Statewide Protocols
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| Adenosine (Adenocard) | show 🗑
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| Adenosine (Adenocard) Dosing | show 🗑
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| Albuterol - Beta Agonist | show 🗑
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| Albuterol - Beta Agonist Dosing | show 🗑
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| show | Indications/Contraindications
-Antiarrhythmic used mainly in wide complex tachycardia and ventricular fibrillation
-Avoid in patients with heart block or profound bradycardia
-Contra: in pts with iodine hypersensitivity
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| Amiodarone (Cordarone) Dosing | show 🗑
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| Aspirin | show 🗑
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| Aspirin Dosing | show 🗑
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| show | Indications:
-Anticholinergic drug used in bradycardia and organophosphate poisonings
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| Atropine Dosing | show 🗑
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| show | Indications:
Antidote for nerve agents or organophosphate overdose
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| show | Nerve agents:
-Pts experiencing: apnea, convulsions, unconsciousness, flaccid paralysis administer 3 DuoDote and 1 Atropine (10mg) auto injectors
-Pts experiencing: dyspnea, twitching, nausea, vomiting, sweating, anxiety, confusion, constricted pupils, restlessness, weakness administer 1 DuoDote
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| Calcium Chloride 10% solution | show 🗑
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| Calcium Chloride 10% solution Dosing | show 🗑
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| Cyanide Antidote Kit (Amyl Nitrite, Sodium Nitrite and Sodium Thiosulfate) | show 🗑
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| Cyanide Antidote Kit (Amyl Nitrite, Sodium Nitrite and Sodium Thiosulfate) Dosing | show 🗑
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| show | Indications:
Antidote for Cyanide Poisoning
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| show | Poisoning:
5gm IV/IO over 15 mins
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| show | Indications:
Symptomatic hypoglycemia
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| show | Diabetic Emergencies:
- 12.5g to 25g IV/IO
Name Concentration Volume (25g)
D50 0.5g/mL. 25g/50mL
D25. 0.25g/mL. 25g/100mL
D10. 0.1g/mL. 25g/250mL
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| show | Indications:
-Seizure control
-Sedation
-Anti-anxiety (anxiolytic)
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| show | Sedation for Electrical Therapy
- 2.5-5mg IV/IO/IM/IN/PR
Nerve Agent
-10mg IV/IN/IO/IM/PR. OR
- 10mg IM via auto-injector
Seizure/Poisoning/Substance abuse/OD
-5-10mg IV/IO/IM/PR
Induced Therapeutic Hypothermia
- 5-10mg IV/IO/IM/PR (for shivering)
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| show | Indications/Contraindications:
-Calcium channel blocker used to treat narrow complex SVT
-Contra: in pts with heart block, ventricular tachycardia, WPW and/or acute MI
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| show | Tachycardia- Narrow Complex Tachycardia:
0.25 mg/kg slow IV/IO push; may repeat dose in 15 mins at 0.35mg/kg if necessary
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| Diphenhydramine (Benadryl) | show 🗑
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| show | Allergic Reaction/Anaphylaxis:
25-50 mg IV/IO/IM
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| Dopamine | show 🗑
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| show | Bradycardia, Post-Resuscitation and Shock
- Infusion 2-20 mcg/kg/min IV/IO
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| Epinephrine 1:1,000 (Auto-Injector ONLY) | show 🗑
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| Epinephrine 1:1,000 (Auto-Injector ONLY) Dosing | show 🗑
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| show | Indications:
Vasopressor Post-Resuscitation, Bradycardia, allergic reaction
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| Epinephrine 1:1,000 (by Infusion ONLY) Dosing | show 🗑
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| Epinephrine 1:10,000 | show 🗑
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| Epinephrine 1:10,000 Dosing | show 🗑
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| Epinephrine (Racemic, for inhalation) | show 🗑
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| Epinephrine (Racemic, for inhalation) Dosing | show 🗑
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| Fentanyl (Sublimaze) | show 🗑
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| Fentanyl (Sublimaze) Dosing | show 🗑
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| show | Indications:
CHF, Pulmonary Edema, Hypertensive Emergencies, Toxicology
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| show | CHF, Pulmonary Edema
20-40mg IV/IO
Hypertensive Emergencies
0.5-1mg/kg IV/IO
Toxicology
40mg IV/IO
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| Glucagon | show 🗑
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| show | Amlodipine (Norvasc)
Diltiazem (Cardizem, Tiazac,)
Felodipine.
Isradipine.
Nicardipine.
