Medications in Crash Trolley ..in PHC OMAN By Elizabeth Joseph K

35
Emergency Medication UPDATED 2017 ELIZABETH JOSEPH SSN BSN, WATTAYAH

Transcript of Medications in Crash Trolley ..in PHC OMAN By Elizabeth Joseph K

Page 1: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

Emergency Medication

UPDATED 2017

ELIZABETH JOSEPHSSN BSN, WATTAYAH

Page 2: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

ADENOSINE [6MG/2ML]INDICATION DOSE ROUTE MONITOR DILUTION

SVT 1.Atrial fibrillation

2.Paroxysmal supraventricular tachycardia (PSVT)

3.Atrial Flutter & Atrial Tachycardia

6MG THEN 12MG PRN WITHIN 2 TO 4 SECONDS

VERY FAST IV IN 30secs to 1 min DIRECTLY FLUSHED. followed by 20 ml saline push and elevate the canulated arm.

BPECG. : Shortness of breath, light headedness,Facial flushing, palpitations, chest pain, sweating, hypotension and metallic taste in the mouth

NOT REQUIRED

Page 3: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

ECG Variations

6sECG_rdm.exe

Page 4: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

Adenosine Administration

Page 5: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

ATROPINE 0.5MG/ML

INDICATION DOSE ROUTE MONITOR DILUTION

Bradicardia 0.5mg every 3 to 5mins, max 3mg

iv Complete monitoring

Iv line

Page 6: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

ADRENALINE[1MG/ML]INDICATIONS

DOSE ROUTE MONITOR DILUTION

Cardiac arrest

1 mg every 3-5mins

iv Bpecg

1ml+9ml NS

bradycardia 2 to 10 microgram/min

Iv infusion 1ml+500ml saline

Anaphylatic shock ,severe asthma

0.5mg every 15mins

im Not reqd

Croup severe asthma

4mg/5ml nebulizer 4mg +1ml NS

Page 7: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ HALOPERIDOL[5MG/ML]INDICATION DOSE ROUTE MONITOR DILUTION

Agitation due to psychosis or alcoholism

2-5mg IM only Mental status

Not reqd

Page 8: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ DOPAMINE HYDROCHLORIDE 40MG/1ML

indication dose route monitor dilution

Shockbradycardia

2 to 20 microgm/min

Iv infusion BpEcg

5ml+250ml normal saline

Page 9: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

Inj dopamine 120 mcg /min is ordered..how many drops will u set.

What we have?40mg/ml.Dilute 1 amp in 250ml .. Use a pediatric burette ..200mg available in250ml1ml contains 200/250 =800mcg120/800x60 = 9 drops.

Page 10: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ DEXAMETHASONE 4MG/ML

INDICATION DOSE ROUTE MONITOR DILUTION

Croup Asthma attack

0.6mg/kg Single dose

IM Respiratory status

Not reqd

Page 11: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ FRUSEMIDE 20MG/MLIndication Dose Route Monitor Dilution

Cardio pulmonary Oedema

20 -40 mg IMSlow IV 5mg/min

Bp Ecg

Only flush reqd

Page 12: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ MAGNESIUM SULPHATE 50%.[5gmIN 10ml Ampule]

INDICATION DOSE ROUTE MONITOR DILUTION

Eclampsia 20% then 50% every 4 hrs

Slow IV over 10mins, then IM

Tendon refluxesBreathing pattern

IV 10ml diluted in 15ml NS. IM undiluted.

