Page 222 - 2022 Ranger Medic Handbook

MPC Reference Card
Below is a quick reference of the most commonly used drugs and resuscitative fluid calculations for MPC triage and POI
care. This reference is precalculated for the average, 31.8kg MPC and is a condensed version of the actual MPC Reference
Card each handler carries for their specific MPC.
MWD Name: CLYDE Weight: 70.0 lb 31.8 kg
Gender MI Date Card Created: 27 JAN 2019 Normal Values
Breed Belgian Malinois ET Tube Size: 10mm Temp: 99–102.5°F
DOB 12-Jun-11 Pulse: 70–120 bpm
Microchip number Anticipation/Excitement/Pain: 100–160 bpm
Permanent duty site FT. BENN, GA Exercising: Up to 300bpm (sled dogs)
Shock: Usually 160–200bpm
Deployment status CAT I Resp: 16–30 bpm (resting) Usually panting
Last FAVN (date and pass/fail) JAN 2019: PASS after exercise or hot outside temp
Most recent vaccinations: Rabies: 25 JAN 19 DA2PP: 25 JAN 19 Lepto: 25 JAN 19 BP: 110–160 Sys/60–90 Dia/85–120
Gastropexied? YES MAP Resusitation End Point MAP > 65
Shock Index: HR/SBP < 1.0
Previous heat injury? NONE PCV: 35–45%
Master problem list TP: 6.5–8g/dL Acute blood loss often has
Diet (type and amount) normal PCV and low TP
Lactate < 2.5mmol/L
Current medications None
Emergency Drug Dosage Units MWD’s dose Units Route
Atropine (bradycardia, bronchoconstriction)---------------------> 0.04 mg/kg 1.3 mg IV or IM
Atropine (organophosphate, carbamate toxicity)---------------> 0.2-0.5 mg/kg 6.4 mg 1/4 dose IV, rest IM or SC
Epinephrine (Hrt stopped, unresp CPR, shock from allerg rxn) 0.01-0.02 mg/kg 0.3 mg IV, IT, IM or SC
Levetriacetam/Keppra seizures (Can use diazepam/midazolam) 30mg/kg IV / 20 mg/kg PO 954.5 mg IV 636.4 mg PO q 8hr
Diphenhydramine (Benadryl) Allergic Reactions-----------> 4 mg/kg 127.3 mg IM
Dexamethasone SP (Allergic Reactions)--------------------------> 0.5 mg/kg 15.9 mg IM or SC
Tranexamic Acid (TXA) (Massive Hemorrhage) 15 mg/kg 477.3 mg IV intitially, then same amt over 24hrs
(Abbreviations): IV= intravenous, IM= intramuscular, SC= subcutaneous, IT= intratracheal, PO=oral
Emergency Fluid Considerations L/per day mL/per hour
Maintenance fluid needs (60mL/kg/day) 1.9 L 79.5
1/4 Shock dose IV Fluids (crystalloid - Plasmalyte, LRS, etc) 700 mL - Give this as fast as possible, then re-assess heart rate, mm, pulse, etc
Full Shock dose of IV fluids (crystalloid - Plasmalyte, LRS, etc) 2864 mL
Hetastarch dose of IV fluids 159 mL Max Dose/24hr: 636 mL
MWD Name: CLYDE Weight: 70.0 lb 31.8 kg
SECTION 6 moving but doesn't hold still & needs treatment) Dosage 0.3 mg/kg MWD’s dose 9.5 mg Route mL 1.909090909
Sedation Mild (Losing consciousness, bleeding, weaker pulse, still
Units
Units
Midazolam OR diazepam (if 5mg/mL)
IM, SC, IV
Ketamine (if 100mg/mL)
1.590909091
159.1 mg
IM, SC, IV
5 mg/kg
Units
Units
Sedation Deep (Alert animal, normal pulse that needs treated)