Nifedipine (Adalat CC, Afeditab CR, Procardia)
Nisoldipine (Sular)
Verapamil (Calan, Verelan)
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| show | acebutolol (Sectral)
atenolol (Tenormin)
betaxolol (Kerlone)
betaxolol (Betoptic S)
bisoprolol fumarate (Zebeta)
carvedilol (Coreg)
esmolol (Brevibloc)
labetalol (Trandate [Normodyne - discontinued])
metoprolol (Lopressor, Toprol XL)
nadolol (Corgard)
nebivolol (Bystolic)
penbutolol (Levatol)
propranolol (Hemangeol, Inderal LA, Inderal XL, InnoPran XL)
sotalol (Betapace, Sorine)
timolol
timolol ophthalmic solution (Timoptic, Betimol, Istalol)
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| show | Diabetic Emergencies
1mg IV/IO/IM/IN/SC
Beta Blocker/Calcium Channel Blocker Overdose
1-5mg IV/IO/IM/IN/SC
Bradycardia
1-5mg IV/IO/IM/IN/SC
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| show | Indications:
Use in conscious hypoglycemic patients
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| show | Diabetic Emergencies
Administer 1-2 tubes of commercially prepared glucose gel or equivalent
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| Haloperidol (Haldol) Phenothiazine Preparation | show 🗑
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| Haloperidol (Haldol) Phenothiazine Preparation Dosing | show 🗑
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| show | Indications/Contra
-Adrenal Insufficiency/Crisis
-Other inflammatory processes (COPD/Asthma)
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| show | Adrenal Insufficiency/Crisis
100mg IV/IO/IM
Respiratory Distress (COPD/Asthma)
100mg IV/IO/IM
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| Ipratropium Bromide (Atrovent) | show 🗑
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| Ipratropium Bromide (Atrovent) Dosing | show 🗑
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| show | Indications:
Agitated patient
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| Ketamine Dosing | show 🗑
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| Lidocaine | show 🗑
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| show | Cardiac Arrest: 1-1.5mg/kg IV/IO; repeat dose 0.75mg/kg up to max 3mg/kg follow by 2-4mg/min maint. infusion
V. Tachycardia c pulses: 1-1.5mg.kg IV/IO (consider 2nd therapy to amiodarone) repeat dose of 0.5-0.75mg/kg every 3-5 mins - total of 3 mg/kg follow by 2-4 mg/min maint. infusion
Post-Resus.: 1-1.5mg/kg IV/IO follow by 2-4mg/min maint infus
Nasotracheal intub.: 2% lidocaine jelly
Intraosseous: 40mg 2% lidocaine slow bolus over 2 mins follow 10mL normal saline flush, then use IO access for meds
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| show | Indications:
Seizure control
Sedation
Anti-anxiety (anxiolytic)
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| show | Used to reduce anxiety
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| show | Behavioral:
2-4mg IV/IO/IM
Nerve Agent/Seizures
2-4mg slow IV/IO/IM
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| Magnesium Sulfate | show 🗑
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| Magnesium Sulfate Dosing | show 🗑
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| show | Indications:
Steroid used in respiratory distress to reverse inflammatory and allergic reactions
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| Methylprednisolone (Solu-Medrol) Dosing | show 🗑
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| show | Rate control for adult patients who are already prescribed a beta blocker
NOTE: do not use IV Beta Blockers with IV Calcium channel blockers
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| Metoprolol (Lopressor) Dosing | show 🗑
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| MIdalozam (Versed) Benzodiazepine | show 🗑
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| MIdalozam (Versed) Benzodiazepine Dosing | show 🗑
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| Morphine Sulfate | show 🗑
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| show | Pain
0.1mg/kg every 5 mins IV/IO/IM/SC up to 10mg max
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| Naloxone (Narcan) Opioid Antagonist | show 🗑
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| Naloxone (Narcan) Opioid Antagonist Dosing | show 🗑
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| Nitroglycerin | show 🗑
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| show | Cardiac conditions/Hypertensive emergencies
-0.4mg SL tabs or 1 spray every 3-5 mins while symptoms persist and if systolic BP remains > 120mmHg
-1 inch paste to chest wall, transdermal
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| Norepinephrine (Levophed) | show 🗑
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| show | Hypotension
0.1mcg/kg/min IV/IO titrate to goal SBP of 90mmHg - generally to a max dose of 30 mcg/min
- 4 mg mixed in 250mL of D5 diluent packaged with medication; max dose: generally to a max dose
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| show | 4 epis and 1 nor
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| Ondansetron (Zofran) Anti-emetic | show 🗑
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| Ondansetron (Zofran) Anti-emetic Dosing | show 🗑
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| Oxygen | show 🗑
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| Oxygen Dosing | show 🗑
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| show | -Antidote for nerve agents or organophosphate overdose
-administered as part of Mark I kit
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| show | Nerve Agent/Organophosphate Poisoning
600mg via Auto-Injector IM per kit, 1-3 kits
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| Sodium Bicarbonate | show 🗑
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| show | Poisoning/Substance Abuse/OD/Toxicology
0.5 - 1 mEq/kg IV/IO
Cardiac Arrest/Known Hyperkalemia/Acidosis/TCA Overdose
1 mEq/kg IV/IO
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| show | Organophosphate are used as insecticides, medications, and nerve agents. Symptoms include increased saliva and tear production, diarrhea, vomiting, small pupils, sweating, muscle tremors, and confusion.
Carbamate poisoning can present similarly.
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| What is a tricyclic overdose? | show 🗑
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| show | Potassium level in your blood that's higher than normal. Potassium is a nutrient that is critical to the function of nerve and muscle cells, including those in your heart. Your blood potassium level is normally 3.6 to 5.2 millimoles per liter (mmol/L).
Symptoms: asymptomatic, nausea,fatigue,muscle weakness, tingling sensations, slow heartbeat or weak pulse
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| Tetracaine 0.5% | show 🗑
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| Tetracaine 0.5% Dosing | show 🗑
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| Vasopressin | show 🗑
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| show | Cardiac Arrest; Asystole, Pulseless Electrical Activity, Ventricular Fibrillation, Ventricular Tachycardia (without pulses)
40 units IV/IO in place of first or second dose of epinephrine
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