Maryland EMT drugs

Acetaminophen

Indications:

Mild to moderate discomfort
Fever >100.4

Acetaminophen

Adverse Effects:

Not clinically significant

Acetaminophen

Precautions:

Does not eliminate the need for transport
Has to be drawn in 3mL, 5mL, or 6mL syringe

Acetaminophen

Contraindications:

Head injury
Hypotension
Administration within 4 hrs
Inability to swallow
Respiratory distress
Persistent vomiting
Allergy
>3mo

Acetaminophen

Dosage:

<3mo no
3mo 1.25mL
4-11mo 2.5mL
12-23mo 3.75mL

2-4y 1 unit (160 mg/5 mL)
5-12y 2 units (320 mg/10 mL)
>13y 4 units (640 mg/20 mL)

Activated Charcoal

Indications:

Poisoning by mouth

Activated Charcoal

Adverse Effects:

May indirectly induce vomiting and cause nausea

Activated Charcoal

Precautions:

Does not absorb all drugs and toxic substances

Activated Charcoal

Contraindications:

Altered mental status
Received emetic

Activated Charcoal

Preparations:

25g / 125mL bottle
50g / 250mL bottle

Activated Charcoal

Dosage:

1g / kg PO

Albuterol

Indications:

Respiratory distress
Bronchospasm/Wheezing associated with Asthma, COPD, Anaphylaxis

Albuterol

Adverse effects:

Tachycardia
Hypertension
Angina
Nervousness
Tremors
Dizziness
Headache
Sweating
Nausea
Sore throat

Albuterol

Precautions:

May cause severe bronchospasm from repeated excessive use

Albuterol

Contraindications:

Known hypersensitivity

Albuterol

Preparations:

Hand-held unit dose aerosol inhaler
Ampule for nebulizer

Albuterol

Dosage:

2 doses(4 puffs)
Adult- 2.5 mg w/ 6-8 lpm oxygen
<2y- 1.25 mg w/ 6-8 lpm oxygen

Aspirin

Indications:

Suspected Acute Coronary Syndrome

Aspirin

Adverse effects:

Heartburn
Nausea
Wheezing

Aspirin

Precautions:

GI bleeding and upset

Aspirin

Contraindications:

Known hypersensitivity
Prior dosage to arrival

Aspirin

Preparations:

Tablets

Aspirin

Dosages:

Adults- 324 or 325 mg chewed
Pediatrics- no

Epinephrine

Indications:

Anaphylactic shock

Allergic reaction with respiratory distress
Severe asthma

Epinephrine

Adverse effects:

Tachycardia
Angina
Headache
Nausea
Dizziness
Hypertension
Nervousness
Tremors

Epinephrine

Precautions:

If for asthma need consultation if patient is pregnant or has past cardiac history

Epinephrine

Contraindications:

None in the presence of anaphylaxis

Epinephrine in syringe

Preparations:

Vial- 1mg in 1mL

Preloaded syringe
Adult .5mg in .5mL
Pediatric .15mg in .15mL

Epinephrine in syringe

Dosage:
>5y .5mg in .5mL in lateral thigh
<5y .15mg in .15mL in lateral thigh

Epinephrine auto-injector

Preparations:

auto-injector

Epinephrine auto-injector

Dosage:

1 dose in lateral thigh(hold for 10 seconds)

Naloxone

Indications:

To reverse respiratory depression induced by opioid/narcotic agent

Naloxone

Adverse effects:

Opioid withdrawal

Naloxone

Precautions:

May cause withdrawal in patients with opioid dependency
Certain drugs may require high doses
Intended to restore respiration, not consciousness
Intranasal must be administered with nasal atomizer
Only lasts around 40 min

Naloxone

Contraindications:

Patients under 28 days of age

Naloxone

Preparations:

Intranasal device
Pre-filled syringe

Naloxone

Dosage:

2mg total, switch between nostrils in 1mL increments

Nitroglycerin

Indications:

Chest pain

Nitroglycerin

Adverse effects:

Hypotension
Headache
Dizziness
Tachycardia

Nitroglycerin

Precautions:

BLS can only give sublingual
Reassess blood pressure before and after administering
Medical consult needed if BP drops by 20 mmHg or more per dose

Nitroglycerin

Contraindications:

Blood pressure below 90mmHG systolic
Heart rate less than 60 or greater than 150
Medication not prescribed
Patient under age 13
If patient has taken meds for Pulmonary Artery Hypertension(Adcirca or Revatio) or bedroom drugs (Viagra, Levitra, or Cialis) within the past 48 hrs, medical consultation is required

Nitroglycerin

Preparations:

Spray or tablet

Nitroglycerin

Dosage:

Adult- .4mg sublingually
Repeat in 3-5 min if pain persists
Maximum of 3 doses

Oral glucose

Indications:

Altered mental status with known diabetic history
Unconscious for unknown reason(Maryland)
Measured blood glucose less than 70mg/L

Oral glucose

Adverse effects:

Bruh it’s just sugar

Oral glucose

Precautions:

Patient without gag reflex may aspirate

Oral glucose

Contraindications:

Bruh it’s just sugar

Oral glucose

Preparations:

tube

Oral glucose

Dosage:

10-15 grams (NR) or whole tube (Maryland) between gum and cheek. Consider additional dose if not improved after 10 min

Oxygen

Indications:

If evidence of hypoxia (less than 94% blood oxygen)
Respiratory distress
Cardiopulmonary arrest
Trauma
Suspected CO exposure
Dyspnea

Oxygen

Adverse effects:

High concentrations will reduce respiratory drive in some COPD patients- carefully monitor them

Oxygen

Precautions:

Never withhold from those who need it
Must be given with caution for patients with COPD
Simple or partial rebreather face masks must be supplied with a minimum of 6 lpm
Non-rebreather masks must be supplied with a minimum 12 lpm

Oxygen

Contraindications:

Bruh it’s oxygen

Oxygen

Dosage:

12-15 lpm via NRB mask
2-6 lpm via nasal cannula
Maintain blood oxygen of 100% if exposed to CO