Medication Standard Orders Quiz
39 Questions
1 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

A patient is experiencing respiratory depression due to suspected opioid overdose. They are 12 years old. What is the appropriate dosage of Naloxone for this patient?

  • 0.1 mg/kg IM/IN
  • 4 mg IN
  • 0.5 mg IM/IN (correct)
  • 10 mg IM/IN

    • In the context of suspected fentanyl overdose with respiratory depression, what is the maximum permissible dosage of Naloxone, regardless of the route of administration?

  • 0.5 mg
  • 4 mg
  • 10 mg (correct)
  • 1 mg/kg

    • For an adult experiencing respiratory depression due to a suspected opioid overdose, what is the recommended administration route for Naloxone in the context of Basic Life Support (BLS)?

  • IO
  • IV
  • IM/IN (correct)
  • Oral

    • What dosage of Naloxone is suggested as a loading dose for adults with suspected Fentanyl overdose accompanied by respiratory depression?

    <p>4 mg</p> Signup and view all the answers

    In the context of Advanced Life Support (ALS) for adults experiencing respiratory depression attributed to suspected opioid overdose, what are the permissible routes of administration for Naloxone?

    <p>IV/IO/IM/IN</p> Signup and view all the answers

    What is the IV dosage of Diazepam (Valium) prescribed for a pediatric patient experiencing seizures due to nerve agent/organophosphate exposure?

    <p>0.05 mg/kg</p> Signup and view all the answers

    Which of the following is NOT a symptom associated with nerve agent/organophosphate exposure?

    <p>Headache</p> Signup and view all the answers

    What is the recommended route of administration for Diazepam (Valium) for an adult experiencing seizures due to nerve agent/organophosphate exposure if IV administration is unavailable?

    <p>Intramuscular (IM)</p> Signup and view all the answers

    If an adult exhibits symptoms of nerve agent exposure, how many NAAK auto-injectors can be administered, and at what interval?

    <p>Two auto-injectors, repeated every 10-15 minutes</p> Signup and view all the answers

    What is the standard order medication for nerve agent exposure with associated symptoms?

    <p>Nerve Agent Antidote Kit (NAAK)/Mark I or DuoDote</p> Signup and view all the answers

    What is the maximum dose of Naloxone that can be administered to a patient who is 10 years old?

    <p>0.5 mg</p> Signup and view all the answers

    Which of the following medications is contraindicated for patients who have taken sexual enhancement medications within the past 48 hours?

    <p>Nitroglycerin</p> Signup and view all the answers

    What is the preferred route of administration for Nitroglycerin in the treatment of Acute Coronary Syndrome (ACS)?

    <p>Sublingual</p> Signup and view all the answers

    For a patient experiencing respiratory depression from suspected opiate overdose, what is the maximum dose of Naloxone that can be administered per administration?

    <p>0.5 mg</p> Signup and view all the answers

    According to the content, which of the following routes of administration are permissible for Naloxone?

    <p>IV, IO, IM, IN</p> Signup and view all the answers

    What is the maximum total dose of Ondansetron that can be administered to a patient aged 12 years old before reaching the base hospital?

    <p>12 mg</p> Signup and view all the answers

    What is the frequency of administration for Nitroglycerin 0.4 mg sublingual/transmucosal?

    <p>Every 3 minutes</p> Signup and view all the answers

    For a patient experiencing respiratory depression from suspected opioid overdose, what is the maximum total dose of Naloxone that can be administered?

    <p>10 mg</p> Signup and view all the answers

    What is the correct dosage of Calcium Chloride for adult patients with suspected hyperkalemia and hemodynamic instability?

    <p>1 gm (10 ml of a 10% solution) IV/IO</p> Signup and view all the answers

    What is the appropriate dose of Dextrose for a pediatric patient aged more than 4 weeks with a blood glucose level less than 60 mg/dL?

    <p>10%/250 ml (D10W 25 gm) 0.5 gm/kg (5 ml/kg) IV/IO</p> Signup and view all the answers

    In cases of seizure in adults when midazolam is not available, which of the following doses of Diazepam is appropriate?

