Page 152 - PJ MED OPS Handbook 8th Ed

4. Intravenous (IV) injection:
Inject slowly into the tubing of an actively running, reliable IV. It’s acceptable to infuse one IV
into another (“piggy back”) if the substances (medications, fluids, blood products) are compati-
ble. IV injection through the port of a saline lock should be followed by a saline flush of 5–10mL.
5. Intraosseous (IO) injection:
Reference Surgical and Medical Procedures chapter for intraosseous injection TTPs.
6. Intranasal (IN):
Intranasal typically absorbs more efficiently and quicker than IM and transmucosally and should
be considered if IV/IO is not available or desired. IN administration is limited in scope by the
maximum volume of the drug that can be pushed at one time: 2mL max (1mL per nostril). This
limits medication delivery to only high concentration drugs such as:
• Ketamine
• Fentanyl
• Versed
• Narcan
• Toradol
• Zofran
• Benadryl
• Dexamethasone
• Pepcid

Other routes of administration may include:
• Endotracheal (e.g., via ETT – NAVEL meds)
• Transdermal
• Transmucosal (e.g., OTFC – oral transmucosal fentanyl citrate)
• Ocular instillation (e.g., drops or ointment)
• Rectal (e.g., suppositories)

Brand Name to Generic Quick Reference

NOTE: All drugs in the PJ Med Handbook formulary are listed alphabetically by their generic
name. Reference the conversion guide below for common brand to generic name assistance.

Adenocard = adenosine Dilaudid = hydromorphone Narcan = naloxone
Afrin = oxymetazoline Doxy = doxycycline Pepcid = famotidine
Augmentin = amoxicillin/ Flagyl = metronidazole Sudafed = pseudoephedrine
clavulanic acid Imodium = loperamide Toradol = ketorolac
Avelox = moxifloxacin Invanz = ertapenem Tylenol = acetaminophen
Benadryl = diphenhydramine Keppra = levetiracetam Versed = midazolam
Cipro = ciprofloxacin Ketalar = ketamine Verticalm = meclizine
Cortaid = 1% hydrocortisone Malarone = atovaquone Zithromax, Z-Pak =
cream 250mg/proguanil 100mg azithromycin
Decadron = dexamethasone Mobic = meloxicam Zofran = ondansetron
Diamox = acetazolamide Motrin = ibuprofen

150 n Pararescue Medical Operations Handbook / 8th Edition