Nh Medications

Front 1

NH

Acetaminophen (Tylenol)

Back 1

Fever - 500-1000mg

Musculoskeletal injuries 325-650mg every 6 hours as needed

Max 3000mg/24 hr

Front 2

NH

Activated Charcoal

Back 2

Poisoning/Substance abuse/OD - 25-50G PO if advised by Poison Control or Medical Control

Front 3

NH

Adenosine (Adenocard)

Back 3

Tachycardia -6mg rapid IV push. Repeat 12mg every 1-2 min twice if no conversion.

Front 4

NH

Albuterol

Back 4

Allergic reaction/Anaphylaxis - 2.5mg nebulizer. repeat ever 5 minutes.

Max 4 doses.

Asthma/COPD/RAD - DuoNeb with Ipatropium.

Max 4 doses then 2.5mg albuterol every 5 min as needed.

4-6 puffs of MDI every 5 min as needed.

Front 5

NH

Amiodarone (Cordarone)

Back 5

Cardiac Arrest:V-Fib/Pulseless V-Tach - 300mg IV push. Repeat of 150mg IV push for a recurrent episode

Wide Complex Tachycardia - 150mg in 50-100 ml normal saline or D5W over 10 min. Repeat once in 10 minutes. If successful consider maintenance infusion of 1mg/min

Contraindated if iodine allergy

Front 6

NH

Atropine

Back 6

Bradycardia - 0.5mg IV every 3-5 min

Max 3mg

Organophosphate poisoning/Nerve Agent - 2mg IM/IV every 5 min until secretions clear

Rapid Sequence Intubation - consider 0.5mg IV for bradycardia

Front 7

NH

Calcium Chloride 10% solution

Back 7

Bradycardia - for suspected hyperkalemia with ECG changes or symptomatic calcium channel blocker overdose consider 1G IV/IO over 5 min. Ensure IV patency and not to exceed 1ml/min

Avoid if on Digoxin

Front 8

NH

Calcium Gluconate

Back 8

Bradycardia - for suspected hyperkalemia with ECG changes or symptomatic calcium channel blocker overdose consider 2G IV/IO over 5 min with constant cardiac monitoring.

Front 9

NH

Dexamethasone

Back 9

Asthma - Adult - 10mg IV

Asthma/Croup - Pediatric - 0.6mg/kg PO/IM/IV

Front 10

NH

Dextrose

Back 10

Diabetic Emergencies - Dextrose 10% IV until mental status returns to baseline and glucose level is >70 or to a

Max of 25G dextrose.

Front 11

NH

Diazepam (Valium)

Back 11

Bradycardia/Hyperthermia/Tachycardia/Traumatic Brain Injury - 2mg IV, may repeat once in 5 min

CPAP - 5mg IV then 2.5 every 5 to a total of 20 for anxiety.

Nerve Agent - 5mg IV every 5 min or 10mg IM or auto-injector every 10 minutes as needed.

Poisoning/Substance abuse/OD - 2mg IV may repeat once in 5 min or 5mg IM may repeat once in 20 min

Seizure - 5-10 IV then 2.5mg every 5 min to max of 20mg

Restraints - 2mg IV repeat once in 5 min or 5 mg IM repeat once in 10 min

Front 12

NH

Diltiazem (Cardizem)

Back 12

Narrow Complex Tachycardia - 0.25mg/kg IV may repeat in 15 min at 0.35mg/kg if necessary.

Max of 20mg each dose

Consider maintenance infusion 5-15mg/hr

Front 13

NH

Diphenhydramine (Benadryl)

Back 13

Allergic reaction/Anaphylaxis- 25-50mg IM/IV or PO

Behavioral - 25-50mg IV or 50mg IM

Nausea/Vomiting, Poisoning/Substance Abuse/OD, Restraints - 25-50MG IV/IM

Motion sickness 25mg PO chewed

Front 14

NH

Dolasetron (Anzemet)

Back 14

Nausea/Vomiting - 12.5mg IV one time dose.

Front 15

NH

Dopamine

Back 15

Bradycardia - 2-10mcg/kg/min

Therapeutic Hypothermia - 5-20mcg/kg/min

Post Resuscitation - 5-20mcg/kg/min

Infusion pump required

Front 16

NH

Epinephrine 1:1,000

Back 16

Allergic Reaction/Anaphylaxis - 0.3mg IM repeat every 5 min to total of 3 doses.

