Acetaminophen MEDICATION REFERENCE CARD

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Acetaminophen MEDICATION REFERENCE CARD NAPA COUNTY EMS AGENCY Acetaminophen MEDICATION REFERENCE CARD • Adults with: • Mild to moderate pain unresponsive to BLS control measures. • Severe pain as an adjunct to Fentanyl INDICATION - • Age < 15 years old. • Known hypersensitivity to acetaminophen CONTRA • Severe hepatic impairment or severe active liver disease INDICATION • • Insomnia Nausea • • Constipation Vomiting SIDE EFFECTS • • Pruritus Headache • 1000 mg in 100 mL NS IV drip over 20 minutes DOSE • ADULT 100mL/20 min 10 gtts/mL set = 50 gtts/min = 1 Drip/1.2 sec ATRIC ***NOT LOCALLY INDICATED FOR PEDIATRIC PATIENTS*** PEDI • Patients with hepatic impairment/disease • Patients with severe hypovolemia • Patients with alcoholism • Patients with severe renal impairment CAUTION • Patients with chronic malnutrition • The precise mechanism of the analgesic and antipyretic properties of acetaminophen is not established but is thought to primarily involve central actions. ACTIONS • AP-13: Pain Management GUIDELINE Effective Date: 07-01-2018 Revised Date: 07-01-2018 Page 1 of 1 NAPA COUNTY EMS AGENCY Adenosine MEDICATION REFERENCE CARD • Narrow Complex Tachycardia • PSVT Including PSVT associated with WPW (Wolff-Parkinson-White syndrome). INDICATION • - 2nd- or 3rd-degree atrioventricular (AV) block • A-Fib, A-Flutter, Wide-Complex Tachycardia • Sick Sinus Syndrome • Stimulant induced tachycardia CONTRA INDICATION • Poisoning induced Tach • Chest pressure • Arrhythmias • • Nausea Facial flushing SIDE • Conduction delay (asystole) for several • Bronchospasm EFFECTS seconds C-06: Supraventricular Tachycardia • Initial: 6mg rapid IV bolus over 1-2 sec • Repeat Administration: If not converted to sinus rhythm w/in 1-2 min, give 12 mg rapid IV DOSE ADULT bolus; may give second 12mg dose if required • Follow each bolus w/ a rapid saline flush • See Pediatric Medication Reference Cards PEDIATRIC • May produce short-lasting 1st-, 2nd-, or • D/C if severe respiratory difficulties 3rd-degree heart block; institute develop. appropriate therapy PRN. • Caution in elderly. • Do not give additional doses if high-level • Does not convert A-fib/flutter, or block develops on 1st dose. ventricular tachycardia to normal sinus • Caution w/ obstructive lung disease not rhythm. CAUTION associated w/ bronchoconstriction (e.g., • A transient modest slowing of ventricular emphysema, bronchitis). response may occur immediately • Caution w/ bronchoconstriction/ following administration in the presence of bronchospasm (e.g., asthma). A-fib/flutter. • Endogenous nucleoside; slows conduction time through AV node, can interrupt reentry pathways through the AV node, and can restore normal sinus rhythm in patients with PSVT, including PSVT associated w/ Wolff-Parkinson-White syndrome. ACTIONS • C-06: Supraventricular Tachycardia • P-06: Pediatric Symptomatic Tachycardia GUIDELINE Effective Date: 01-01-2018 Revised Date: 01-01-2018 Page 1 of 1 NAPA COUNTY EMS AGENCY Albuterol MEDICATION REFERENCE CARD • Relief of bronchospasm in patients w/ reversible obstructive airway disease and acute attacks of bronchospasm (i.e., chronic obstructive pulmonary disease, asthma, and allergic reaction). • Suspected hyperkalemia in crush injury patients. INDICATION - • Patients complaining of cardiac chest pain • Known Hypokalemia CONTRA INDICATION • Tremors • Nausea • Dizziness • Headache SIDE • • Nervousness Insomnia EFFECTS M-03: Respiratory Distress - Bronchospasm M-07: Allergic Reaction/Anaphylaxis • 5mg in 6 mL of NS. Can be administered • 5mg in 6 mL of NS. Can be administered via handheld nebulizer, mask, or in-line with via handheld nebulizer, mask, or in-line BVM or CPAP. with BVM or CPAP. M-04: Respiratory Distress - Pulmonary T-04: Crush Syndrome DOSE ADULT Edema/Congestive Heart Failure • 5mg in 6 mL of NS. Can be administered • 5mg in 6 mL of NS. Can be administered via handheld nebulizer, mask, or in-line via handheld nebulizer, mask, or in-line with with BVM or CPAP. BVM or CPAP. • See Pediatric Medication Reference Cards PEDIATRIC • Caution w/ cardiovascular (CV) disorders (especially coronary insufficiency, cardiac arrhythmias, and HTN). CAUTION S • Acts on Beta-2 receptors to potentiate bronchial dilation and bronchial smooth muscle relaxation. It has minimal Alpha and Beta-1 stimulation and also acts as a CNS stimulant. It shifts potassium intracellularly to reduce serum levels. ACTION • M-03: Respiratory Distress – • M-07: Allergic Reaction/Anaphylaxis Bronchospasm • T-04: Crush Syndrome • M-04: Respiratory Distress - Pulmonary • P-07: Pediatric Allergic Reaction/ Edema/Congestive Heart Failure GUIDELINE Anaphylaxis Effective Date: 01-01-2018 Revised Date: 01-01-2018 Page 1 of 1 NAPA COUNTY EMS AGENCY Amiodarone MEDICATION REFERENCE CARD • Ventricular