EMT cards

Aspirin (Bayer, Ecotrin)

Mechanism of Action: Anti-platelet aggregate that inhibits cyclooxygenase (COX-1 and COX-2), preventing thromboxane A2 formation and reducing blood clot formation. Indications: Suspected acute coronary syndrome, chest pain suggestive of myocardial infarction. Contraindications: Hypersensitivity to aspirin/NSAIDs, active GI bleeding, bleeding disorders, pediatric patients with viral illness. Route of Administration: Oral (chewed). Dosage:

• Adult: $162\,\text{mg}$ to $324\,\text{mg}$ ($2$ to $4$ chewable $81\,\text{mg}$ tablets).
• Pediatric: N/A (not indicated in prehospital setting). Side Effects: Nausea, heartburn, epigastric pain, GI bleeding. Interactions: Anticoagulants and other NSAIDs increase bleeding risk. Administration Concerns: Ensure patient chews tablets prior to swallowing for rapid absorption. Onset of Action: $15$ to $30\,\text{minutes}$.

Albuterol (MDI and Nebulizer) (Proventil, Ventolin)

Mechanism of Action: Selective beta-2 adrenergic agonist that relaxes bronchial smooth muscle and causes bronchodilation. Indications: Bronchospasm associated with asthma, COPD, or anaphylaxis. Contraindications: Hypersensitivity, severe tachycardia, digitalis toxicity. Route of Administration: Inhalation (MDI or Small-Volume Nebulizer). Dosage:

• Adult: $2.5\,\text{mg}$ in $3\,\text{mL}$ normal saline via nebulizer; or $1$ to $2$ puffs via MDI.
• Pediatric: $1.25\,\text{mg}$ to $2.5\,\text{mg}$ in $3\,\text{mL}$ normal saline via nebulizer; or $1$ to $2$ puffs via MDI. Side Effects: Tachycardia, tremors, anxiety, palpitations, hypertension. Interactions: Synergistic with other sympathomimetics; antagonized by beta-blockers. Administration Concerns: Assess heart rate and lung sounds before and after administration. Onset of Action: $5$ to $15\,\text{minutes}$.

Activated Charcoal (Actidose-Aqua)

Mechanism of Action: Adsorbs ingested toxic substances in the GI tract, preventing systemic absorption. Indications: Acute oral poisonings and toxin ingestions (within $1\,\text{hour}$). Contraindications: Altered mental status, inability to maintain airway, ingestion of acids, alkalis, or petroleum distillates. Route of Administration: Oral. Dosage:

• Adult: $1\,\text{g/kg}$ (typically $25$ to $50\,\text{g}$).
• Pediatric: $1\,\text{g/kg}$ (typically $12.5$ to $25\,\text{g}$). Side Effects: Nausea, vomiting, black stools, constipation. Interactions: Inactivates other oral medications given concurrently. Administration Concerns: Shake container vigorously before administration; protect airway against aspiration. Onset of Action: Immediate upon contact with toxin in GI tract.

Oxygen

Mechanism of Action: Increases arterial oxygen tension ($PaO_2$) and improves tissue and cellular oxygenation. Indications: Hypoxia ($SpO_2 < 94\%$), respiratory distress, chest pain, shock, trauma, severe anemia. Contraindications: None in emergency settings. Route of Administration: Inhalation (Nasal Cannula, NRB, BVM). Dosage:

• Adult: $1$ to $6\,\text{L/min}$ (Nasal Cannula), $10$ to $15\,\text{L/min}$ (Non-Rebreather Mask), $15\,\text{L/min}$ (BVM).
• Pediatric: Titrate flow to maintain $SpO_2 \ge 94\%$ ($1$ to $6\,\text{L/min}$ NC, $10$ to $15\,\text{L/min}$ NRB). Side Effects: Dry nasal passages, hyperoxia-induced vasoconstriction. Interactions: Supports combustion. Administration Concerns: Keep away from open flames and sparks; monitor oxygen saturation continuously. Onset of Action: Immediate.

Naloxone (Narcan)

Mechanism of Action: Competitive opioid receptor antagonist that displaces opioids from CNS receptor sites, reversing respiratory and CNS depression. Indications: Suspected or known opioid overdose with respiratory depression ($RR < 10$ breaths/min) and altered mental status. Contraindications: Hypersensitivity to naloxone. Route of Administration: Intranasal (IN), Intramuscular (IM), Subcutaneous (SQ). Dosage:

• Adult: $0.4$ to $2\,\text{mg}$ IN/IM (typically $2\,\text{mg}$ IN divided equally between nostrils).
• Pediatric: $0.1\,\text{mg/kg}$ IN/IM (max $2\,\text{mg}$). Side Effects: Acute opioid withdrawal syndrome (agitation, nausea, vomiting, tachycardia, diaphoresis). Interactions: Rapidly reverses opioid analgesia. Administration Concerns: Titrate dose to restore adequate spontaneous respiration rather than full consciousness; opioid duration may exceed naloxone duration. Onset of Action: $1$ to $2\,\text{minutes}$.