Dexmedetomide (dose range is 0.001-0.020mg/kg) Dosage 0.008 mg/kg MWD’s dose 0.3 mg Route mL 0.509090909
IM, SC
Midazolam OR diazepam (if 5mg/mL)--------------------> 0.3 mg/kg 9.5 mg IM, SC, IV 1.909090909
Ketamine (if 100mg/mL)---------------------------------------> 5 mg/kg 159.1 mg IM, SC, IV 1.590909091
Sedation (For alert animal, normal pulse when no ket/mid available) Dosage Units MWD’s dose Units If 0.5mg/mL Units/Route
Dexmedetomide (dose range is 0.001–0.020mg/kg) 0.013 mg/kg 0.4 mg 0.8 mL IM
Analgesia (pain mgmt) NO Advil (ibuprofen) or Tylenol! Dosage Units MWD’s dose Units Route mL
2% Lidocaine Max Dose (local/skin/nn blocks for lacs) 5 min 5 mg/kg 159.1 mg SC, IM 7.95454545
Bupivacaine (0.5% Marcaine) Max Dose (nerve blocks) 30 min 2 mg/kg 63.6 mg SC, IM 12.7272727
Rimadyl (carprofen/NSAID)-----------------------------------> 2.2 mg/kg 70.0 mg PO, SC Every 24 hr
Mobic (meloxicam/NSAID) Don’t combine w/other NSAIDs--> 0.1 mg/kg 3.2 mg PO, Every 24 hr
Hydromorphone -------------------------------------------------------> 0.1 mg/kg 3.2 mg IV, IM Every 2–6 hr
Naloxone (opioid overdose) 0.04–0.16 mg/kg 1.3 mg IV, IM, SC 3.181818182
Fentanyl 50mcg/mL loading dose - excruciating pain 0.01 mg/kg 0.3 mg IV, IM 6.363636364
CRNA Ax in a syringe for dogs Induction Dose / Route
Fentanyl 150mcg (3mL) + midazolam 5mg (1mL) + ketamine 200mg (2mL) + 3mL IM, IV, IO lasts 20-30 minutes
dexmedetomidine 0.25mg (0.5mL) Dex will cause bradycardia (40–60 bpm) - Okay as long as BP is good
For reference, the CRNA Ax in a syringe human mix is: Maintenance Dose
Fentanyl 100mcg (2mL) + midazolam 5mg (1mL) + ketamine 100mg (1mL) 1–2mL as needed IM, IV, IO (App every 20–30 minutes)
(Add 1mL fentanyl, 1mL ketamine, 0.5mL dexmedetomidine) to this mix
Chemical Attacks (Save yourself first, MOPP gear then decon the MPC)
Nerve Agent Attack (Sarin, Soman Tabun, Vx) Signs: Constricted pupils, difficult breathing, secretions, rapid pant, decr HR, muscle facsiculations.
Tx: 1-3 ATNAA injectors + 1 CANA injector IM. Add 1 Atropen q 3min until secretions stop breathing eases.
BZ Agent Attack Signs: Dialated pupils, incr HR, Behavioral changes, incoordination may not respond to commands
Tx: Physostigmine salicylate 1-10mg IV Slow, IM Decon and DON’T SEDATE!
Arsenic Blister Agent Attack (Lewisite) Signs: Redness, edema of the skin, cough nasal disch, restlessness, bloody diarhea, vomiting
Tx: 100mg dimercaprol IM (aka BAL) 4.5g Na thiosulfate IV, 1.5mg albuterol PO
Cyanide Signs: Stops breathing, seizuring coma within minutes, death in 5-10 minutes.
Tx: 21mg Na nitrate IM, 600mg Na thiosulfate IM/4500mg hydroxocobalamin IV 300mg (10mL ampule of 3%) sodium nitrate IV followed by 12.5g sodium thiosulfate IV over 30 min
208 SECTION 6 MPC/CANINE TRAUMA & TACTICAL MEDICAL EMERGENCY PROTOCOLS