Emergency Medications Available in the Village

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NOTE: Health Aides can NOT give any medications via IV route, even if ordered by a physician.

Remember to use the Pediatric Critical Care Guide for weight-based dosing if available

Epinephrine 1mg/ml Ampule

NOTE: In the absence of standard IV/IO route of administration, epinephrine may be given IM if it does not compromise CPR. Efficacy is unknown for this route in humans.

Resuscitation

  • Adult Dose=1mg IM
  • Pediatric Dose 0.01 mg/kg IM = 0.01 ml/kg (using1mg/ml concentration epinephrine)

Anaphylaxis

  • Adults and peds > 30kg = 0.3mg IM anterolateral thigh (0.3ml)
  • Pediatric <30kg = 0.01mg/kg IM anterolateral thigh (0.01ml/kg using 1mg/ml concentration epinephrine) (Max 0.3mg=0.3ml)

Croup

  • If no racemic epinephrine available, mix 1 ampule of epinephrine 1 mg/ml with 3 mL NS bullet and then nebulize.

Ceftriaxone 1gm vials

  • Adult Dose=2 grams IM
  • Pediatric Dose = 100mg/kg IM (max dose= 2grams)

Midazolam (Versed) 10mg/2ml

NOTE: If dosing intranasal, divide dose equally between both nares

  • Adults 0.2mg/kg IM or IN
  • Pediatric 0.2 mg/kg IM or IN

Dosing Chart

Weight Range in pounds Intranasal midazolam dose
less than 17 lbs Ask provider for dose
17-20 lbs 2 mg = 0.4 mL =0.2 mL/naris
21-24 lbs 2.5 mg = 0.5 mL = 0.3 mL ro one naris and 0.2 mL to other naris
25-31 lbs 3 mg = 0.6 mL = 0.3 mL/naris
32-40 lbs 4 mg = 0.8 mL = 0.4 mL/naris
41-51 lbs 4.5 mg = 0.9 mL = 0.5 mL to one naris and 0.4 mL to other naris
52-64 lbs 5.5 mg = 1.1 mL = 0.6 mL to one naris and 0.5 mL to other naris
>65 lbs 6.5 mg = 1.3 mL = 0.7 mL to one naris and 0.6 mL to other naris

Diazepam (Valium) 10mg/2ml

  • Adult Dose=10mg rectally or IM. (total max dose = 20 mg)
    • May repeat once in 10-15 minutes
  • Pediatric Dose=0.5mg/kg rectally or IM. (total max dose = 20 mg)
    • May repeat q 5-10 minutes prn

Phenobarbital 130mg/ml (1 ampule)

  • Adult Dose=10-20 mg/kg IM q 20 min prn
  • Pediatric Dose=20mg/kg IM
    • May give another 5-10mg/kg q 15-30 min prn up to a total dose of 40mg/kg
    • Pay close attention to respiratory rate if repeating phenobarb doses

Instaglucose 24 grams in a tube

NOTE: Use care in administering to an unconscious patient to prevent aspiration. Use small amounts in the buccal area bilaterally or smear on gums and cheeks. Glucose is not rectally absorbed.

  • Adult Dose: 15-20 gm
  • Pediatric Dose:
Weight (lbs) Dose
Less than 11 lbs 1 ml
11-20 lbs 4 ml
21-30 lbs 8 ml
31-40 lbs 12 ml
> 41 lbs 20 ml

Glucagon 1mg/ml (one ampule)

Note: Glucagon is only effective if hypoglycemia is due to hyperinsulinism-either because of insulin administration or endogenous insulin production. It is not rectally absorbed

  • Adults and Peds > 20kg Dose=1mg SC/IM. May repeat q15 minutes
  • Pediatric Dose= 0.5mg SC/IM. May repeat q15 minutes

Morphine 10mg/ml (one ampule)

  • Adult Dose=10-30mg PO, 2 to 10 mg IM
  • Pediatric Dose=0.05-0.2mg/kg IM (max dose=10 mg)

Naloxone 1mg/ml injectable solution

  • Adult Dose=0.4-2mg IM/SQ or 2-4mg intranasal-may repeat q2-3 minutes
  • Pediatric Dose=0.1mg/kg IM/SQ (Max dose=2 mg IM or 2-4mg intranasal) May repeat q2-3 minutes

Dexamethasone 10mg/ml

  • Adult Dose=depends on condition IM
  • Pediatric Dose
    • Croup/Stridor 0.6 mg/kg IM or PO. (Max 10mg)
    • Congenital Adrenal Hyperplasia 0.7 mg/kg/dose IM (1.5-2 mg/m2/dose)

Home supply of emergency Solu Cortef should be given preferentially according to directions OR use the following table

Solu Cortef Act-O-Vial 100mg/2ml IM dose
Under 4yo 25mg = 0.5ml
4-12 yo 50mg = 1ml
Over 12yo 100mg = 2ml (whole vial)

May repeat in 12-24 hrs (give sooner if sicker) if not able to get to a higher level of care

Prednisone 10mg tablets

  • Adult Dose=40-60mg PO
  • Pediatric Dose=2mg/kg PO (tablets crushed and mixed with palatable substance)

Albuterol 2.5 mg/3mL

  • Adult Dose=1 unit dose
  • Pediatric Dose=1 unit dose

Duo-nebs (ipratropium 0.5 mg and albuterol 3mg per 3 mL)

  • Adult Dose=1 unit dose
  • Pediatric Dose=1 unit dose

Racemic Epinephrine 2.25%

  • Adult Dose=1 unit dose in nebulizer (0.5ml) diluted with 3 mls NS bullet
  • Pediatric Dose= Give nebulized racemic epinephrine:

<10 kg: 0.25 mL mixed with 3 mL NS

>10 kg: 0.5 mL mixed with 3 mL NS

Note: Monitor pulse during and after administration.

If no racemic epinephrine available, mix 1 ampule of epinephrine 1 mg/ml with 3 mL NS bullet and then nebulize.