Adult: 6mg rapid IVP immediately followed by 20ml NS flush. Repeat in 2 min, at 12mg rapid IVP, followed by 20ml NS flush.

Pediatric: 0.1mg/kg (max dose 6mg) rapid IVP immediately followed by 6ml NS flush. Repeat in 2 min, at 0.2mg/kg (max dose 12mg) rapid IVP, followed by 6ml NS flush.

If over 1y or 10kg: Add 2.5mg of Albuterol mixed in 3ml of NS to the nebulizer and flow oxygen at 6-8L/min.

If under 1y or 10kg: Add 1.25mg of albuterol in 1.5ml of NS to the nebulizer and flow oxygen at 3L/min.

Adult: VT with a pulse and SVT: 150mg IV in 50ml D5W over 10min. May repeat ever 10 min PRN.

VF and pulseless VT: 300mg IV push.

Pediatric:VT with a pulse and SVT: 5mg/kg IV/IO in 50ml D5W over 20min.

VF and pulseless VT: 5mg/kg IV push.

Atropine Sulfate

(Cardiac Agent)

Adult: Bradycardia: 0.5-1mg IV, or 1-2mg ET: may repeat every 3-5min until improved or total of 0.04mg/kg or 3mg is reached.

Pediatric: 0.02mg/kg IV or ET (min dose=0.1mg. Max dose=0.5mg for a child and 1mg for an adolescent).

Atropine

(Antidote Poisonings)

Adult: 0.03mg/kg IV, repeat every 5-10 min until atropinization occurs.

Pediatric: 0.05mg/kg (max dose=3mg) IV, repeat every 5-10 min until atropinization occurs.

Adult: For hypotension following administration of calcium-channel blockers(e.g. Cardizem, Verapamil):4mg/kg IV, slowly. If patient is taking digitalis, 2mg/kg IV, slowly. Repeat 10min PRN.

For calcium-channel blocker overdose and hyperkalemia: 8-16mg/kg IV, slowly.

Pediatric: 5mg/kg or 0.2ml/kg IV, slowly, every 10 min PRN.

For calcium-channel blocker overdose and hyperkalemia: 20mg/kg IV, slowly.

Adult: Burns to eyes: Mix calcium gluconate (10%) 50ml in NS 500ml and wash the eyes with the solution using a Morgan Lens.

Burns to skin: Mix calcium gluconate (10%) 50ml into a 2-oz tube of sterile water-based gel lubricant (KY Jelly). Apply the gel to the burned skin area.

Inhalation: Administer calcium gluconate (10%) 1ml mixed with NS 3ml via nebulizer. For severe exposure, administer calcium gluconate (10%) 1-2g via slow IV over 5 min.

Adult: (Over 8y) 50ml of a 50% solution: (25g) IV. If conscious, glucose may be given orally (25g).

Pediatric: (Under 8y) 2ml/kg slow IV of a 25%

Newborn: 5ml/kg IV of a 10% solution (Dilute D50 4:1 with NS)

Adult: 5-20mg IV slowly--- no faster than 5mg/min or 10mg PR.

Pediatric: For status epilepticus: 0.1-0.2mg/kg (Max dose 10mg) IV slowly or 0.5mg/kg (Max dose 10mg) rectally.

Adult: 25-50mg IV or 50mg deep IM preferable lateral thigh. The patient may require as much as 100mg. Do not exceed 400mg per day.

Pediatric: 1mg/kg (Max dose 50mg) IM or IV if administering IV dilute with 9ml NS to equal 50mg/10ml. Not to exceed 300mg a day.

Adult: 0.3 (0.3-0.5ml) IM lateral thigh; may be repeated every 15min x 3. If the patient in anaphylaxis is hypotensive, start an IV and administer 3ml of a 1:10,000 solution via slow IV.

Pediatric: 0.01mg/kg, up to 0.3mg IM lateral thigh. Epinephrine (1:1000) is also given in a dosage of 0.1mg/kg IV or ET as a cardia agent.

Adult: IV push 1mg (10ml) repeat every 3-5min.

ETT (1:1000) 2mg (2ml diluted with 8ml of NS) repeat every 3-5min

Pediatric: 0.01mg/kg (0.1ml/kg IV or IO) repeat every 3-5min.

Use epinephrine (1:1000) 0.1mg/kg (max dose 2ml) any time given via ET.

Adult: 0.5-1 unit (or 0.5-1mg) of glucagon IM (or IV). This can be repeated twice.