Page 13: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

Calcium Gluconate 10% in 10ml

Indication Dose Route Monitor Dilution

Magnesium antidote to reverse respiratory paralysis

10ml every 10 to 15mins

iv General Through iv line

Page 14: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ NALAXONE 0.4MG/MLINDICATION DOSE ROUTE MONITOR DILUTION

Opiod antidote to reverse repiratory failure

0.4mg every 2min

IVIms/c

Respratory status

Only for iv

Page 15: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ HYDROCORTISONE 100MGINDICATION DOSE ROUTE MONITOR DILUTION

Anaphylatic shockSevere allergyPost asthma attack

5mg/kg body wt.Max dose 400mg

IV General 2 to 3ml water for injection. Flush reqd

Page 16: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ AMIDARONE 150MG/3MLINDICATION DOSE ROUTE MONITOR DILUTION

Any arrhythmia

150mg every 10-15mins

Slow iv in 10mins

BPECG

3ml+100ml D5W

Cardiac arrestVF/VT

300mg then 150mg

Rapid IV 6/3ML +20ML D5W

Page 17: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ PROCYCLIDINE 5MG/MLINDICATION DOSE ROUTE MONITOR DILUTION

Dyskinesia drug induced from ante emetics and antipsychotics

•5 -10mg IV/IM

•<2yrs 0.5 -2mg im/iv

•2-10yrs 2-5mg im/iv

IV/IMPrefered iv

General Not reqd

Page 18: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

DYSKINESIA

Page 19: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

Inj GLUCAGON1mg vialINDICATION DOSE ROUTE MONITOR DILUTION

Hypoglycemia Adult 1mg IM

Pead 0.5mg IM

IM Blood glucose levels

Not reqd

Page 20: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ SYNTOMETRINE 500MG/ML

INDICATION DOSE ROUTE MONITOR DILUTION

To induce labour

Post partum hemorrhage

Single injection

IM on the thigh just after birth

Bleedingvitals

Not reqd

Page 21: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ DEXTROSE 50% IN 20ML AMPULE

INDICATION DOSE ROUTE MONITOR DILUTION

Hypoglycemia insulin induced

20 to 50 ml IV.Very slow

HypoglycemiaAcute kidney injury

Dilute in 1:1 proportion

Alcohol intoxication

Monitor iv line patency ...Infiltration causes irreparable tissue damage

Before and after injecting, 50ml saline push is indicated

Page 22: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

Tab ASPIRIN 300mg chewableINDICATION DOSE ROUTE MONITOR DILUTION

MI 162 to 324 mg

Chewable Gastriits Nil

Page 23: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

GTN 0.5MG [Tab/Spray]INDICATION DOSE ROUTE MONITOR DILUTION

•MI•Cardiopulmonary edema

0.5mg every 5mins. Max 3 doses

S/L Hypotension Nil

Page 24: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K
Page 25: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

Tab Captopril 25 mg INDICATION DOSE ROUTE MONITOR DILUTION

HTN urgency

12.5 to 25mg repeated prn.S/L action in 5-15mins

oral in 15 to 30mins

OralS/L

Hypotension Nil

Page 26: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

Inj MORPHINE 10mg/mlINDICATION DOSE ROUTE MONITOR DILUTION

•Severe pain•MI•CP edema

•4 to 10mg every 4 hrs•SCD 5 to 10mg every 15mins

•IV OR IM •LOC•Breathing pattern

•IM no dilution•IV : 1 ml +9ml NS

Page 27: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ PETHIDINE 50MG/MLINDICATION DOSE ROUTE MONITOR DILUTION

In case of morphine allergy only

50 to 100mg Slow IV or IM •LOC•Breathing pattern

•IM no dilution•IV : 1 ml +9ml NS

Page 28: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

INJ DIAZEPAM 5MG/MLINDICATION DOSE ROUTE MONITOR DILUTION

•Agitation unknown

•Alcohol withdrawal

•Seizures

•Seizures with no IV access

•2 -10mg

•10mg

•5 to 10mg every 15mins

•0.4mg/kg

•Slow IV/IM

•Slow IV/IM

•Slow IV

•Rectally

•Conation •Breathing pattern

•2ml+8ml NS

•Rectally and IM No dilution

Page 29: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K

Rectal Administration

Page 30: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K
Page 31: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K
Page 32: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K
Page 33: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K
Page 34: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K
Page 35: Medications in Crash Trolley ..in PHC  OMAN By Elizabeth Joseph K