Hermannems.com

Acetaminophen (Children’s Tylenol) How Supplied: Concentration:
Dose: 160-480mg PO
118ml btl
160mg per 5ml
Anti-Pyretic • Minor Aches & Pains
Contra: Contact medical control if patient is on Warfarin or has liver disease • Severe liver
damage can occur if patient takes more than 5 doses in 24 hour period • Do not use with other
drugs containing acetaminophen
Administration Notes:
Children’s Tylenol
Under 24 lbs
Under 2 years
Ask a doctor
24 – 35 lbs
2 – 3 years
1 teaspoon or 5 ml
1 ½ teaspoons or 7.5
36 – 47 lbs
4 – 5 years
48 – 59 lbs
6 – 8 years
2 teaspoons or 10 ml
2 ½ teaspoons or 12.5
60 – 71 lbs
9 – 10 years
72 – 95 lbs
3 teaspoons or 15 ml
Activated charcoal (Actidose)
How Supplied:
Concentration:
Dose: 1gm/kg PO
25gm/120ml btl
0.2gm per ml
Overdose of many Ingested Poisons
Ineffective for poisonings or OD of Cyanide, mineral acids & alkalies
Administration Notes:
Children < 12: 1gm/kg to max of 50gm. 12 and older 50 – 100gm (2 – 4 bottles)
Contains sorbitol for laxative properties to aid in elimination of bound toxins.
Adenosine (Adenocard):
How Supplied:
Concentration:
Dose: 6mg - Rapid IVP
6mg/2ml PF
3mg per ml
2nd: 12mg - Rapid IVP
12mg/4ml PF
May repeat x 1
Supra-Ventricular Tachycardia (SVT)
2° or 3° AV block • VT • Sick Sinus Syndrome
Administration Notes: For best results, use most proximal vein such as antecubital; have 10ml
saline flush attached to 2nd port & push immediately after or simultaneously with push of
adenosine.

Albuterol (Proventil)
How Supplied:
Concentration:
Dose: 2.5mg Nebulized
2.5mg/3ml amp
0.83mg per ml
Bronchospasm
Tachydysrhythmias • Use with caution in pt’s with Hx of heart disease or
hypertension
Administration Notes:
Place 2.5mg with 3ml of normal saline in nebulizer cup & set o2 to 5-6 liters per minute.

Amiodarone (Cordarone)
How Supplied:
Concentration:
Dose: 150mg - IV over 10min
150mg/3ml PF
50mg per ml
300mg – IVP
Pulmonary congestion • Cardiogenic shock • Hypotension
Administration Notes:
Loading dose for cardiac arrest: 300 mg IVP (2 Prefilled syringes)
For unstable VT – 150mg IV over 10 min:

Place 150mg (1 prefilled syringe) in 100ml of normal saline, give over 10 min
Set pump to 600ml/hr if using IV pump.
If setting manual drip: Using 10gtt IV Set:
150mg in 100ml, you need to give 10ml per minute or 100ml in 10 min.
100gtts per min. or approx: 1.5gtts per second = 100ml in 10 min.

Aspirin (ASA)
How Supplied:
Concentration:
Dose: 324mg PO
81mg per tab
Anti-Platelet Aggregation
GI Bleeding • Bleeding disorders • Children under 12 with Flu-like symptoms •
Peptic ulcer • Liver problems

