maryland bls medications 2023

activated charcoal indications

poisoning by mouth

activated charcoal adverse effects

May indirectly induce vomiting and cause nausea

activated charcoal precautions

must do consult

activated charcoal contraindications

1. altered mental status

2. patients who have received an emetic

activated charcoal dosage

1g/1kg

albuterol indications

1. signs and symptoms of respiratory distress

2. bronchospasm / wheezing associated with either asthma, copd/emphysema, allergic reactions

albuterol precautions

May cause severe bronchospasm from repeated excessive use

albuterol contraindications

Known hypersensitivity

albuterol adverse effects

HHAND TNT SS

hypertension

headache

angina

nausea/vomiting

dizziness

tachycardia/palpations

nervousness/anxiety

tremors

sweating

sore throat

albuterol can be given through...

1. inhaler

2. nebulizer

albuterol dosage

inhaler: 2 doses of 2 puffs (4 puffs over 30 minutes)

nebulizer

age 2+ : 2.5 mg, may repeat one time

age less than 2 : 1.25 mg, may repeat one time

consult for additional doses

aspirin pharmacology

1. Platelet inhibitor (prevents blood clots in arteries)

2. anti-inflammatory (relieve pain and swelling)

aspirin pharmacokinetics

Blocks platelet aggregation

aspirin indications

heart attack (suspected acute coronary syndrome or STEMI)

aspirin contraindications

1. known hypersensitivity

2. received full dose prior to EMS arrival

aspirin adverse effects

1. heart burn

2. nausea / vomiting

3. wheezing

aspirin precautions

gi bleeding and upset

aspirin dosage

adult : 324 mg chewed

ped : not indicated

epinephrine indications

1. allergic reactions

2. severe asthma

epinephrine adverse effects

HHAND TNT

hypertension

headache

angina

nausea/vomiting

dizziness

tachycardia/palpations

nervousness/anxiety

tremors

epinephrine precautions

must consult before administering epi to asthma patients with pregnancy or cardiac history

epinephrine contraindications

None in the presence of anaphylaxis

epinephrine dosage

syringe

patients age 5+ : 0.5 mg

patients less than age 5 : 0.15 mg

auto injector

patients age 5+ : 0.3 mg

patients less than age 5 : 0.15 mg

consult for additional doses

naloxone pharmacology

reverses all effects due to opioid agents

naloxone indications

opioid overdose

naloxone contraindications

patients under 28 days

naloxone adverse effects

Opioid withdrawal symptoms

nausea/vomiting, sweating, dyspnea, tremor, hypotension/hypertension

naloxone dosage

2 mg (1 mg in each nare) OR 4 mg in one nare

repeat as necessary

nitroglycerin indications

chest pain

nitroglycerin adverse effects

1. hypotension

2. headache

3. dizziness

4. tachycardia

nitroglycerin precautions

1. must be patient prescribed nitroglycerin

2. Reassess blood pressure before and after administration

3. If systolic blood pressure drops more than 20 mmHg, consult before further administration

nitroglycerin contraindications

1. blood pressure below 90 systolic

2. heart rate less than 60 or more than 150

3. med not prescribed

4. under age 13

5. patient took medication for Pulmonary Artery

Hypertension (adcirca, revatio) or erectile dysfunction (viagra, levitra, cialis) within past 48 hours

nitroglycerin dosage

0.4 mg sublingually (one tablet)

repeat in 3-5 minutes if chest pain continues

max of 3 doses

oral glucose indications

1. altered mental status with known diabetic history

2. unconscious for unknown reason

3. measured blood glucose less than 70 mg

oral glucose adverse effects

not clinically significant

oral glucose precautions

patients without gag reflex may aspirate

oral glucose contraindications

not clinically significant

oral glucose dosage

10 - 15 g between gum and cheek

1 more additional dose if not improved

oxygen pharmacology

1. Increases oxygen content of the blood

2. Improves tissue oxygenation

3. Decreases energy expended for respirations

oxygen indications

1. evidence of hypoxia (less than 94%)

2. respiratory distress

3. cardiopulmonary arrest

4. trauma

5. suspected co exposure

6. dyspnea

oxygen contraindications

not clinically significant

oxygen adverse effects

high oxygen will reduce respiratory drive in copd patients

oxygen dosage

nasal cannula : 2-6 lpm

nonrebreather mask : 12-15 lpm