Page 105 - 2023 SMOG Digital

MAX DOSE/ REPEATABILITY Maint Infusion of 100‐150mEq in 1L D5W @ 100‐200mL/hr for TCA OD Repeat one time 20mcg/kg/hr infusion for Beta OD; 1000mg q10‐20 x3 doses prn for Ca Chan Blocker OD Double dose if previous dose does not relieve secretions (atropinization) If symptoms remain after 15min, re‐i

DURATION 1‐2hr 15‐60min 30min‐4hr 5‐15min 15min 20‐30min 30‐120min 30min 3‐8hr prn prn N/A N/A 2+ weeks prn prn 6hr VENTILATOR MANAGEMENT Initial Vent Settings Ideal Body Weight Calculation Troubleshooting D.O.P.E.‐‐ Displacement; Obstructions; Pneumothorax; Equipment Failure

RESTRICTIONS/ WARNINGS Do not mix with other meds/ Flush line after Lower MAP by <20% Central Line use preferred Requires large amounts of Atropine (5‐20 boxes) Use Atropine 1st if only using single dose 2‐Pam (Mark 1/NAAK Kit) Respiratory Depression Respiratory Depression Dilute into 50‐100mL NS

INDICATIONS TCA OD; Prolonged Cardiac Arrest HTN Urgency/Emergency Hyperkalemia/ Beta&Calcium Channel Blocker OD Organophosphate/ Nerve Agent Organophosphate/ Nerve Agent Anxiety/ Seizures/ Nerve Agent Seizures Seizures/ Agitated or Combative Patient Seizures/ Wheezing in Resp Distress/ (Pre

LARGE ADULT (100kg) 220LBS 100mEq 5mg 100g 150mL/hr(TKO) 10mL * % BSA+200mL Per Hour CHEMISTRIES BLOOD GAS FLUID MANAGEMENT Shock: Calculate 90mL/kg for total fluid to be infused: reasess; give 25% >20min(prn) reassess; give 25% > 10 min prn; last 25% >10 min prn Intubate w/10.0 ET tube

ADULT (80kg) 176LBS 80mEq 10‐20mg IV/IO over 1‐2min 500‐1000mg over 2‐5 min for Hyper K issues; 20mg/kg >5‐10min for Beta Blocker OD; 1g >5min for Ca Ch Blocker OD; 1g>5min after Blood 4mg Inject 1‐3 injectors (based on severity of symptoms) IM. DuoDote/ATNAA Injector contains both Atropine (2.1mg
SMALL ADULT (60kg) 132LBS 60mEq 3mg Anxiety: 2‐10mg IV/IM q6hrs///Seizures: 5‐10mg q3‐4hr///Seizures following Nerve agent Exposure: 10mg IM for seizures or if 3x Mark 1 Kits used 60g 75mL/hr(TKO) 10mL * % BSA Per Hour MILITARY WORKING DOG Excited 103 ºF Panting

STANDARD DOSING 1mEq/kg IV/IO 10‐20mg IV/IO over 1‐2min Ca Gluconate can alternatively be used @ 3x doses listed here (except for Beta Blocker OD) 0.05‐0.1mg/kg IV/IO q5‐10min prn 1‐3 Auto‐Injectors (600mg ea) 1‐2mg IV/IO 1‐2g IV/IO 1g/kg IV over <20 min ≤20mL/kg 1‐2mL/kg LR 10ml * %TBSA (Ba

DRUG Calcium Chloride (100mg/mL) Pralidoxime Chloride (2‐Pam) (DuoDote Blood Products and Management HEMATOLOGY VITALS INDICATION Anelgesia‐‐Intermittent IV/IO/IM Analgesia‐‐ Continuous IV/IO Infusion Agitated K9 Sedation‐‐ IM 1st/IV prn Alternate K9 Sedation‐‐ IV/IO Cardiopulmonary Arrest BL
CARDIAC‐continued Sodium Bicarbonate Labetalol CBRNE Atropine ATNAA) Multi‐Use/ Seizures/ Other Diazepam Lorazepam Magnesium Sulfate Mannitol (20%) FLUIDS Resuscitation (Crystaloid) Maintenance Burns >20% TBSA Hypertonic Saline (3%) HetaStarch/Hextend (HTS) PRBC (1u=250mL) FFP (1u=200‐25

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