    <p>10 mg IM, single dose only</p> Signup and view all the answers

    What is the correct administration route for Dextrose in adult patients with hypoglycemia and blood glucose less than 80 mg/dL?

    <p>IV/IO</p> Signup and view all the answers

    Which medication and dose is indicated specifically for pediatric patients with hypoglycemia under 4 weeks of age?

    <p>Dextrose 10%/250 ml (D10W 25 gm) 0.5 gm/kg (5 ml/kg) IV/IO</p> Signup and view all the answers

    What is the maximum number of doses of atropine that can be administered for mild symptoms of nerve agent poisoning?

    <p>Three doses</p> Signup and view all the answers

    Which route is specified for administering atropine to a patient weighing more than 41 kg?

    <p>Intramuscular</p> Signup and view all the answers

    For a child weighing 10 kg, how much atropine should be administered?

    <p>0.5 mg</p> Signup and view all the answers

    In the case of severe symptoms manifesting after the first dose of atropine, how soon should additional doses be administered?

    <p>10 minutes</p> Signup and view all the answers

    What is NOT a mild symptom of nerve agent poisoning?

    <p>Severe chest pain</p> Signup and view all the answers

    Which medication form is specified for patients less than 6.8 kg?

    <p>Multi-dose vial</p> Signup and view all the answers

    What action should be taken if profound anticholinergic effects occur without excessive bronchial secretions?

    <p>Withhold further doses of atropine</p> Signup and view all the answers

    How is the dosing of atropine determined for patients with known nerve agent exposure?

    <p>Based on weight</p> Signup and view all the answers

    What is the dosage for adult Atropine when used for organophosphate poisoning?

    <p>2 mg IV/IO, repeat at 2 mg increments every five minutes</p> Signup and view all the answers

    How often can Albuterol MDI be administered to a pediatric patient experiencing continued shortness of breath?

    <p>Every ten minutes for up to four doses</p> Signup and view all the answers

    What is the maximum dose of Buprenorphine-Naloxone for treating opioid withdrawal in adults?

    <p>24 mg/6 mg</p> Signup and view all the answers

    What is the recommended administration route for Calcium Chloride in adults experiencing calcium channel blocker poisoning?

    <p>IV/IO</p> Signup and view all the answers

    In pediatric patients under 14 years of age with organophosphate poisoning, what is the starting dose of Atropine based on weight?

    <p>0.05 mg/kg IV/IO not to exceed 2 mg</p> Signup and view all the answers

    What is the administration frequency for Atropine when treating symptomatic organophosphate poisoning in adults?

    <p>Every five minutes</p> Signup and view all the answers

    How should the chewable Aspirin dosage be delivered to adults?

    <p>Four chewable 81 mg tablets</p> Signup and view all the answers

    In cases of cardiac arrest with suspected hyperkalemia, what is the recommended dosage of Calcium Chloride?

    <p>1 gm (10 ml of a 10% solution) IV/IO</p> Signup and view all the answers

    Study Notes

    Medication - Standard Orders

    • Acetaminophen (Tylenol) - Adult (ALS): Used for mild to moderate pain (1-5 scale) or moderate to severe pain when other meds are contraindicated or deferred. Administered as a 1 gram IV/IO infusion over 15 minutes. Single dose only.

    • Acetaminophen (Tylenol) – Pediatric (ALS): Used for mild to moderate pain (1-5 scale) or moderate to severe pain when other medications are contraindicated or deferred for children aged 2 to 14 years. Administered as 15 mg/kg (maximum 1000mg) or 1 gram IV/IO infusion over 15 minutes. Single dose only.

    • Adenosine (Adenocard) - Adult (ALS): Used for stable narrow-complex SVT or wide complex tachycardia. Administered as two 6 mg rapid IVP doses, followed immediately by 20cc of normal saline. A 12mg rapid IVP dose, followed immediately by 20cc of normal saline, can be administered if there is no conversion. May repeat once.

