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UW Health Ambulatory Emergency Response Cart Medications

UW Health Ambulatory Emergency Response Cart Medications - Departments & Programs, UW Health, Ambulatory Education, Ambulatory Emergency, Resources


Drug Indications Dosage/Administration
Epinephrine (Adrenalin)
1 mg = 1 mL of 1:1000
Supplied as: 1 mL vial for injection kit
ξ Anaphylactic shock,
hypersensitivity reactions,
bronchospasms
Administer as directed by provider or per Delegation Protocol (Medical Emergency Care-
Adult/Pediatric-Ambulatory under Anaphylaxis)

Epinephrine 1:1000
(NOTE: 1 mg = 1 mL of 1:1000)
Doses:
Adults: 0.3 mg/0.3 mL IM
Pediatric dose based on 0.01 mL/kg
>60 lbs. (> 27 kg) = 0.3 mg/0.3 mL IM
50 lbs. (22.7 kg) = 0.25 mg/0.25 mL IM
40 lbs. (18 kg) = 0.2 mg/0.2 mL IM
30 lbs. (13.6 kg) = 0.15 mg/0.15 mL IM
<20 lbs. (<9 kg) = 0.1 mg/0.1 mL IM

ξ Epinephrine intramuscular (IM) for 1 dose to all patients.
ξ May repeat in 10 minutes if inadequate response.
ξ Give in outer thigh if possible, otherwise give in deltoid.

Diphenhydramine (Benadryl)
50 mg/mL
Supplied as: 1 mL syringe
ξ Allergic symptoms and
reactions
Administer as directed by provider or Delegation Protocol (Medical Emergency Care-Adult/Pediatric-
Ambulatory under Anaphylaxis)

Diphenhydramine (BENADRYL) Doses:
Adults and children > 12 years old = 50 mg IM
Pediatrics: dose based on 1-2 mg/kg
>60 lbs. (>27 kg) = 50 mg/1 mL IM
50 lbs. (22.7 kg) = 37.5 mg/0.75 mL IM
40 lbs. (18 kg)= 25 mg/0.5 mL IM
30 lbs. (13.6 kg)= 20 mg/0.4 mL IM
<20 lbs. (<9 kg)= 12.5 mg/0.25 mL IM

ξ Diphenhydramine (BENADRYL) IM for 1 dose to all patients

Ambulatory Emergency Medications


Aspirin
Supplied as : 81 mg chewable tablet
ξ Chest pain













Administer as directed by provider or Delegation Protocol (Medical Emergency Care-Adult/Pediatric-
Ambulatory under Cardiac Emergency Management-Adult)

Aspirin Dose: Instructions:
Adult:

Pediatric:
324 mg (4 chewable aspirin)

Not applicable or contraindicated
Instruct to chew 4 tabs and swallow

Nitroglycerin
Supplied as: 0.4 mg sublingual tablet
ξ Chest Pain



















Administer as directed by provider or Delegation Protocol (Medical Emergency Care-Adult/Pediatric-
Ambulatory under Cardiac Emergency Management-Adult)

Nitroglycerin Dose: Instructions:
Adult:





Pediatric:
0.4 mg sublingually if systolic blood
pressure (BP) > 90 mmHg.





Not applicable
Best to have patient in sitting or lying
position
May repeat every 3-5 minutes up to 3
doses until relief obtained or patient
ready for transport.
BP & Pulse should be taken and
documented before each new dose
given.


Glucose Tablets
Supplied as: 4 gm tablet

ξ Hypoglycemia when level of
consciousness is NOT
altered and patient can
safely take medications by
mouth






























Administer as directed by provider or Delegation Protocol (Medical Emergency Care-Adult/Pediatric-
Ambulatory under Hypoglycemia)

Level of Consciousness: NOT ALTERED – give 15 gm of carbohydrate
Intervention Dose
Dex 4 (drink)
Glucose tablets
Fruit juice

Drink one 2 oz bottle of Dex 4 (or)

4 glucose tabs (or)

Drink 4 ounces of fruit juice
If after 15 minutes the blood glucose remains below 70 mg/dL, administer another dose
of one of the three interventions



Dextrose 50%
Supplied as: 25 gm/50 mL vial for
injection




Glucagon 1mg
Supplied as: 1mg/1ml kit for injection
ξ Hypoglycemia when level of
consciousness is ALTERED
or patient is unable to
safely take medications by
mouth






























Administer as directed by provider or Delegation Protocol (Medical Emergency Care-Adult/Pediatric-
Ambulatory under Hypoglycemia)