Administration Notes:
4 tablets = 324

Atropine sulfate
How Supplied:
Concentration:
Dose: 0.5 – 1mg IVP
1mg/10ml PF
0.1mg per ml
Asystole • PEA • Symptomatic Bradycardia • Organophosphate Poisoning
Atrial fibrillation or Atrial flutter with rapid ventricular response (RVR) •
Glaucoma • Myocardial Infarction (USE WITH EXTREME CAUTION)
Administration Notes:
Bradycardia: 0.5 – 1mg IV q 5 min until desired heart rate reached or total of 0.04mg/kg has
been given (approx. 3mg in average sized adult; 4 mg in larger adult)
Asystole: 1mg IVP q 3-5 min, max 0.04mg/kg; Peds: 0.02mg/kg IV or ET to max of 0.5 mg for
children, 1mg in adolescents.
Organophosphate poisoning: Your most likely not going to have enough Atropine on board
the truck; Rx for OP poisoning is 1 – 3mg IV as a loading dose; Continue administration of
Atropine at 1 – 3mg q 30 min until SLUDGE symptoms subside; The dose listed is a minimum &
should be titrated to patient response; more or less may be needed; monitor your patient
closely.
SLUDGE – Salivation – Lacrimation – Urination – Defecation – Gastrointestinal motility - Emesis
Calcium chloride
How Supplied:
Concentration:
Dose: 2 – 4mg/kg IVP
1gm/10ml PF
100mg per ml
Calcium Channel Blocker Toxicity • Hypocalcemia with Tetany • Hyperkalemia •
Hypermagnesemia
Use with caution in digitalized patients due to increased ventricular irritability &
can precipitate digitalis toxicity • Precipitates with Sodium Bicarbonate

Administration Notes:
Refer to mg/kg chart for quick reference
Calcium Chloride is not a common medication given pre-hospital, contact medical control for
use if any questions arise and/or 2nd dose is needed.

Clopidogrel bisulfate (Plavix)
How Supplied:
Concentration:
Dose: 300mg PO
75mg/tab
75mg per tab
STEMI Pt’s up to 75 years of Age Receiving ASA & Heparin
Active bleeding • Recent Hx (Within 3 months) of cerebrovascular, intracranial or
intraspinal event • Suspected aortic dissection • Major surgery or trauma within
14 days • Severe uncontrolled hypertension

Administration Notes:
4 – 75mg tablets = 300mg

Diazepam (Valium)
How Supplied:
Concentration:
Dose: 2.5 - 5mg IV
10mg/2ml CJ
5mg per ml
Status Epilepticus • Sedative Prior to Cardioversion
Pregnancy • Head Injury • Hypotension • In conjunction with other CNS
depressants • Acute Narrow Angle Glaucoma • MONITOR PATIENT FOR S/S OF
RESPIRTORY DEPRESSION.

Administration Notes:
Administer in 2.5mg IV Increments titrated to effect. Check & record patient’s VS prior to and
after administration. Total dose not to exceed 10mg. For status epilepticus 5 to 10mg IV slow
may be needed: MONITOR PATIENT FOR S/S OF RESPIRATORY DEPRESSION. PPV may be
needed for ventilatory support.

Diltiazem (Cardizem)
How Supplied:
Concentration:
Dose: 0.25 mg/kg IV over 2 min
25mg/5ml Vial
5mg per ml
2nd: 0.35 mg/kg IV over 2 min
Rx:
Atrial Fibrillation • Atrial Flutter • PSVT
VT • Sick Sinus Syndrome • 2nd or 3rd Degree Heart Block • WPW • Hypotension
less than 90 mm/Hg • Acute MI • Pulmonary Congestion
Administration Notes:
Bolus 0.25mg/kg over 2 min initially. If ineffective after 15 minutes, may repeat bolus @
0.35mg/kg over 2 minutes. IV drip of 5 – 15mg/hr should follow initial bolus.

Diltiazem 5mg/ml
Patient weight in kg
Bolus Doses in ml’s
1st dose 0.25mg/kg
2nd dose 0.35mg/kg
For maintenance drip of 5 – 15mg/hr: Mix 10mg (2ml) in a 100ml bag of normal saline. Set IV
pump at a rate of 100ml/hr which = 10mg/hr

Manual drip set up: For 10mg/hr: Using a 10gtt IV set. Mix 10mg (2ml) in a 100ml bag of
normal saline. Set drip rate at approx. 17gtts/min or approx. 1gtt/4 seconds

Dextrose (D50)
How Supplied:
Concentration:
Dose: 12.5 – 25gm IV
25gm/50ml PF
0.5gm per ml
Peds: 0.5 – 1gm/kg IV Slow
Rx:
Hypoglycemia
Intracranial Hemorrhage • Known Hyperglycemia

