Emergency Medication Dosages and Protocols

Anaphylaxis and Life-Threatening Asthma

• Route: IM
• Dose: 0.5 mg (0.5 ml at 1:1,000)
• Repeat: Every 5 mins, no maximum dose.

Cardiac Arrest

• Medication: Adrenaline
• Route: IV/IO
• Initial Dose: 1 mg (1 ml at 1:1,000)
• Repeat: Every 3-5 mins (every second loop).

Post Return of Spontaneous Circulation (ROSC)

• Medication: Adrenaline (50 mcg)
• Route: IV
• Dose Preparation: Add 9 ml NaCl to make 1 mg/10 ml.
• Repeat: Every 3-5 mins to maintain systolic BP > 100 mmHg after 2 × 250 ml NaCl boluses.

Amiodarone for Cardiac Arrest

• Indication: Persistent/shock-resistant VF/pulseless VT after 3rd shock.
• Route: IV/IO
• Initial Dose: 300 mg (6 ml).
• Repeat: 150 mg after the 5th shock.

Aspirin

• Indication: Chest pain/discomfort of presumed cardiac origin.
• Route: PO
• Dose: 300 mg (1 tablet).
• Administration: Single dose.

Symptomatic Bradycardia

• Medication: Atropine
• Route: IV
• Dose: 0.6 mg (0.5 ml as neat).
• Repeat: Every 3-5 mins (max 3 mg).

Organophosphate Poisoning

• Route: IV
• Dose: 1-2 mg (10-20 ml), add 11 ml NaCl for dilution to make 1.2 mg/12 ml.
• Repeat: Every 5 mins until Atropinisation.
• Alternate Routes: IN (10 sprays max 10), PO/Topical (5 sprays max 5), IM (5-10 mg).

Moderate to Severe Pain Management

• Adult (IN): 180 mcg (3 x 0.2 ml); repeat 60 mcg after 5 mins.
• Small/Elderly/Frail (IN): 120 mcg (2 x 0.2 ml); repeat 60 mcg after 5 mins.

Glucagon

• Indication: Hypoglycemia (3rd line agent if IV access not available).
• Route: IM
• Dose: 1 mg (1 ml).
• Administration: Use Hypokit with 3 ml vanishing point; repeat once after 10 mins.

Glucose Administration

• Glucose 10% (IV): Treats hypoglycemia; initial dose 15 g (150 ml).
• Repeat: 5-10 mins, giving 10 g titrating to effect.
• Glucose Gel: PO, 15 g single tube, repeat once after 10 mins.

Glyceryl Trinitrate

• Indication: Acute cardiac pulmonary edema and autonomic dysreflexia.
• Route: SL
• Dose: 400 mcg (1 spray); repeat every 5 mins with no max.

Heparin

• Indication: Confirmed STEMI for CATH lab transport.
• Route: IV
• Single Dose: 5000 IU (5 ml).

Opioid Pain Management

• Nebulised Fentanyl: 500 mcg (2 ml); repeat every 20 mins (max 3 doses).
• IV Fentanyl: 5-20 mg titrated to effect (1-2 ml), max repeat every 5 mins.
• IM/Fentanyl: First line for severe trauma; 1 mg/kg (max 100 mg).

Sedatives/Behavioral Management

• IM Dose: 4 mg/kg (max 400 mg); for severely disturbed behavior.
• For Combative TBI: 2 mg/kg (max 200 mg).

Methoxyflurane

• Indication: Pain management contraindicated in severe renal impairment.
• Routes: IH (3 ml), IM (5 mg 1 ml), IV (2.5 mg 2.5 ml with NaCl).

Paracetamol

• Indication: Mild to moderate pain.
• Route: PO
• Dosage: 500-1000 mg (1-2 tablets); max dose 4 g in 24 hrs.
• Repeat: Every 4 hrs if needed.

Miscellaneous Route Options

• Inhaled/Nebulised Dosage Forms: Varying according to condition and age; ensure spacing and repeat guidelines are adhered to.