Fibrillation • Ventricular Tachycardia INDICATION - • Cardiogenic shock, marked sinus bradycardia, 2nd- or 3rd-degree atrioventricular (AV) block unless a functioning pacemaker is available. CONTRA INDICATION • Hypotension • Liver function abnormality • asystole/cardiac arrest/pulseless electrical • nausea activity SIDE • Ventricular Tachycardia • cardiogenic shock EFFECTS • AV block • CHF C-03: Ventricular Fibrillation/Pulseless Ventricular C-05: Wide-Complex Tachycardia Tachycardia • Add 150mg to 100 mL of NS and infuse • total contents over 10 minutes 300mg IV/IO, followed by a 20 mL NS flush DOSE ADULT • Repeat once at 150 mg IV/IO, followed by a 20 mL NS flush. • See Pediatric Medication Reference Cards • See Pediatric Cardiac Arrest Dosing Reference Cards PEDIATRIC • Monitor for hypotension, bradycardia, AV block, hepatic injury, centrolobular confluent hepatocellular necrosis, worsening of existing or precipitation of new arrhythmia, pulmonary toxicity, ARDS, anaphylactic/anaphylactoid reactions, and other adverse reactions. • May prolong QT intervals so do not use with Procainamide. Watch for negative inotropic CAUTION effects. • Decreases AV conduction velocity and sinus node function and also includes alpha and beta adrenergic blocking properties. It also prolongs the effective refractory period. ACTIONS • C-03: Ventricular Fibrillation/Pulseless • P-03: Pediatric Ventricular Fibrillation/ Ventricular Tachycardia Pulseless Ventricular Tachycardia • C-05: Wide-Complex Tachycardia • P-06: Pediatric Symptomatic Tachycardia GUIDELINE Effective Date: 01-01-2018 Revised Date: 01-01-2018 Page 1 of 1 NAPA COUNTY EMS AGENCY Aspirin MEDICATION REFERENCE CARD • Chest pain with suspected ACS • Acute pulmonary edema with suspected ACS INDICATION - • Active GI bleeding. • Children < 12 years old • Hemorrhagic Stroke CONTRA • Hypersensitivity to this drug or non-steroidal anti-inflammatory. INDICATION • Tinnitus – (only in overdoses) • Vomiting • Stomach irritation • Petechiae (with chronic use) SIDE • • Nausea GI Bleeding EFFECTS M-04: Respiratory Distress – Pulmonary C-09: Suspected Acute Coronary Syndrome Edema/Congestive Heart Failure • 162 mg or two 81 mg tablets PO (one • 162 mg or two 81 mg tablets PO (one time dose). DOSE ADULT time dose). • Have patient chew if possible. • Have patient chew if possible. ***NOT LOCALLY INDICATED FOR PEDIATRIC PATIENTS*** PEDIATRIC • May potentiate with Coumadin or other blood thinners. Acceptable to give one time dose • Use with caution in patients with pregnancy, asthma or recent surgery. AUTION C • Reduces the loss of myocardium in MI. • Inhibits prostaglandin synthesis for anti-inflammatory effect. • Aspirin blocks the formation of Thromboxane A2, which causes platelets to aggregate. ACTIONS • Aspirin blocks pain impulses in the CNS. • C-09: Suspected Acute Coronary Syndrome • M-04: Respiratory Distress – Pulmonary Edema/Congestive Heart Failure GUIDELINE Effective Date: 01-01-2018 Revised Date: 01-01-2018 Page 1 of 1 NAPA COUNTY EMS AGENCY Atropine Sulfate MEDICATION REFERENCE CARD • Symptomatic bradycardia • Poisoning/Overdose from organophosphates or carbonates INDICATION - • Tachycardia • Hypersensitivity • Narrow-angle glaucoma CONTRA INDICATION • Tachycardia • Dry mouth SIDE • Blurred vision EFFECTS • Photophobia C-04: Symptomatic Bradycardia M-09: Poisoning/Overdose • 0.5 mg IV/IO. Repeat every five (5) • 2.0 mg IV/IO. If not tachycardia or pupil minutes to a total dose of 3mg. dilation, repeat 2.0mg IV until signs of DOSE ADULT atropinization appear (dilated pupils, mild tachycardia). • See Pediatric Medication Reference Cards PEDIATRIC • Elderly: Start at lower end of dosing range. CAUTION • Anticholinergic; inhibits muscarinic actions of acetylcholine on structures innervated by postganglionic cholinergic nerves, and on smooth muscles, which respond to endogenous acetylcholine but are not so innervated. Major action is by competitive or surmountable ACTIONS antagonism. • C-04: Symptomatic Bradycardia • M-09: Poisoning/Overdose • P-05: Pediatric Symptomatic Bradycardia GUIDELINE Effective Date: 01-01-2018 Revised Date: 01-01-2018 Page 1 of 1 NAPA COUNTY EMS AGENCY Calcium Chloride MEDICATION REFERENCE CARD • Cardiac arrest when hyperkalemia is suspected in renal dialysis patients. • Suspected hyperkalemia in crush injury patients. INDICATION - • History of digitalis use, unless in the setting of cardiac arrest. • Respiratory failure • Hypercalcemia CONTRA INDICATION • Peripheral vasodilation SIDE • Localized “burning” sensation EFFECTS C-02: Asystole/Pulseless Electrical Activity T-04: Crush Syndrome • IV/IO slow IVP 1G of 10% calcium • 1 gm slow IVP over 60 seconds chloride DOSE ADULT ***Physician Order Only*** ***NOT LOCALLY INDICATED FOR PEDIATRIC PATIENTS*** PEDIATRIC • Necrotic to tissue, avoid
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