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Revision as of 17:24, 31 March 2015

Intubation

Pretreatment
Medication	Dose	Calculation
Lidocaine	120 mg	1.5 mg/kg^[1]
Fentanyl	80 mcg	1 mcg/kg
RSI
Etomidate	24 mg	0.3 mg/kg
Succinylcholine	120 mg	1.5 mg/kg
Midazolam (Versed)	8 mg	0.1 mg/kg
Ketamine	160 mg	2 mg/kg
Vecuronium	8 mg	0.1 mg/kg
Rocuronium	80 mg	1 mg/kg
Equipment
ET Tube (cuffed)	8 ±0.5	age/4+3
Blade	3-4	Miller or MAC
cm to teeth	23	3 x ETT size

Pulseless Arrest

Medication	Dose	Calculation
Defibrilation First Shock	200J	2 J/kg
Epinephrine (1:10,000)	0.8mg	0.01 mg/kg (max 1 mg)
Amiodarone load (without pulse)	300 mg	5 mg/kg (max 300)
Lidocaine	80 mg	1 mg/kg
Lidocaine Infusion	4000 mcg/min	50 mcg/kg/min
Magnesium sulfate	2,000 mg	50 mg/kg
CalCl (100mg/mL)	1600 mg	20 mg/kg

Cardiac with Pulse

Medication	Dose	Calculation
Adenosine	6 mg	0.1 mg/kg (max 6 mg)
Adenosine Repeat	12 mg	0.2 mg/kg (max 12 mg)
Amiodarone load (with pulse)	150 mg	5 mg/kg
Amiodarone 2nd/3rd dose	repeat loading dose up to total 3 times	15 mg/kg max
Atropine	1.6 mg	0.02 mg/kg
Cardioversion First Shock	80 J	1 J/kg
Cardioversion Second Shock	160 J	2 J/kg
Procainamide	1200 mg	15
Diltiazem	20 mg	0.25 mg/kg
Esmolol	8000 mcg	100 mcg/kg/min
Magnesium sulfate	2,000 mg	50 mg/kg
Nitroglycerin drip	4 mcg	0.05 mcg/kg/min
Glucagon	2 mg	0.025 mg/kg

Hypoglycemia

Medication	Dose	Calculation
D50W	50mL (1 amp)	1 mL/kg
D25W	160mL	2 mL/kg
D10 W	200mL	2.5 mL/kg
Glucagon	2mg	0.025 mg/kg

Vasopressors

Medication	IV Dose (mcg/kg/min)	Concentration
Norepinephrine (Levophed)	0.1-2 mcg/kg/min	8mg in 500mL D5W
Dopamine	2-20 mcg/kg/min	400mg in 250 D5W
Dobutamine	2-20 mcg/kg/min	250mg in 250 mg D5W
Epinephrine	0.1-1 mcg/kg/min	1mg in 250 D5W

Sedation

Medication	Dose	Calculation
Lorazepam (Ativan)	4 mg	0.05 mg/kg
Morphine	8 mg	0.1 mg/kg
Fenatnyl	80 mcg	1 mcg/kg
Ketamine	80 mg	1 mg/kg
Midazolam (Versed)	4 mg	0.05 mg/kg
Propofol IV (initial)	80 mg	1 mg/kg
Propofol (drip)	4000 mcg	50 mcg/kg/min

Seizure and CNS

Medication	Dose	Calculation
Lorazepam (Ativan)	4 mg	0.05 mg/kg
Fosphenytoin (PE = phenytoin equivalent	1600 PE	20 PE/kg
Phenytoin (Dilantin)	1600 mg	20 mg/kg
Phenobarbitol	800 mg	10 mg/kg
Diazepam (Valium) rectal	8 mg	0.1 mg/kg every 2 min
Mannitol	80 g	1 mg/kg
Hypoglycemia	IV dextrose	see glucose table

↑ Robinson N, Clancy M. Emerg Med J. 2001 Nov; 18(6): 453–457. In patients with head injury undergoing rapid sequence intubation, does pretreatment with intravenous lignocaine/lidocaine lead to an improved neurological outcome? A review of the literature doi:10.1136/emj.18.6.453 PMCID:PMC1725712

[1] Robinson N, Clancy M. Emerg Med J. 2001 Nov; 18(6): 453–457. In patients with head injury undergoing rapid sequence intubation, does pretreatment with intravenous lignocaine/lidocaine lead to an improved neurological outcome? A review of the literature doi:10.1136/emj.18.6.453 PMCID:PMC1725712