Asthma/COPD/RAD - 0.3mg IM single dose only

Septic Shock 2-10 mcg/min (1mg in 1000ml or NS = 1mcg/ml or in 250ml = 4mcg/ml)

Front 17

NH

Epinephrine 1:10,000

Back 17

Cardiac Arrest - 1mg IV every 3-5 min

Therapeutic Hypothermia - 2-10mcg/min titrated to effect

Front 18

NH

Etomidate (Amidate)

Back 18

Rapid Sequence Intubation - 0.3mg/kg IV/IO

Max 40mg

Front 19

NH

Fentanyl (Sublimaze)

Back 19

Acute Coronary Syndrome - 25-100 mcg slow IV push

Pain - 25-100 mcg slow IV push or 50-100 mcg IM/IN Repeat every 5 min to a

Max 300mcg IV/IM

Post Intubation - 50-100mcg slow IV push

Avoid is BP <100

Front 20

NH

Glucagon

Back 20

Hypoglycemia - 1mg IM. Recheck glucose in 15 minutes. May repeat dose once if glucose is <70 with continued altered mental status

Bradycardia - 5mg IV over 3-5 minutes

Front 21

NH

Granisetron (Kytril)

Back 21

Nausea/Vomiting - 0.1-1mg IV over 5 min one time dose

Front 22

NH

Haloperidol (Haldol)

Back 22

Restraints - 5-10 mg IM. May repeat once in 5 min.

Max total dose 10mg

Excited Delirium 10mg IM may repeat once in 10 minutes. Contract Medical Control if more than 20 mg is needed.

Front 23

NH

Heparin

Back 23

Acute Coronary Syndrome - 5000u IV bolus

Front 24

NH

Hydrocortisone (Solu-Cortef)

Back 24

Adrenal Insufficiency - 100mg IV/IM

Front 25

NH

Hydromorphone

Back 25

Pain - Adult - 0.5-1mg IV every 10 min to a

Max 4mg

Front 26

NH

Ibuprofen (Motrin)

Back 26

Fever - 400-800mg Oral or rectal. if taken in past 6 hours consider acetaminophen.

Fever - Extended Care - May repeat dose 400-600mg every 6 hours or 800mg every 8 hours

Musculoskeletal - 400-600mg PO every 6 hours as needed

Max 2,400mg/24hrs

Avoid in pregnant pt's

Front 27

NH

Ipratropium Bromide (Atrovent)

Back 27

Asthma/COPD/RAD - 0.5mg as DuoNeb with 2.5mg Albuterol. Repeat every 5 min to

Max 3 doses.

Front 28

NH

Ketamine

Back 28

Rapid Sequence Intubation - 2mg/kg IV

Front 29

NH

Ketorolac (Toradol)

Back 29

Pain Management - 15-30mg IV or 30-60mg IM

One time dose.

Avoid in pregnant pt's, pt's taking anticoagulants such as Coumadin, renal insufficiency, ASA allergy, or known peptic ulcer disease

Front 30

NH

Levalbuterol (Xopenex)

Back 30

Asthma/COPD/RAD - 1.25mg nebulizer every 20 min

Max 4 doses.

Front 31

NH

Lidocaine

Back 31

Cardiac Arrest - 1-1.5mg/kg IV. Repeat of 0.75mg/kg up to a

Max of 3mg/kg

Tachycardia - 1-1.5mg/kg IV (2nd line to amiodorone) repeat once in 5 min to max of 3mg/kg. If successful consider maintenance infusion of 1-4mg/min

Traumatic Brain Injury - 1.5mg/kg prior to intubation

Nasotracheal Intubation - 2% lidocaine jelly

Rapid Sequence Intubation - 1.5mg/kg

Intraosseous - 1-2.5ml (20-50mg) 2% lidocaine

Front 32

NH

Lorazepam (Ativan)

Back 32

Bradycardia, Hyperthermia, Nerve Agent, Poisoning/Substance Abuse/OD, restraints, Tachycardia, Traumatic Brain Injury - 1mg IV, may repeat once in 5 min or 2mg IM, may repeat once in 10 min

CPAP - 0.5-1mg IV, may repeat once in 5 min or 1-2 mg IM, may repeat in 10 min

Therapeutic Hypothermia, Post Intubation/SGA Care - 1-2mg IV. May repeat every 15 min as needed for shivering or sedation.

Max 10mg

Seizure - 2-4mg IV every 5 min to total of 8mg

Front 33

NH

Magnesium Sulfate

Back 33

Asthma/COPD/RAD - 2G in 100ml IV over 10 min

OB/Seizure - 4G in 100ml over 10 min then consider 1G/hr infusion

Cardiac Arrest/Torsades de Points - 1-2G IV over 5 min.

Front 34

NH

Methylprednisolone (Solu-Medrol)

Back 34

Allergic Reaction, Asthma/COPD/RAD - 125mg IV

Front 35

NH

Metoclopramide (Reglan)

Back 35

Nausea/Vomiting - 5mg IV. may repeat after 10 min if N/V persists

Front 36

NH

Metoprolol (Lopressor)

Back 36

Tachycardia - 5mgIV over 2-5 min. May repeat every 5 min to achieve a ventricular rate of 90-100

Max of 15mg

Front 37

NH

Midazolam (Versed)

Back 37

Bradycardia, Tachycardia, CPAP, Hyperthermia, Nerve Agent, Poisoning/Substance Abuse/OD, Therapeutic Hypothermia, Traumatic Brain Injury - 2.5mg IV/IN may repeat once in 5 min or 5mg IM may repeat once in 10 min.

