Page 173 - PJ MED OPS Handbook 8th Ed

• Dose: 1 or 2 drops – 2–3 minutes before procedure
Contraindications: not for prolonged use – do not discharge with medicine, pregnancy

• Side-effects: stinging, tearing
• Adverse reactions: conjunctival redness, hypersensitivity reactions
NOTE: Plan to place rigid shield after placement of tetracaine for 12 hours.

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Tranexamic Acid (Cyklokapron ) – TXA
• Class: antifibrinolytic agent
• Action: competitive inhibitor of plasminogen activation, stabilizes clots
• Indications: If a casualty will likely need a blood transfusion (for example: presents with hem-
orrhagic shock, one or more major amputations, penetrating torso trauma, or evidence of
severe bleeding) or If the casualty has signs or symptoms of significant TBI or has altered
mental status associated with blast injury or blunt trauma
• Dose: Administer 2g of tranexamic acid via slow IV or IO push as soon as possible but NOT
later than 3 hours after injury
Contraindications: subarachnoid hemorrhage, active intravascular clotting
• Side-effects: angina pectoris, chest pain, hypotension, myocardial infarction, postural hypo-
tension, tachycardia

WARNING Rapid administration may result in hypotension.

Vecuronium Bromide (Norcuron)

• Description: non-depolarizing paralytic agent, secondary choice for RSI (primary rocuronium)
• Indications: facilitates ET intubation by paralyzing skeletal muscle, skeletal muscle relaxation
during RSI and mechanical ventilation
• Adult Dosage:
○ Intubation: 0.1mg/kg over 30–60 seconds IV/IO
○ Usual dose 10mg
○ Onset of 2–3 minutes, duration of 25–30 minutes
• Maintenance: 0.01mg/kg IV/IO q20–45min PRN
Contraindications: hypersensitivity to vecuronium
• Adverse reactions: apnea, allergy, rare cardiovascular
• Special Information:
○ Paralysis may be prolonged by succinylcholine, quinidine, and beta blockers
○ Refrigeration not required
○ Must be used after adequate sedation

Chapter 9. Pararescue Drug Formulary n 171