[1]

@@ Line 1: / Line 1: @@
 {{Dosing Variables}}
+{{#vardefine:age|80}} {{#vardefine:weight|80}}
 ==[[Intubation]]==
 {| class="wikitable"
@@ Line 52: / Line 53: @@
 | align="center" style="background:#f0f0f0;"|'''Dose'''
 | align="center" style="background:#f0f0f0;"|'''Calculation'''
-| align="center" style="background:#f0f0f0;"|'''Adult Max Dose'''
 |-
 | [[Defibrilation]] First Shock||{{#ifexpr:{{#expr:{{#var:weight}} >50}} |200J|{{#expr:{{#var:weight}}*{{#var:defib-first}} }}  J}}||  {{#var:defib-first}} J/kg
 |-
-|[[Epinephrine]] (1:10,000)|| {{#ifexpr:{{#expr:{{#var:weight}}*{{#var:epi}} }}< {{#var:epimax}} | {{#expr:{{#var:weight}}*{{#var:epi}} }}mg | {{#var:epimax}} }}|| {{#var:epi}} mg/kg || {{#var:epimax}} mg
+|[[Epinephrine]] (1:10,000)|| {{#ifexpr:{{#expr:{{#var:weight}}*{{#var:epi}} }}< {{#var:epimax}} | {{#expr:{{#var:weight}}*{{#var:epi}} }}mg | {{#var:epimax}} }}|| {{#var:epi}} mg/kg <br>(max {{#var:epimax}} mg)
 |-
-| [[Amiodarone]] load (without pulse)|| {{#ifexpr:{{#expr:{{#var:weight}}*{{#var:amioload}} }} > 300|300|{{#expr:{{#var:weight}}*{{#var:amioload}} round 0 }} }} mg|| {{#var:amioload}} mg/kg
+| [[Amiodarone]] load (without pulse)|| {{#ifexpr:{{#expr:{{#var:weight}}*{{#var:amioload}} }} > {{#var:amiomax}} | {{#var:amiomax}} | {{#expr:{{#var:weight}}*{{#var:amioload}} round 0 }} }} mg|| {{#var:amioload}} mg/kg <br> (max {{#var:amiomax}})
 |-
 | [[Lidocaine]]|| {{#expr:{{#var:weight}}*{{#var:lidocaine}} }} mg || {{#var:lidocaine}} mg/kg
@@ Line 76: / Line 76: @@
 | align="center" style="background:#f0f0f0;"|'''Calculation'''
 |-
-| [[Adenosine]]|| {{#ifexpr:{{#expr:{{#var:weight}}*{{#var:adenosine}} }} > 6|6|{{#expr:{{#var:weight}}*{{#var:adenosine}} }}  }} mg|| {{#var:adenosine}} mg/kg
+| [[Adenosine]]|| {{#ifexpr:{{#expr:{{#var:weight}}*{{#var:adenosine}} }} >{{#var:adenosinemaxfirst}} | {{#var:adenosinemaxfirst}} | {{#expr:{{#var:weight}}*{{#var:adenosine}} }}  }} mg|| {{#var:adenosine}} mg/kg <br> (max {{#var:adenosinemaxfirst}} mg)
 |-
-| [[Adenosine]] Repeat|| {{#ifexpr:{{#expr:{{#var:weight}}*{{#var:adenosinerepeat}} }} > 12|12|{{#expr:{{#var:weight}}*{{#var:adenosinerepeat}} }}  }} mg|| {{#var:adenosinerepeat}} mg/kg
+| [[Adenosine]] Repeat|| {{#ifexpr:{{#expr:{{#var:weight}}*{{#var:adenosinerepeat}} }} > {{#var:adenosinemaxsecond}} | {{#var:adenosinemaxsecond}} | {{#expr:{{#var:weight}}*{{#var:adenosinerepeat}} }}  }} mg|| {{#var:adenosinerepeat}} mg/kg <br> (max {{#var:adenosinemaxsecond}} mg)
 |-
 | [[Amiodarone]] load (with pulse)|| {{#ifexpr:{{#expr:{{#var:weight}}*{{#var:amioload}} }} > 150|150|{{#expr:{{#var:weight}}*{{#var:amioload}} round 0 }} }} mg|| {{#var:amioload}} mg/kg