Post ETT care - 2-5mg IV every 5-10 min as needed

Rapid Sequence Intubation - 0.2mg/kg IV. 0.1mg/kg IV for pt's in shock

Seizure - 10mg IM preferred every 10 min or 5-10mg IV/IN every 5 min.

Restraints - 5mg IM. May repeat once in 20 min or 2.5mg IV/IN may repeat once in 5 min.

Excited/agitated Delirium 5mg IV/IM/IN may repeat once in 10 min

Front 38

NH

Morphine Sulfate

Back 38

Pain - 2-5mg IV/IM every 10 min to a max of 20mg titrated to pain relief and if BP >100

Acute Coronary Syndrome - 2-5mg IV/IM every 5 min to a max of 15mg titrated to pain and BP >100

Front 39

NH

Naloxone (Narcan)

Back 39

Pain Antidote - 0.4mg IV/IM or 2mg IN for hypoventilation from opiate administration by EMS. May repeat every 5 min to a max of 10mg

Poisoning/Substance Abuse/OD - 2mg IN (1mg in each nostril) If no response repeat in 3-5 min or 0.4-2mg IV/IM

Front 40

NH

Nitroglycerine

Back 40

Acute Coronary Syndrome - Pt's own prescription every 3-5 min to a max of 3 doses. Or 0.4 SL every 3-5 min. 10 mcg/min infusion if symptoms persist after 3rd dose of SL (Must be on a pump). Increase infusion 10mcg/min every 5 min while symptoms persist and BP >100. If IV nitro not available consider 1-2 inches of nitro paste transdermal.

Congestive Heart Failure - 0.4mg SL every 5 min while symptoms persist and BP is >140. If still symptomatic and BP >140 IV nitro 5mcg/min, increase 5mcg/min every 3-5 to 20mcg/min (Must be on infusion pump). If no response may increase by 10-20 mcg/min every 3-5 min. Max dose 400 mcg/min

Nitro past 1-2" transdermal

Front 41

NH

Nitrous Oxide

Back 41

Pain - Self administered by the pt as needed.

Front 42

NH

Norepinephrine (Levophed)

Back 42

Bradycardia, Therpeutic Hypothermia, Post resuscitation care, Septic Shock - infusion 1-30 mcg/min

Dilute 4mg in 1000mL for 4mcg/ml)

Must use infusion pump

Front 43

NH

Ondansetron (Zofran)

Back 43

Nausea/Vomiting - 4mg PO/IV

Front 44

NH

Oxytocin (Pitocin)

Back 44

Obstetrical - 10 units IM after placental delivery

Front 45

NH

Phenylephrine (Neo-Synephrine)

Back 45

Therapeutic Hypothermia, Post Resuscitative Care - 100-180 mcg loading dose followed by infusion 40-60 mcg/min

Pump Required

Front 46

NH

Pralidoxime (2-Pam)

Back 46

Nerve Agent - 1-2G over 30-60 min. Medical control infusion up to 500mg/hr

Max 12G/day

Front 47

NH

Prochlorperazine (Compazine)

Back 47

Nausea/Vomiting - 5-10mg IV or 5mg IM

Front 48

NH

Proparacaine (Alcaine)

Back 48

Eye & Dental - 2 Drops to affected eye. Repeat every 5 min as needed.

Front 49

NH

Rocuronium

Back 49

Therapeutic Hypothermia & Rapid Sequence Intibation - 1mg/kg

Front 50

NH

Sodium Bicarbonate

Back 50

Poisoning/Substance Abuse/OD, Tricyclic with symptomatic dysrhythmias and Cardiac Arrest - 2mEq/kg IV

Front 51

NH

Succinylcholine Paralytic Agent

Back 51

Rapid Sequence Intubation - 1.5mg/kg IV immediately after sedation.

Max 150mg

Front 52

NH

Sucrose

Back 52

Pain - Pediatric - Full term infants-60 days old slowly administer 1.5-2ml of 24% solution directly to infants anterior, tongue over a period of 2 minutes and may repeat once. Provide a pacifier for non-nutritive sucking and wait two minutes for onset. Pain control effects persist up to 8 mins

Preterm infants same administration using 0.1-1ml. May repeat dose once.

Front 53

NH

Tetracaine

Back 53

Eye & Dental - 2 drop affected eye, repeat every 5 minutes as needed

Front 54

NH

Vasopressin (Pitressin)

Back 54

Cardiac Arrest - 40 Units IV/IO, may replace Epinephrine as first or second dose

Front 55

NH

Vecuronium Paralytic Agent

Back 55

Therpeutic Hypothermia & Rapid Sequence Intubation - 0.1mg/kg IV