Administration Notes:
Start IV in most accessible proximal vein, i.e. Antecubital.
Diphenhydramine (Benadryl)
How Supplied:
Concentration:
Dose: 10 - 50mg Deep IM or IV
50mg/ml CJ
50mg per ml
Allergic Reactions • Anaphylactic Shock • Dystonic Reactions resulting from
Phenothiazine ingestion (Haldol, Phenergan etc.)
Asthma • Ulcer Disease • Enlarged Prostate • Glaucoma
Administration Notes:
Most cases, Benadryl is given deep IM but can be given IV slowly

Dopamine (Intropin)
How Supplied:
Concentration:
Dose: 5 - 20µg/kg/min IV
400mg/250ml Premix 1600µg per ml
Cardiogenic Shock • Hypotension • Bradycardia
HYPOVOLEMIC SHOCK • Phenochromocytoma (Tumor that produces
epinephrine) • VF • Tachydysrhythmias • Deactivates with Sodium Bicarb
Administration Notes:
It is not advised to manually set drip of dopamine: PLACE ON IV PUMP. Drip calculator in IV
Pump has dopamine pre-programmed.
**If IV Pump OOS and manual drip is only option: MONITOR YOUR PATIENT CLOSELY. Use
the following chart to calculate gtts/min based on desired dose, pt’s weight in kg, & drip set.
(60gtt or 10gtt)
Dopamine Drip Chart
Next Page
Dopamine Drip Chart
400mg/250ml (1600µg/ml)
5µg/kg/min
10µg/kg/min
15µg/kg/min
20µg/kg/min
kg lbs gtts/minute
gtts/minute
gtts/minute
gtts/minute
60gtts/ml IV Tubing
10gtts/ml IV Tubing
Epinephrine 1:1000 (Adrenalin)
How Supplied:
Concentration:
Dose: 0.3 – 0.5mg SQ
1mg/ml amp
1mg per ml
30mg/30ml Vial
1mg per ml
Severe Allergic Reaction • Anaphylactic Shock • Acute Asthma
Use with caution in patients with angina, hypertension & hyperthyroidism

Administration Notes:
Allergy or anaphylaxis: 0.5mg SQ
Mild to moderate asthma attacks: 0.3 – 0.5mg SQ
Peds: 0.01mg/kg 1:1000 up to max of 0.3mg SQ
See administration notes under Epi – 1:10,000 for 1:1000 ETT Dosing and for IV drip set up.

Epinephrine 1:10,000 (Adrenalin)
How Supplied:
Concentration:
Dose: 1mg IVP q 3 – 5 min
1mg/10ml PF
0.1mg per ml
ETT: 2 – 2.5mg q 3 – 5 min
Peds: 0.01mg/kg IV/IO q 3 - 5min - Max 1mg single dose
ETT: 0.1mg/kg (1:1000) Max 2mg single dose
Rx:
Cardiac Arrest
None in cardiac arrest
Administration Notes:
To administer 1mg q 3 minutes during cardiac arrest, if time permits and/or available
personnel on scene to assist. IV drip can be set up to accommodate 1mg q 3 minutes using
the following drip set up:
Mix 12mg of epinephrine (1:1000) from multi-dose vial in 100ml of Normal Saline. This gives
you 0.1mg/ml
Therefore 10ml = 1mg. 10ml q 3 min = 1mg q 3 min
Set IV pump at 200ml/hr = 1mg q 3 min. If setting manual drip: Spike IV bag with 10gtt set &
hang drip at 33gtts/min or 1 gtt q 2 seconds.
Drip Chart Next Page
Using a drip for administration of Epi during a code ensures adequate dosing at given time
intervals & frees up hands from having to stop & administer Epi via prefilled every 3 minutes.
BE SURE IF PATIENT HAS A ROSC (RETURN OF SPONTANEOUS CIRCULATION) TO TURN
OFF EPI DRIP & DISCONNECT TO PREVENT ACCIDENTAL BOLUS!
Pediatric Epinephrine Administration
0.15 0.35 0.7
0.01mg/kg
ETT Dose 0.2 0.4 0.7
Milliliters or cc’s of drug to be given
Furosemide (Lasix)
How Supplied:
Concentration:
Dose: 0.5 – 1mg/kg IV slow
100mg/10ml PF
10mg per ml
Up to 40mg
Pulmonary Edema
Pregnancy • Hypokalemia
Administration Notes:
May give up to 2 times daily dose of Lasix in acute pulmonary edema. IV injected slow over 1–
2 minutes.
Glucagon
How Supplied:
Concentration:
Dose: 1mg SQ, IM or slow IV
1mg/ml PF
1mg per ml
Peds: See notes
Reconstitutable
Hypoglycemia
Known hypersensitivity
Administration Notes:
1mg SQ, IM or slow IV should give response within 5 – 10 minutes.
Peds: 0.5mg (<20 kg) or 0.003 – 0.1mg/kg not to exceed 1mg SQ, IM or slow IV.

