Term
| 2006 ACLS Dosage for Oxygen. |
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Definition
-Nasal cannula
o 1-6 L/min 21-44% O2
-Venturi mask
o 4-12 L/min 24-50 %
-Partial rebreather mask
o 6-10 L/min 35-60 %
-Nonrebreather mask
o 6-15 L/min 60-100%
-Bag mask with non rebreather
o 15 L/min 95-100% |
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Term
| 2006 ACLS Dosage for Epinephrine. |
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Definition
-IV/IO dose: 1 mg (10 mL of 1:10000 solution) administered every 3 to 5 minutes during resuscitation. Follow each dose with 20 mL flush, elevate arm for 10 to 20 seconds after dose.
-Higher dose: Higher doses (up to 0.2 mg/kg) may be used for specific indications (B-blocker or calcium channel blocker overdose)
-Continuous infusion: Add 1 mg epinephrine to 500 mL NS or D5W. Initial infusion rate of 1 ug/min titrated to effect (typical dose 2 to 10 ug/min).
-Endotracheal route: 2 to 2.5 mg diluted in 10 mL NS
-Profound bradycardia or hypotension: 2 to 10 ug/min infusion; titrate to patient response |
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Term
| 2006 ACLS Dosage for Atropine. |
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Definition
-Asystole or PEA
o 1 mg IV/IO push
o May repeat every 3 to 5 minutes (if asystole persists) to a maximum of 3 doses (3 mg).
-Bradycardia
o 0.5 mg IV every 3 to 5 minutes as needed, not to exceed total dose of 0.04 mg/kg (total 3 mg)
o Use shorter dosing interval (3 minutes) and higher doses in severe clinical conditions.
-Acute Coronary Syndromes
o ACC/AHA STEMI guidelines recommend 0.6 to 1 mg IV repeated every 5 mintues for ACS patients (total dose 0.04 mg)
-Endotracheal Administration
o 2 to 3 mg diluted in 10 mL water or NS.
-Organophosphate poisoning
o Extremely large doses (2 to 4 mg or more) may be needed. |
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Term
| 2006 ACLS Dosage for Lidocaine. |
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Definition
-Cardiac arrest from VF/VT
o Initial dose 1-1.5 mg/kg IV/IO
o For refractory VF may give additional 0.5 to 0.75 mg/kg IV push, repeat in 5 to 10 minutes; maximum 3 doses or total 3 mg/kg.
o Endotracheal administration
-Perfusing Arrhythmia
o For stable VT wide-complex tachycardia of uncertain type, significant ectopy:
-Doses ranging from 0.5 to 0.75 mg/kg and up to 1 to 1.5 mg/kg may be used.
-Repeat 0.5 to 0.75 mg/kg every 5 to 10 minutes; maximum total dose: 3 mg/kg
-Maintenance infusion
o 1 to 4 mg/min (30 to 50 ug/kg per minute) can dilute in d5W, d10W, or NS. |
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Term
| 2006 ACLS Dosage for Procainamide. |
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Definition
-Recurrent VF/VT
o 20 mg/min IV infusion (maximum total dose 17 mg/kg)
o In urgent situations up to 50 mg/min may be administered to a total dose of 17mg/kg
-Other Indications
o 20 mg/min IV infusion until one of the following occurs
-Arrhythmia suppression
-Hypotension
-QRS widens by >50%
-Total Dose of 17 mg/kg is given
o Use in cardiac arrest limited by need for slow infusion and uncertain efficacy |
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Term
| 2006 ACLS Dosage for Vasopressin. |
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Definition
| One dose for cardiac arrest: 40 U IV/IO push may replace either first or second dose of epinephrine. Epinephrine can be administered every 3 to 5 minutes during cardiac arrest. |
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Term
| 2006 ACLS Dosage for Adenosine. |
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Definition
| 6 mg rapid IV push, if rhythm does not convert within 1-2 min give second dose 12mg, if rhythm does not convert within 1-2 min give third dose 12 mg |
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Term
| 2006 ACLS Dosage for Magnesium. |
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Definition
-Cardiac Arrest (Due to Hypomagnesemia or Torsades de Pointes)
o 1 to 2 g (2 to 4 mL of a 50% solution) diluted in 10 mL of D5W IV/IO over 5 to 20 minutes.
