State of Hawaii MICT Adult Standing Orders Questions & Answers
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State of Hawaii MICT Adult
Institution
State Of Hawaii MICT Adult
A-1 Allergic Reaction, Severe without Shock - ANSWERSO2 10-15lpm
Epi 1:1000 O.3mg IM
Normal Saline 300ml IV rapid infusion
Diphenhydramine 25mg IV repeat PRN in 10 min (OR 50mg IM)
Methylprednisolone 125 mg IV (for severe, generalized reaction)
Albuterol 5mg aerosolized (for wheezing or resp. ...
State of Hawaii MICT Adult Standing
Orders Questions & Answers
A-1 Allergic Reaction, Severe without Shock - ANSWERSO2 10-15lpm
Epi 1:1000 O.3mg IM
Normal Saline 300ml IV rapid infusion
Diphenhydramine 25mg IV repeat PRN in 10 min (OR 50mg IM)
Methylprednisolone 125 mg IV (for severe, generalized reaction)
Albuterol 5mg aerosolized (for wheezing or resp. distress)
A-1 Allergic Reaction, Severe with Shock - ANSWERSO2 10-15lpm
Epi 1:1000 0.3mg IM
Normal Saline 300ml IV rapid infusion
If still in shock follow SHOCK-HYPOVOLEMIA Standing Order A-18 (rapid transport, NS
IV until BP>90)
If still in shock give Epi 1:10, 000 IV at 0.1mg increments titrated up to 0.5mg
Dyphenhydramine 50mg IV
Methylprednisolone 125mg IV
Albuterol 5mg aerosolized (for wheezing or resp. distress)
A-1 Allergic Reaction, Severe with Shock, NO IV AVAILABLE - ANSWERSO2
Repeat Epi 1:1000 0.3mg IV 5 minutes after 1st dose if still in shock
Diphenhydramine 50mg IM
A-2.a Arrest, Cardiac-Asystole - ANSWERSABCs---CPR
Monitor---Asystole? (2 leads?)
Establish IV NS TKO
Epi 1:10,000 1mg IV q 3-5 min
Intubate
A-2.a Arrest, Cardiac-PEA - ANSWERSABCs---CPR
Monitor---PEA
NS 300ml IV Rapid Infusion (if no CHF)
Epi 1:10,000 1mg IV q 3-5 min
Intubate
Causes?
A-2.c Arrest, Cardiac -In Renal Dialysis Patient - ANSWERS1. Calcium Chloride 1g IV
2. Flush Line!
3. Sodium Bicarbonate 1mEq/kg IV
If no change, FLUSH LINE and repeat once
A-2.d Arrest, Cardiac-VF or Pulseless VT - ANSWERSShock
, IV/Intubate
Shock
Epi
Shock
Amiodarone 300mg IV
Shock
Amiodarone 150mg IV AND Epi
Shock
Lidocaine 1.5mg/kg IV
Shock
Epi
A-2.d Arrest, Cardiac-VF or Pulseless VT AFTER CONVERION - ANSWERSIf
conversion after Amiodarone
-150mg in 100ml NS, run over 10 min (15mg/min or 10ml/min)
-With a 10gtts/ml set---100gtts/min
-2gtts/sec
If conversion after Lidocaine
-1-2mg/min drip
-With a 60gtts/ml set and a 4mg/ml bag---15-30gtts/min
-1gtt q 1-2sec
A-3 Arrest, Respiratory (with pulse) - ANSWERSBVM with O2
Intubate
If no success w/intubation:
-BVM
-Supraglottic Airway
-PATI Standing Order A-11
-Criothyrotomy only if unable to OXYGENATE because of facial trauma or other
persistent airway obstruction (may oxygenate with minimal ventilation).
Establish IV NS TKO
A-4 Symptomatic Bradycardia - ANSWERSHR<60 BP<90 and one or more
signs/symptoms:
-Chest Px
-SOB
-Skin pale, cool, clammy
O2
Apply Pads
Establish IV NS TKO
Turn on pacemaker
If BP<90 and Pt is symptomatic
-NS 300ml IV bolus (if no CHF)
-Atropine 0.5mg IV (repeat PRN q 3-5min up to 3mg total)
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