Haloperidol (Haldol)
How Supplied:
Concentration:
Dose: 2 – 5mg IM
5mg/ml Vial
5mg per ml

Peds: 0.05 to 0.15mg IM
Rx:
Acute Psychotic Disorders • Emergency Sedation of Severely Agitated or Delirious
Person
CNS depression • Coma • Pregnancy • Severe Liver & Cardiac Disease

Administration Notes:
To be given IM only
Haldol is rarely given to pediatrics pre-hospital. Contact medical control.

Heparin (Unfractionated)
How Supplied:
Concentration:
Dose: 60 IU/kg – max 4000 IU IV
5000 IU/ml CJ
5000 IU per ml
Patients Undergoing Percutaneous or Surgical Revascularization
Severe thrombocytopenia • Active bleeding • Hx Stroke within 3 months •
Major Surgery or Trauma within 14 days
Administration Notes:
70 or >
weight
Bolus
2000 2700 IU 3000 IU 3300 IU 3600 IU 3900 IU 4000 IU
Ipratropium bromide (DuoNeb)
How Supplied:
Concentration:
Dose: 0.5mg Unit Dose (Nebulized) 0.5mg/3ml amp
0.16mg per ml
Bronchospasm • Exacerbation of COPD
Hypersensitivity to peanuts, soy lecithin or atropine derivatives •
Glaucoma
Administration Notes:
DuoNeb or Combivent contains 0.5mg Ipratropium bromide & 3mg albuterol sulfate.
Ketorolac (Toradol)
How Supplied:
Concentration:
Dose: 15 – 60mg IM or IV
60mg/2ml CJ
30mg per ml
Analgesia
Allergy to NSAID’s • Active peptic ulcer
Administration Notes:
< 65 years old – one 60mg dose IM
> 65 years old – one 30mg dose IM

< 65 years old – one 30mg dose IV
65 or >, renal impairment or weight < 50kg - one 15mg dose IV

Lidocaine (Xylocaine)
How Supplied:
Concentration:
Dose: 1 – 1.5mg/kg IV or ET
100mg/5ml PF
20mg per ml
2nd: 0.5 – 1.5mg/kg q 3 – 5 min
2gm/500ml Premix
4mg per ml
to max of 3mg/kg
PVC’s • Prophylactic tx of VF or Recurrence of VF after Cardioversion • VT
2nd or 3rd degree heart block • Sinus bradycardia • Idioventricular rhythm

Administration Notes:
Bolus: See mg/kg chart for quick reference
Lidocaine drip: 1 – 4mg/min
IV Pump has drip calculator for Lidocaine
To set manual drip: Spike Lidocaine premix with 60gtt Micro Tubing and run according to
chart:
Drip Rate
µgtts/min
1gtt q 1.5
gtts/sec
1gtt q 4 sec
1gtt q 2 sec
1gtt q sec
Magnesium sulfate
How Supplied:
Concentration:
Dose: 1 – 4gm IV
5gm/10ml PF
0.5gm per ml
Cardiac Arrest • Torsades De Points • Seizures 2o Eclampsia • Hypomagnesemia
Heart block • Myocardial damage