Level of Consciousness: IS ALTERED
Or patient unable to swallow
Blood Glucose
40-69 mg/dL







Adults or children weighing more than 44 lbs. (>20 kg):

If intravenous (IV) route available or able to quickly establish IV
Med Dose/instructions
Dextrose 50% 12.5 grams (25 mL)
By slow IV push
Do NOT dilute

If unable to quickly establish an IV:
Med Dose/instructions
Glucagon 1 mg SQ or IM

Children weighing 44 lbs. (20 kg) or less:

Med Dose/instructions
Glucagon 0.5 mg SQ or IM

<40 mg/dL Adults or children weighing more than 44 lbs. (>20 kg):

If intravenous (IV) route available or able to quickly establish IV
Med Dose/instructions
Dextrose 50% 25 grams (50 mL)
By Slow IV

Children weighing 44 lbs. or less (<20 kg):
If unable to quickly establish an IV:
Med Dose/instructions
Glucagon 0.5 mg SQ or IM

Repeat in 15 minutes if patient’s blood glucose remains under 70 mg/dL and
their level of consciousness remains altered.


Naloxone (Narcan)
Supplied as : 2 mg/2 mL vial or syringe
for injection
ξ Narcotic Overdose/reversal Administer as directed by provider

Adult Dose: 0.4-2 mg IV, IM, SQ, or Nasal with adapter at 2-3 minute intervals if needed

Pediatric Dose: 0.1 mg/kg (maximum single dose: 2mg) IV, IM, SQ, or Nasal with adapter at 2-3
minute intervals if needed

Administration: Over 30 seconds IV push

May need to repeat doses every 2 to 3 minutes

Flumazenil (Romazicon)
Supplied as: 0.5 mg/5 mL vial for
injection

ξ Benzodiazepine reversal Administer as directed by provider
Adult Dose: Initial dose: 0.2 mg IV over 15 seconds; if the desired level of consciousness is not
obtained 30-60 seconds after the initial dose, 0.3 mg IV can be given over 30 seconds
Pediatric Dose: Initial dose: 0.01 mg/kg (maximum single dose: 0.2 mg) IV over 15 seconds; if the
desired level of consciousness is not obtained 30-60 seconds after the dose, repeated dose can be
given
Administration: Give IV over 15 seconds

Sodium Chloride Flush 0.9%
Available as 10 mL vial or syringe
ξ IV line Flush Flush IV line












UW Health IV administration Guidelines:
https://uconnect.wisc.edu/clinical/cckm-tools/content/?path=/content/cpg/medications/name-97579-en.cckm

Additional Emergency Medications (if applicable for specific clinic site)
Adenosine (Adenocard)
3 mg/mL

Supplied as: 2 mL
syringe or vial
ξ First drug for narrow-complex
PSVT(paroxysmal
supraventricular tachycardia)
ξ May be used diagnostically
(after lidocaine) in wide-
complex tachycardias of
uncertain type.


Administer as directed by provider
Follow UW Health IV administration Guidelines for administering Adenosine

Adult Dose:
Initial: 6 mg IV push (rapid, over 1 to 2 seconds)
Repeat dose: If not effective within 1 to 2 minutes, 12 mg IV push may be given;
(Maximum single dose: 12 mg).
Follow each dose with rapid 20 mL normal saline flush

Instructions:
Rapid IV bolus (over 1 to 2 second)
Use at a peripheral IV site as proximal as possible to trunk (not in lower arm, hand, lower leg, or foot);
Follow each bolus with a rapid normal saline flush to ensure all medication reaches site of action

Precautions: Transient side effects including flushing, chest pain or tightness, brief periods of asystole or
bradycardia
*Patients rhythm should be monitored when given.
Atropine Sulfate
0.1 mg/1 mL

Supplied as: 1mg/10 mL
syringe for injection

ξ Symptomatic bradycardia
ξ AV (atrioventricular) block
ξ Asystole


Administer as directed by provider
Follow UW Health IV administration Guideline for administering Atropine

Adult Dose: 0.5 mg IV every 3 to 5 minutes, not to exceed a total of 3 mg or 0.04 mg/kg total dose

Instructions: Administer undiluted by rapid IV injection;
Slow injection may result in paradoxical bradycardia.
When treating symptomatic bradycardia, atropine administration should not delay treatment with external
pacing

Precautions: Use with caution in presence of myocardial ischemia and hypoxia. Avoid in hypothermia.
*Patients rhythm should be monitored when given.
Reviewed By: Clinical Staff Education Department, 2017