Page 195 - 2025 Ranger Medic Handbook

DRUG QUICK REFERENCE
ACETAMINOPHEN (Tylenol): 325–1,000mg PO q4–6hr KETOROLAC (Toradol): 15mg IV or 30mg IM q6hr
prn (max: 3g/d) LIDOCAINE: Infiltration 0.5%–2% injection
ALBUTEROL MDI: 2 puffs q4–6hr prn LOPERAMIDE: 4mg PO then 2mg after each unformed
CALCIUM CHLORIDE: 1g IV/IO q4 units of blood stool (max 16mg/day)
transfused MELOXICAM (Mobic): 7.5–15mg PO qd
CALCIUM GLUCONATE: 1–3g IV/IO q4 units of blood MIDAZOLAM (Versed): 2mg slow IV push q2–3min to
transfused max dose of 10mg OR 5–10mg IM for seizure control
DEXAMETHASONE (Decadron): 4mg PO q6–12hr; 10mg MOXIFLOXACIN: 400mg PO/IV QD 5–10d
IV/IM single dose NALOXONE (Narcan): 0.4–2.0mg IV; repeat q2–3min to
DIPHENHYDRAMINE (Benadryl): 25–50mg IV/IM/PO max of 10mg prn
q4–6hr NAPROXEN: 250–500mg PO bid
EPINEPHRINE (1:1,000): 0.3–0.5mg IM q10–15min NORMAL SALINE (HYPERTONIC): 30mL 23.4% bullet
ERTAPENEM (Invanz): 1g IV/IM q24hr for impending herniation or 250mL bolus of 3% for
FENTANYL ORAL LOZ: 800–1,600mcg (max: 1,600mcg/d) emergent hyponatremia
FENTANYL: 50–100mcg IV/IM q1–2hr prn ONDANSETRON (Zofran): 4–8mg slow IV push or IM
HYDROMORPHONE (Dilaudid): 1mg PO/SC/IM/IV q4hr prn OR 4–8mg PO q4hr prn
q2–4hr prn PROMETHAZINE (Phenergan): 12.5–25mg PO/IM/IV SECTION 4
IBUPROFEN: 600mg PO tid q4–6hr prn
KETAMINE: pain: 0.1–0.3mg/kg IV; sedation: 1–1.5mg/kg TRANEXAMIC ACID (TXA): 2g IV/IO ASAP
slow IV push until nystagmus, bump 20–25mg q10–20min
Ketamine Drip
Ketamine drip (for sedation): Sedation loading dose first (1.5mg/kg IV/IO over 60 seconds).
MIX: 250mg (1/2 vial of 500mg/5mL) in 250mL of normal saline (1mg/mL solution).
Initial drip dose:
Best: Using an IV pump, set to µg/kg/min dose desired. Increase or decrease dose by 5–1µg/kg/min increments.
Better: Using a dial flow adaptor, initial drip rate in mL/h equals the casualty’s weight in kg divided by 2 (sedations)
or 4 (pain).
Minimum: Count drip rate. Increase or decrease rate by 1–2 drips/min (very slowly) to achieve goal.
250mg Ketamine / 250mL Saline Bag
Ketamine Drip Dosing Tables
Ketamine Drip Rate for Dial Flow (starting dose highlighted)
Patient’s Weight, kg
Dose 60 80 100
mg/kg/hr Infusion Rate, Dial Flow Setting
0.5 30 40 50
0.75 45 60 75
1 60 80 100
1.25 75 100 125
1.5 90 120 150
1.75 105 140 175
2 120 160 200
Ketamine Drip Rate for × drip set
1.5 60 80 100
Drip Set Size Infusion Rate, 1 drip/X seconds
10 1 drop per 4 seconds 1 drop per 3 seconds 1 drop per 2.4 seconds
15 1 drop per 2.67 seconds 1 drop per 2 seconds 1 drop per 1.6 seconds
20 1 drop per 2 seconds 1 drop per 1.5 seconds 1 drop per 1.2 seconds
Note: Ranger medics will use their best judgement in determining drip estimation in varying drop set sizes.

2025 RANGER MEDIC HANDBOOK 181