older patients

Indication 2: Asthma.

Dosage: 0. 3 milligrams SC

Indication 3: respiratory arrest secondary to asthma or bronchospasm dosage: 0.3 milligrams IM

Front 11

Fentanyl: indications dosages and contraindications

Back 11

Indication 1: Pain control

Dosage: 50mcg-200mcg IV

Consider 25mcg in young or elderly.

100mcg IN

50-100mcg IM

Indication 2: Sedation

Dosage: 25mcg-100mcg IV 25-50mcg increments

Front 12

Glucagon : Indications, doseages, contraindications

Back 12

Indication: hypoglycemia

Doseage: 1mg IM

Contraindications: Hypersensitivity

Front 13

Lidocaine: Indications, doseages, contraindications.

Back 13

Indication: IO Anesthetic

Dose: 40mg IO repeat dose 20 mg

Administer over 20 minutes

Front 14

Midazolam: Indication, dose, contraindications.

Back 14

Indication 1: seizure/ status epilepsy

Dose: 1-5mg IV in 1-2 mg incriments.

0.1mg/kg IM max of 5

Indication 2 : Sedation

Dosage : 1-5mg IV 1-2mg increments for cardioversion or paceing

2-5 mg IV in 2 mg increments for intubated pts.

5mg IM or 1-3mg IV in 1 mg increments for behavior emergencies.

Front 15

Naloxone: indications dosages and contraindications

Back 15

Indication: respiratory depression suspected narcotics OD.

Dose: 1-2mg IV / 2mg IN

Dilute 1:10 for chronic or terminal pain pts.

Front 16

Nitroglycerin: Indications dosages and contraindications

Back 16

Indication 1 : chest pain non-stemi

Doseage : .4mg sublingual max 3 doses

Indication 2: pulmonary edema

Doseages :

If systolic bp less the 150 0.4mg sl

If systolic bp greater then 150 0.8mg sl

Max dose 4.8mg

Contraindications: systolic bp less then 90.

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Front 17

Ondansetron: Indications dosages and contraindications

Back 17

Indication : vomiting / severe nausea

Doseages :

4mg po iv or im may repeat x2 10 mins prn

Front 18

Sodium bicarbonate : Indications dosages and contraindications

Back 18

Indication: cardiac arrest

Dose: 1meq/ kg

Indication: TCA overdose (effecting hemodynamic stability)

Dose: 1meq/kg

Indication : crush injury / hyperkalemia

Dose : 1meq/ kg + 1meq/kg with 1 liter in separate iv