Administration Notes:
Cardiac Arrest: 1 to 2gm IVP (2 – 4ml)
Torsades with a pulse: 1 to 2gm diluted in 100ml D5W over 5 to 30 minutes. Mix 1 – 2gm (2 –
4ml) in a 100ml bag of D5W place on pump @ the following settings for given time you want to
infuse it in:
Manual Drip Using 10gtt Set
200ml/hr
30 minutes
200ml/hr or 30min
33gtts/min or 1gtt/2sec
400ml/hr
15 minutes
400ml/hr or 15min
66gtts/min or 1gtt/sec
800ml/hr
7.5 minutes
800ml/hr or 7.5min
132gtts/min or 2gtts/sec

Seizures 2o Eclampsia: 2 – 4gm IV over 25 minutes
Mix 3gm (6ml) in 100ml normal saline: Set pump at 250ml/hr OR: 1gtt/1.5 seconds using a
10gtt set (Manual)
Meperidine (Demerol)
How Supplied:
Concentration:
Dose: 50 – 100mg IM or IV
50mg/ml CJ
50mg per ml
Moderate to Severe Pain
Diarrhea caused by poisoning • Pt’s taking MOI (Monoamine Oxidase
Inhibitor) medications • L&D of a premature infant • Abdominal or head

Administration Notes:
50 – 100mg IM
List of common MOI medications:
10 – 25mg IV
Parnate (tranylcypromine) Marplan(isocarboxazid)
Pediatric dose: 1-2mg/kg dose IM or IV
Zelepar (selegiline) Nardil (phenelzine)
Emsam (selegiline) Eldepryl (selegiline)
Methylprednisolone (Solu-Medrol)
How Supplied:
Concentration:
Dose: 40 – 125mg IV
125mg/2ml Vial
62.5mg per ml
Reconstitutable
Anaphylaxis • Bronchodilator for Unresponsive Asthma
Use with caution in patients with GI bleeding & diabetes • Pregnancy
safety not established

Administration Notes:
Can be given deep IM
Metoprolol (Lopressor)
How Supplied:
Concentration:
Dose: 25mg PO
25mg per tab
Beta Blocker Therapy for Acute Coronary Syndrome
Heart rate < 50 bpm • Systolic pressure < 100mm/Hg • CHF • S/S of shock
• Heart blocks • Severe active asthma
Administration Notes:
Monitor for hypotension & decreased heart rate.

Midazolam (Versed)
How Supplied:
Concentration:
Dose: 2.5 – 5mg IV or IM
5mg/ml CJ
5mg per ml
Sedation Prior to Cardioversion or RSI • Seizures
Acute narrow angle glaucoma • Sensitivity to Benzodiazepines

Administration Notes:
Titrate dose to achieve desired effect. Contact medical control if more than 5mg is needed to
achieve sedation. 5mg can be given IM for seizure episodes when IV has not been
established.
Morphine sulfate
How Supplied:
Concentration:
Dose: 2 – 5mg IV
10mg/ml CJ
10mg per ml
Pulmonary Edema associated with CHF • Chest Pain in association
Myocardial Infarction
Contra:
Hypotension • Respiratory depression • Asthma • COPD • Ingestion of
depressant drugs • Head injury • Abdominal pain

Administration Notes:
Give 2 to 5mg IV titrated to effect. Contact medical control for additional dosage.