    • Albuterol (Proventil) Aerosolized Solution - Adult (LALS, ALS): 2.5 mg nebulized. May repeat twice.

    • Albuterol (Proventil) Metered-Dose Inhaler (MDI) - Adult (BLS, LALS, ALS): Four (4) puffs every 10 minutes for continued shortness of breath and wheezing.

    • Albuterol (Proventil) - Pediatric (LALS, ALS): 2.5 mg nebulized. May repeat twice.

    • Aspirin, chewable -Adult (LALS, ALS): 325mg PO chewed (one adult non-enteric coated aspirin) or four 81 mg chewable aspirin.

    • Atropine (ALS) - Adult: 1 mg IV/IO. May repeat every 5 minutes up to a maximum of 3 mg or 0.04 mg/kg. For organophosphate poisoning, administer 2 mg IV/IO, repeat in 5-minute intervals at 2 mg increments, as long as symptoms persist.

    • Atropine - Pediatric (ALS): 0.05 mg/kg IV/IO, max adult dose, repeat 0.1 mg/kg increments every 5 minutes if symptoms persist, for organophosphate poisoning in children under 14 years.

    • Buprenorphine-Naloxone (Suboxone®)-Adult (ALS): Used for opioid withdrawal with a score of ≥8 on the Clinical Opioid Withdrawal Scale. Administered as 16 mg/4mg sublingual, may be repeated at 8mg/2mg sublingual every 10 minutes. Maximum total dose is 24mg/6mg.

    • Calcium Chloride - Adult (ALS): 1 gm (10 ml of a 10% solution) IV/IO. Used for calcium channel blocker poisoning, hyperkalemia, hypermagnesemia or cardiac arrest with suspected hypocalcemia.

    • Dextrose - Adult (LALS, ALS): Used for hypoglycemia with blood glucose less than 80 mg/dL. Administered as a 10%/250 ml (D10W 25 gm) IV/IO bolus.

    • Dextrose - Pediatric (LALS, ALS): Used for hypoglycemia, for neonates (0-4 weeks) with blood glucose less than 35 mg/dL, and for pediatric patients (over 4 weeks) with blood glucose less than 60 mg/dL. Administered as a 10%/250ml (D10W 25 gm) 0.5 gm/kg(5 ml/kg) IV/IO.

    • Diazepam - Adult (ALS): Used for seizure activity (with midazolam unavailable), administered as 5 mg IV/IO single dose or 10 mg IM single dose.

    • Diazepam- Pediatric (ALS): Used for seizure activity (with midazolam unavailable), administered as 0.1mg/kg IV/IO single dose, not to exceed 5 mg; or 0.2mg/kg IM single dose, not to exceed 10 mg.

    • Diphenhydramine - Adult (ALS): Administered as 25mg IV/IO or 50mg IM for allergic reactions, max adult dose 25 mg IV/IO or 50 mg IM.

    • Diphenhydramine - Pediatric (ALS): Administered as 1mg/kg (slow IV/IO) or 2mg/kg (IM), max 25 mg/50 mg for allergic reactions.

    • Epinephrine (1 mg/ml) - Adult (LALS, ALS): Used for severe bronchospasm, asthma attacks, pending respiratory failure, severe allergic reactions. Administered as 0.3 mg IM. May repeat after 15 minutes if symptoms do not improve.

    • Epinephrine (0.1 mg/ml) - Adult (ALS): Used for severe anaphylactic reactions. Administered as 0.1mg slow IVP/IO, repeat every 5 minutes, up to a total of 0.5 mg. Used for cardiac arrest, asystole, PEA. Administered as 1 mg IV/IO.

    • Epinephrine (0.3 Auto injector) - Adult (BLS, LALS, ALS): Used for severe asthma and/or anaphylaxis. May repeat after 15 minutes.

    • Epinephrine (0.15 Auto injector Jr.) - Pediatric (BLS,LALS, ALS): Used for anaphylaxis only.