If administered via IV, only compatible with D5W. May require very high doses for beta-blocker overdose (8-10mg IV).

Pediatric: If patient less than or equal to 20kg: 0.5mg IM.

Patient greater than 20kg: 1mg IM.

Not as effective in children as in adults.

Adult: 5-10mg IM

Pediatric: 0.1mg/kg IM (Max 5mg)

Adult: Add 0.5mg (0.5ml) of Atrovent to the nebulizer (in addition to the standard dose of albuterol) and flow oxygen at 6-8L/min.

Pediatric: Add Atrovent to Albuterol nebulizer treatment and flow oxygen at 6-8L/min.

If patient less than 8y, 0.25mg/1.25ml

If patient greater than 8y, 0.5mg/2.5ml

Adult: 4mg/kg IM (max 400mg) to the lateral thigh or deltoid.

2mg/kg IN

1mg/kg IV

Adult: 1-2mg IV, IM or IN may be repeated once as needed up to max of 4mg.

Pediatric: 0.1mg/kg IV, IM or IN, max dose 2mg. If no effect after 5min may be repeated once to max 4mg.

For eccamptic seizures 4mg IV (mixed in 50ml of D5W and administered 5-10min).

May repeat once at 2g IV (mixed in 50ml of D5W and administered 5-10min). 

For torsades de pointes and refractory VF: 1-2g IV (mixed in 50ml of D5W and administered 1-2min) followed by maintanence infusion (1g in 250ml of D5W administered at 30-60gtts/min)

Adult: Sedation and seizures 2-5mg increments IV, IO, IM, or IN

Pediatric: 0.1mg/kg max dose of 4mg IV, IO, IM. For IN administration use 0.2mg/kg (use 10mg/2ml concentration) max dose 5mg: may repeat once if necessary. Max total dose of 10mg.

Adult: 2-10mg IV slowly. Repeat with small increments every 5min until desired response is achieved. (Max 10mg) Can also be given IM.

Pediatric: 0.1-0.2mg/kg IV slowly.

Infant: 0.05-0.1mg/kg IV slowly.

Adult: An initial dose of 2mg may be administered IV, IM, IN or as a last resort ET. May repeat in 2-3min. If no response after 10mg, then condition is probably not due to narcotic. Fentanyl may require large doses of nalozone to reverse fentanyl's effects.

Pediatric: 0.1mg/kg IV, IM, IO, IN or as a last resort ET. May repeat with 0.1mg/kg if no improvement noted.

Adult: IV infusion 1-2g in 100ml of saline over 30min

If pulmonary edema is present, give IVP over 5min

Pediatric: 20-40mg/kg in 100ml of saline over 30min as IV infusion.

Packaged: 1g dry powder: Mix with 20ml sterile water (50mg/ml)

Adult: 1mEq/kg (8.4%) Repeat with 0.5mEq/kg every 10min

Pediatric: 1mEq/kg IV (8.4%). Repeat with 0.5mEq/kg every 10min

Infant: 1mEq/kg IV (4.2%) slowly, may repeat in 10 min.

Adult: 300mg IV over 4-5min

Pediatric: 0.2ml/kg IV over 4-5min. Use extreme caution because methemoglobin can be fatal in children.

Repeat dose: For both adults and children, give half the initial dose after 30min.

Adult: 1mg/kg IV

• Preoxygenate the patient and ready the intulation equipment.
• Prepare atropine for bradycardia and hypersecretions.
• Premidicate the awake adult, preferably with Midazolam (Versed). If Midazolam is unavailable, use Diazepam (Valium).
• Consider Lidocaine 1-1.5mg/kg for the patient with a head injury.
• Administer Succinylcholine 1mg/kg IV over 30-60sec.

Adult: 0.25mg SQ

Pediatric: 0.01mg/kg SQ. Rarely used in pediatric patients younger than 12y

Adult and Pediatric (over 10y): 0.08-0.1mg/kg slow administration over 30-60sec IV

Dose is usually 5-7mg for an average-size adult.

Pediatric (1-9y): May require higher dose.

Adult: Injection 4mg slow IV or IO push over 2-3min or IM lateral thigh. May be repeated once if no improvement within 30min. Do not exceed 8mg total dosage.

Pediatric: Injection: (40kg or more) 4mg slow IV or IO push over 2-3min or IM lateral thigh.

Under 40kg: 0.1mg/kg IV or IO over 2-3min or IM lateral thigh/deltoid. May be repeated once if no improvement within 30min. Do not exceed 8mg total dosage.