NC 2009 Paramedic Drug Protocols

CLASSIFICATION antipyretic, non-narcotic analgesic

ACTION(S) antipyretic activity, analgesic activity, inhibition of peripheral and central prostaglandin synthesis

NCCEP PROTOCOL(S)
#8-Fever
#10-Pain Control-Adult
#11-Pain Control-Pediatric
#47-Pediatric Seizure

INDICATION(S)
-pain and fever control

CONTRAINDICATION(S)
-patients with severe liver disease
-hypersensitivity

ADVERSE REACTION(S)
-none, common

DOSAGE
-ADULT: 1000 mg PO
-PEDIATRIC: (refer to Broslow) 10 mg/kg po

HOW SUPPLIED
-325 & 500 mg tab
-liquid (pediatric)

CLASSIFICATION antiarrhythmic

ACTION(S) An endogenous nucleotide from human body cells, it slows conduction time through the AV-node restoring patients to a normal sinus rhythm.

NCCEP PROTOCOL(S)
#32-Supraventricular Tachycardia
#48-Pediatric Supraventricular Tachycardia

INDICATION(S)
-Paroxysmal supraventricular tachycardia
-Narrow complex tachycardia

CONTRAINDICATION(S)
- 2nd or 3rd degree AV block
-Known sick sinus syndrome unless an artificial pacemaker is in place
-Known hypersensitivity to adenosine

ADVERSE REACTION(S)
-Transient high grade AV block, chest pain, palpitations, and shortness of breath.

DOSAGE
-ADULT: 6 mg IV push over 1-3 seconds. If no effect after 1-2 minutes, Repeat with 12 mg IV push over 1-3 seconds. Repeat once if necessary (use stopcock and 20 ml NaCl flush with each dose)
PEDIATRIC: 0.1 mg/kg IV (Max 6 mg) push over 1-3 seconds. If no effect after 1-2 minutes, Repeat with 0.2 mg/kg IV (Max 12 mg) push over 1-3 seconds. Repeat once if necessary (use stopcock and 20 ml NaCl flush with each dose)

HOW SUPPLIED
-6 mg in a 2 ml pre-filled syringe. 12 mg in a 4 ml pre-filled syringe.
-6 mg in a 2 ml vial

CLASSIFICATION Sympathominmetic, Bronchodilator

ACTION(S) beta 2-adrenergic agonist which helps relax the bronchial smooth muscle

NCCEP PROTOCOL(S)
#30-Respiratory Distress
#46-Pediatric Respiratory Distress
#52-Drowning

INDICATION(S)
-Relief of bronchospasm
-beta-blocker overdose
-Hyperkalemia

CONTRAINDICATION(S)
-Prior hypersensitivity reaction to albuterol
-Cardiac dysrhythmias associated with tachycardia


ADVERSE REACTION(S)
-Tremors, dizziness, palpitations, tachycardia

DOSAGE
-ADULT: 2.5-5.0 mg (3cc) in nebulizer continuously x 3 doses, if no hx of cardiac disease and HR< 150
-PEDIATRIC: 2.5mg (3cc) in nebulizer continuously x 3 doses, if no hx of cardiac disease and HR < 200.

HOW SUPPLIED
-unit dose vial of 2.5 mg of Albuterol in 3 ml of NaCl

CLASSIFICATION antiarrythmic agent

ACTION class III antiarrythmic agent which prolongs phase III of cardiac action potential.

NCCEP PROTOCOL(S)
#35-Ventricular Fibrillation
#36-Ventricular Tachycardia
#45-Pediatric Pulseless Arrest

INDICATION(S)
-ventricular fibrillation
-ventricular tachycardia
-atrial fibrillation

CONTRAINDICATION(S)
-known anaphylaxis to amiodarone
-patients with heart block or profound bradycardia.

ADVERSE REACTION(S)
-hypotension

DOSAGE
-ADULT:
+V-fib / pulseless V-tach: 300 mg IV push, Repeat dose of 150 mg IV push for recurrent episodes
+V-tach with a pulse: 150 mg in 100cc D5W over 10 min
-PEDIATRIC:
+V-fib / pulseless V-tach: 5 mg/kg IV push over 5 min for SVT
+V-tach with a pulse:5 mg/kg IV push over 5 min (*Avoid Broslow-PINK*)

HOW SUPPLIED
-50 mg/mL in 3-mL ampule

CLASSIFICATION anti-pyretic, anti-platlet, NSAIDs

ACTION decreases platelet aggregation, prolongs clotting time, anti-pyretic activity

NCCEP PROTOCOL(S)
#21-Chest Pain and STEMI

INDICATION(S)
-acute MI
-coronary artery disease
-pericarditis

CONTRAINDICATION(S)
-patient who is already on anti-coagulants
-bleeding disorders
-hypersensitivity

ADVERSE REACTION(S)
-heart burn, nausea, wheezing, tinnitus (ringing in ears)

DOSAGE
-ADULT: 81 mg chewable (baby) Aspirin. Give 4 tablets to equal usual adult dose.
-PEDIATRIC: not indicated

HOW SUPPLIED
-81 mg chewable tablets