Page 193 - 2022 Ranger Medic Handbook

DRUG QUICK REFERENCE
ACETAMINOPHEN (Tylenol): 325–1,000mg PO q4–6hr LIDOCAINE: Infiltration 0.5%–2% injection
prn (max: 4g/d) LEVETIRACETAM: 1,000–4,000mg for seizure prevention
ALBUTEROL MDI: 2 puffs q4–6hr prn or 4,000mg for seizure treatment
CALCIUM GLUCONATE: 1–3g IV/IO q4 units of blood LOPERAMIDE: 4mg PO then 2mg after each unformed
transfused stool (max 16mg/day)
DEXAMETHASONE (Decadron): 4mg PO q6–12hr; 10mg MELOXICAM (Mobic): 7.5–15mg PO qd
IV/IM single dose MIDAZOLAM (Versed): 2mg slow IV push q2–3min to
DIPHENHYDRAMINE (Benadryl): 25–50mg IV/IM/PO max dose of 10mg OR 5–10mg IM for seizure control
q4–6hr MOXIFLOXACIN: 400mg PO/IV QD 5–10d
EPINEPHRINE (1:1,000): 0.3–0.5mg IM q10–15min NALOXONE (Narcan): 0.4–2.0mg IV; repeat q2–3min to
ERTAPENEM (Invanz): 1g IV/IM q24hr max of 10mg prn
FENTANYL ORAL LOZ: 800–1,600mcg NAPROXEN: 250–500mg PO bid
(max: 1,600mcg/d) NORMAL SALINE (HYPERTONIC): 30mL 23.4% bullet
FENTANYL: 50–100mcg IV/IM q1–2hr prn for impending herniation or 250mL bolus of 3% for
HYDROMORPHONE (Dilaudid): 1mg PO/SC/IM/IV emergent hyponatremia
q2–4hr prn ONDANSETRON (Zofran): 4–8mg slow IV push or IM
IBUPROFEN: 600mg PO tid q4hr prn OR 4–8mg PO q4hr prn
KETAMINE: pain: 0.3mg/kg IV; sedation: 1–1.5mg/kg PROMETHAZINE (Phenergan): 12.5–25mg PO/IM/IV
slow IV push until nystagmus, bump 20–25mg q10–20min q4–6hr prn SECTION 4
KETOROLAC (Toradol): 15mg IV or 30mg IM q6hr TRANEXAMIC ACID (TXA): 2g IV/IO ASAP
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.
250 mg 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 X 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.

2022 RANGER MEDIC HANDBOOK 179