Naloxone (Narcan)
How Supplied:
Concentration:
Dose: 2 mg IV
2mg/2ml PF
1mg per ml
Peds: 0.01mg/kg may repeat at 0.1mg/kg max of 2mg
Known Narcotic Overdose
Administration Notes:
Rapid administration may precipitate projectile vomiting, dysrhythmias, acute withdrawal
syndrome & in rare cases pulmonary edema &/or sudden death.
Be aware that the half-life is usually shorter than most narcotics & may require additional
doses to prevent further or recurrent respiratory depression.
Nitroglycerin (Nitrostat, Tridil) How Supplied:
Concentration:
Dose: 0.4mg SL
0.4mg tab
0.4mg per tab
5µg/min IV titrated
25mg/250ml Vial 100µg per ml
Ischemic Chest Pain
Known sensitivity to organic Nitrates • Suspected inferior wall MI with
possible right ventricular involvement • Systolic pressure < 90 mm/Hg •
Extreme Bradycardia • Uncorrected hypovolemia • In conjunction with
medications used for erectile dysfunction within last 48 hours
Administration Notes:
0.4 mg q 3 – 5 minutes SL to max of 0.04mg/kg or 3 doses in adults. Larger adults 4 doses.
IV nitro should be administered at a starting dose of 5µg/minute via IV PUMP ONLY capable of
exact dosing. Titrate response to medication q 3 – 5 minutes in 5µg increments then in 3µg
increments as you approach desired effect as well as increased time intervals between dose
increments. Monitor your patient closely for hypotension. HYPOTENSION MAY WORSEN
MYOCARDIAL ISCHEMIA – Hypotension usually responds well to IV fluids. ESTABLISH
SECOND IV LINE PRIOR TO ADMINISTRATION OF IV NITRO.
Ondansetron (Zofran)
How Supplied:
Concentration:
Dose: 4mg IV/IO/IM
4mg/2ml Vial
2mg per ml
Nausea & Vomiting
Hypersensitivity • Children < 2 years of age
Administration Notes:
Adults: 4mg IV, IO or IM
Pediatrics: < 40 kg - 0.1mg/kg IV, IO or IM (See mg/kg chart for quick reference)
> 40 kg – 4mg
Rocuronium (Zemuron)
How Supplied:
Concentration:
Dose: 1mg/kg IV
100mg/10ml Vial
10mg per ml
Paralysis to Facilitate Intubation
Known hypersensitivity
Administration Notes:
Adults & Peds: 1mg/kg IV
Defasiculating dose: 0.05 mg/kg
Defasiculating dose chart: 0.05mg/kg
mg 0.15 0.25
1.25 1.5 1.75
0.05 0.05 0.05 0.05
100 110 120 130
3.25 3.5 3.75
Racemic epinephrine
How Supplied:
Concentration:
Dose: 2.25% Nebulized
11.25mg/0.5ml amp
11.25mg per ½ ml
Croup in Pediatric Patient’s
Hypersensitivity
Administration Notes:
Mix 2.25% (0.5ml single unit dose) with 3ml of normal saline & nebulize.
Succinylcholine (Anectine)
How Supplied:
Concentration:
Dose: 1mg/kg IV
200mg/10ml Vial
20mg per ml
Peds < 2: 2mg/kg IV
Paralysis to Facilitate Intubation
Acute narrow angle glaucoma • Penetrating eye injuries • Burns &
Massive crush injuries > 8 hours old
Administration Notes:
Review RSI or Medication Assisted Intubation thoroughly.
Pediatric dose in children < 2 is 2mg/kg due to faster metabolism.
Sodium bicarbonate 8.4%
How Supplied:
Concentration:
Dose: 1mEq/kg IV
50mEq/50ml Vial
1mEq per ml
Cardiac Arrest • Hyperkalemia • Tricyclic Anti-Depressant Overdose
Metabolic alkalosis
Administration Notes:
1ml/kg followed by 0.5ml/kg q 10 min for Cardiac Arrest.
1ml/kg for Hyperkalemia & Tricyclic OD
Thiamine (B1)
How Supplied:
Concentration:
Dose: 100mg IM or Slow IV
100mg/ml Vial
100mg per ml
Chronic Alcoholism for Thiamine Deficiency
Administration Notes:
Administer prior to D50 if alcoholism is suspected in hypoglycemic patients.
Vasopressin (Pitressin)
How Supplied:
Concentration:
Dose: 40 IU IV
20IU/ml Vial
20IU per ml
Alternative to Epinephrine for Asystole & PEA • Given with Epinephrine for VF,
Pulseless VT
None in cardiac arrest
Administration Notes:
Give 40 IU (2 vials) IV to replace epinephrine with first or second dose of epinephrine during
cardiac arrest.
Give 40 IU (2 vials) IV with first dose of epinephrine during cardiac arrest when pt is in VF or
Pulseless VT.

Source: http://www.hermannems.com/files/IphoneDrugIndex.pdf