-Torsades de Pointes with a Pulse or AMI with Hypomagnesemia
o Loading dose of 1 to 2 g mixed in 50 to 100mL of D5W over 5 to 60 minutes IV.
o Follow with 0.5 to 1 g/h IV (titrate to control torsades) |
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Term
| 2006 ACLS Dosage for Sodium Bicarbonate. |
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Definition
-1 mEq/kg IV bolus
-If rapidly available use arterial blood gas analysis to guide bicarbonate therapy (calculated base deficits or bicarbonate concentration) ABG results not reliable indicators of acidosis during cardiac arrest. |
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Term
| 2006 ACLS Dosage for Morphine. |
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Definition
-Initial dose: 2 to 4 mg IV (over 1 to 5 minutes) every 5 to 30 minutes.
-Repeat dose 2 to 8 mg at 5 to 15- minute intervals |
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Term
| 2006 ACLS Dosage for Norepinephrine. |
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Definition
-0.5 to 1 ug/min titrated to improve blood pressure (up to 30 ug/min)
-Add 4 mg of norepinephrine or 8 mg of norepinephrine bitartrate to 250 mL of D5W or D5NS but not NS alone
-Do not administer in same IV line as alkaline solutions
-Poison/drug induced hypotension may require higher doses to achieve adequate perfusion |
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Term
| 2006 ACLS Dosage for Dopamine. |
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Definition
-Usual infusion rate is 2 to 20 ug/kg/per minute.
-Titrate to patient response, taper slowly |
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Term
| 2006 ACLS Dosage for Dobutamine. |
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Definition
-Usual infusion rate is 2 to 20 ug/kg/per minute.
-Titrate so heart rate dose not increase by >10% of baseline.
-Hemodynamic monitoring is recommended for optimal use.
-Elderly patients may have a significantly decreased response. |
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Term
| 2006 ACLS Dosage for Isoproterenol. |
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Definition
-Infuse at 2 to 10 ug/min
-Titrate to adequate heart rate
-In torsades de pointes titrate to increase heart rate until VT is suppressed. |
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Term
| 2006 ACLS Dosage for Nitroglycerin. |
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Definition
-IV Administration
o IV bolus: 12.5 to 25 ug (if no SL or spray given)
o Infusion: Begin at 10 to 20 ug/min Titrate to effect, increase by 5 to 10 ug/min every 5 to 10 minutes until desired effect.
-Route of choice for emergencies
-Use appropriate IV sets provided by pharmaceutical companies.
-Dilute in D5W or NS.
-Sublingual Route- 1 tablet (0.3 to 0.4 mg) repeated for total of 3 doses at 5-minute intervals
-Aerosol Spray- 1 to 2 sprays for 0.5 to 1 second at 5-minute intervals (provides 0.4 mg per dose). Maximum 3 sprays within 15 minutes. |
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Term
| 2006 ACLS Dosage for Furosemide. |
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Definition
-0.5 to 1 mg/kg give over 1 to 2 minutes
-If no response double dose to 2 mg/kg slowly over 1 to 2 minutes
-For new onset pulmonary edema with hypovolemia <0.5 mg/kg |
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Term
| 2006 ACLS Dosage for Tissue Plasminogen Activator. |
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Definition
-Recommended total dose is based on patient’s weight. For AMI the total dose should not exceed 100 mg; for acute ischemic stroke the total dose should not exceed 90 mg. Not that there is a dose regimen for STEMI patients and a different regimen for acute ischemic stroke.
o For AMI:
-Accelerated infusion (1.5 hours)
• Give 15 mg IV bolus
• Then 0.75 mg/kg over next 30 minutes (not to exceed 50 mg)
• Then 0.5 mg/kg over 60 minutes (not to exceed 35 mg)
o For Acute Ischemic Stroke:
• Give 0.9 mg/kg (maximum 90 mg) infused over 60 minutes.
• Give 10% of the total dose as an initial IV bolus over 1 minute.
• Give the remaining 90% over the next 60 minutes. |
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Term
| 2006 ACLS Dosage for Nitroprusside. |
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Definition
-Add 50 or 100 mg to 250 mL D5W
-Begin at 0.1 ug/kg per minute and titrate upward every 3 to 5 minutes to desired effect (usually up to 5 ug/kg per minute but higher doses up to 10 ug/kg may be needed)
-Use with an infusion pump; use hemodynamic monitoring for optimal safety.
-Action occurs within 1 to 2 minutes.
-Light-sensitive, cover drug reservoir and tubing with opaque material. |
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