Emergency Medications Available in the Village
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 (if available) according to directions OR use the following table)
- Solu Cortef Emergency Injection. CHOP (video)
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.