    • Epinephrine (0.01 mg/ml) - Adult (ALS): For post-resuscitation persistent shock, hypotension, and persistent shock due to trauma where cardiac arrest is imminent. Prepare Epinephrine solution by mixing 9 ml of normal saline with 1ml of 0.1 mg/ml Epinephrine in a 10 ml syringe. Administer 1 ml every 1-5 minutes.

    • Epinephrine (1 mg/ml)- Pediatric (LALS, ALS): Used for severe bronchospasm, asthma attacks, pending respiratory failure, severe allergic reactions.

    • Fentanyl - Adult (ALS): Used for chest pain (presumed ischemic origin). Administered as 50 mcg slow IV/IO over 1 minute, may repeat every 5 minutes up to a max of 200 mcg. Other uses—acute traumatic injury, acute abdominal pain, burns, cancer pain, sickle cell crisis (50mcg slow IV/IO, max 200mcg). IM/IN route available (50 mcg/100 mcg, respectively; max 200mcg).

    • Fentanyl - Pediatric (ALS): 0.5 mcg/kg slow IV/IO over 1 minute; max 50 mcg. IM/IN route available (1 mcg/kg, max 100mcg).

    • Glucose - Oral - Adult (BLS, LALS, ALS): Administered in cases of blood glucose levels less than 80mg/dL. May use 1 tube per patient with intact gag reflex.

    • Glucose - Oral - Pediatric (BLS, LALS, ALS): Administered in cases of hypoglycemia. Neonates (0-4 weeks) with glucose less than 35mg/dL, or pediatric patients who are over 4 weeks and have blood glucose less than 60 mg/dL may use 1 glucose tube per patient with intact gag reflex.

    • Glucagon - Adult (LALS, ALS): Administered IM/SC/IN if IV cannot be established. 1mg max, single dose only.

    • Glucagon - Pediatric (LALS, ALS): Administered IM/IN if IV cannot be established. 0.03 mg/kg IM/IN, with max 1mg total. Repeatable at 20 minutes.

    • Ipratropium Bromide (Atrovent) Inhalation Solution use with Albuterol (Adult): 0.5 mg nebulized. Administer once only.

    • Ipratropium Bromide (Atrovent) Metered-Dose Inhaler (MDI) use with Albuterol (Adult): Administer in conjunction with Albuterol MDI dosing.

    • Ipratropium Bromide (Atrovent) Inhalation Solution use with Albuterol (Ped): 0.25 mg or 0.5 mg nebulized. Administered once only, based upon age.

    • Ipratropium Bromide (Atrovent) Metered-Dose Inhaler (MDI) use with Albuterol (Ped): Administer in conjunction with Albuterol MDI dosing.

    • Ketamine - Adult (ALS): Used for acute traumatic injury, abdominal pain, burns, cancer pain, sickle cell crisis. 0.3 mg/kg to 30 mg max into 50-100ml of NS in five minutes; repeat after 15 minutes if pain level remains at five or higher. Not for IVP, IO, IM, or IN. Official pain scale used for patient assessment.

    • Lidocaine - Adult (ALS): For VF/pulseless VT: Initial dose of 1.5 mg/kg IV/IO. For refractory VT/pulseless VT, additional 0.75 mg/kg IV/IO may administered. Max total dose 3 mg/kg. For V-Tach Wide Complex Tachycardia with pulse: 1.5 mg/kg slow IV/IO.

    • Lidocaine - Pediatric (ALS): For cardiac arrest (1 day-8 years): 1.0 mg/kg IV/IO, repeat at 0.5 mg/kg after 5 minutes; max dose 3 mg/kg. For cardiac arrest (9-14 years): 1.0 mg/kg IV/IO, repeat at 0.5 mg/kg after 5 minutes; max dose 3 mg/kg.

    • Lidocaine 2% (Intravenous Solution) - Pediatric and Adult (ALS): For pain associated with an IO infusion. 0.5mg/kg slow IO push; maximum total dose: 40mg.