Oral Glucose (Glutose, Insta-Glucose)

Mechanism of Action: Direct absorption of simple carbohydrate to rapidly elevate blood glucose levels. Indications: Hypoglycemia ($BG < 60\,\text{mg/dL}$) in conscious patients with altered mental status. Contraindications: Unconsciousness, inability to swallow, compromised airway. Route of Administration: Buccal / Oral. Dosage:

• Adult: $15$ to $24\,\text{g}$ (typically $1$ tube / $15\,\text{g}$).
• Pediatric: $15\,\text{g}$. Side Effects: Nausea, airway obstruction if aspirated. Interactions: None significant in prehospital emergency setting. Administration Concerns: Ensure patient is awake and able to swallow; place between cheek and gum. Onset of Action: $10$ to $20\,\text{minutes}$.

Nitroglycerin (Nitrostat, Nitro-Bid)

Mechanism of Action: Vascular smooth muscle relaxant and vasodilator that reduces preload, afterload, and myocardial oxygen demand. Indications: Chest pain of cardiac origin (angina, acute myocardial infarction). Contraindications: Systolic BP $< 100\,\text{mmHg}$, severe bradycardia or tachycardia, erectile dysfunction drug use within $24$ to $48\,\text{hours}$, intracranial hemorrhage. Route of Administration: Sublingual (tablet or spray). Dosage:

• Adult: $0.4\,\text{mg}$ SL every $5\,\text{minutes}$ (max $3$ doses).
• Pediatric: N/A (not indicated in prehospital setting). Side Effects: Hypotension, headache, dizziness, flushing, reflex tachycardia. Interactions: Severe, fatal hypotension when combined with PDE-5 inhibitors. Administration Concerns: Reassess blood pressure and pain severity before each dose. Onset of Action: $1$ to $3\,\text{minutes}$.

Epinephrine 1:1000 (Adrenalin)

Mechanism of Action: Non-selective adrenergic agonist causing vasoconstriction ($\alpha_1$), bronchodilation ($\beta_2$), and increased cardiac output ($\beta_1$). Indications: Severe allergic reactions, anaphylaxis, severe acute asthma. Contraindications: None in life-threatening anaphylaxis. Route of Administration: Intramuscular (IM). Dosage:

• Adult: $0.3\,\text{mg}$ IM ($0.3\,\text{mL}$ of $1:1000$ solution).
• Pediatric: $0.15\,\text{mg}$ IM ($0.15\,\text{mL}$ of $1:1000$ solution). Side Effects: Tachycardia, tremors, anxiety, palpitations, hypertension, headache. Interactions: Potentiated by other sympathomimetics. Administration Concerns: Inject into vastus lateralis muscle (outer thigh); monitor vital signs continuously. Onset of Action: $1$ to $5\,\text{minutes}$.

Epi-pen

Mechanism of Action: Auto-injector delivery of epinephrine causing vasoconstriction, bronchodilation, and increased cardiac output. Indications: Severe allergic reactions and anaphylaxis in adult patients. Contraindications: None in life-threatening anaphylaxis. Route of Administration: Intramuscular (IM) auto-injector. Dosage:

• Adult: $0.3\,\text{mg}$ IM auto-injector.
• Pediatric: N/A (will not have a pediatric dose; see Epi-pen Jr). Side Effects: Tachycardia, tremors, anxiety, palpitations, hypertension. Interactions: Potentiated by other sympathomimetics. Administration Concerns: Hold securely against outer thigh for $3$ to $10\,\text{seconds}$; dispose of in sharps container. Onset of Action: $1$ to $3\,\text{minutes}$.

Epi-pen Jr

Mechanism of Action: Pediatric auto-injector delivery of epinephrine causing vasoconstriction, bronchodilation, and increased cardiac output. Indications: Severe allergic reactions and anaphylaxis in pediatric patients weighing $15$ to $30\,\text{kg}$. Contraindications: None in life-threatening anaphylaxis. Route of Administration: Intramuscular (IM) auto-injector. Dosage:

• Adult: N/A (will not have an adult dose; see Epi-pen).
• Pediatric: $0.15\,\text{mg}$ IM auto-injector. Side Effects: Tachycardia, tremors, anxiety, palpitations, hypertension. Interactions: Potentiated by other sympathomimetics. Administration Concerns: Hold securely against outer thigh for $3$ to $10\,\text{seconds}$; massage injection site if advised. Onset of Action: $1$ to $3\,\text{minutes}$.