    • Magnesium Sulfate-Adult (ALS): Used for Polymorphic ventricular tachycardia. Administer 2gm IV/IO over 5 minutes. For eclampsia, administer 4gm IV/IO over 3-4 minutes; used to prevent continued seizures (10mg/min IV/IO drip). 2 gm maximum use in patients with severe asthma and/or respiratory distress.

    • Magnesium Sulfate-Pediatric (ALS): Used for severe asthma and/or respiratory distress. Administered as 50mg/kg slow IV drip, max 2 gm total.

    • Midazolam (Versed) - Adult (ALS): Used for behavioral emergencies, and dangerous or fatal agitation. Administer 2.5mg IV/IO; repeat in 5 min, or 5 mg IM/IN; repeat in 10 min. 3 doses max.

    • Midazolam (Versed) - Pediatric (ALS): Used for seizures. Administer 0.1mg/kg IV/IO, maximum 2.5 mg, repeat in 5 minutes or 0.2 mg/kg IM/IN, maximum 5 mg, repeat in 10 minutes.

    • Naloxone (Narcan) - Adult (BLS): 0.5mg IM/IN, repeat every 2 to 3 minutes if needed to improve respiratory effort. For suspected fentanyl overdose with respiratory depression; administer 4 mg IN or repeat 0.5mg IV/IO/IM/IN every 2-3 minutes if needed. Maximum total dose: 10mg.

    • Naloxone (Narcan) - Pediatric (BLS): 0.1mg/kg IM/IV/IO; repeat every 2-3 minutes to improve respiratory effort, max 10mg.

    • Nitroglycerin (NTG) -Adult (LALS, ALS): 0.4 mg sublingual/transmucosal every 3 minutes as needed, to address suspected right ventricular infarction. Nitroglycerin paste (1 inch 1 gm) requires base hospital contact.

    • Ondansetron (Zofran): Administered in cases of nausea or vomiting. For 4-year-old patients, max 4mg dose. For 9-year-old patients and older, max 4mg dose. Either can be repeated, 10 minutes apart, up to a two-time maximum dose of 12mg.

    • Oxygen - Pediatric and Adult (BLS, LALS, ALS): For patients who are not intubated; for hypoxia, titrate oxygen to maintain SpO2 at 94% or 90% based on patient's conditions (COPD or non-COPD). Do not provide supplemental oxygen if SPO2 exceeds 95% or 91%, respectively.

    • Sodium Bicarbonate - Adult (ALS): Used for tricyclic poisoning, cardiac arrest with suspected metabolic acidosis, hyperkalemia or tricyclic poisoning. For tricyclic poisoning: 1 mEq/kg IV/IO. For arrest and suspected metabolic acidosis or hyperkalemia: 50 mEq IV/IO..

    • Sodium Bicarbonate - Pediatric (ALS): For tricyclic poisoning: 1mEq/kg IV/IO.

    • Tranexamic Acid (TXA) - Patients 15 years of age and older (ALS): Used for hemorrhagic shock. Administer 1 gm in 50-100 ml (Normal Saline) IV/IO over 10 minutes. Administer this for postpartum hemorrhagic shock by the same method.

    • Appendix I - Medications: Contains medications for self-administration or with the ChemPack deployment. Only use for associated ICEMA Treatment Protocol purposes. Consult with Base Hospital physician for any other uses, routes, or dosages. This section includes important information about atropine for nerve agent/organophosphate poisoning, including dosages and symptoms to follow. It also details critical information regarding diazepam (Valium) for seizures associated with nerve agent/organophosphate exposure.

    • Nerve Agent Antidote Kit (NAAK): Contains Atropine/Pralidoxime Chloride. Administered as a single (1) IM auto-injector dose into outer thigh. May be repeated up to two (2) times every 10 to 15 minutes, as necessary, if symptoms persist.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Inland Counties Emergency Medical Agency Policy And Protocol Manual PDF

    Description

    Test your knowledge on standard medication orders for adults and pediatrics, including dosages and administration routes. This quiz covers common medications such as Acetaminophen, Adenosine, and Albuterol. Ideal for healthcare professionals and students in advanced life support training.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser