Push Dose Pressors

Drips

TXA

Cyanokit

RSI

Post-intubation Sedation/Analgesia

other

Push Dose Pressors

Epinephrine

  • Mix: Add 1ml (1:10,000 cardiac epi) to 9ml saline syringe

    • Take 10ml saline flush and discard 1ml

    • Draw up 1ml of cardiac epinephrine into saline flush with remaining 9ml saline

    • LABLE SYRINGE

    • Final concentration: 10mcg/1ml

  • Administer: 0.5-2 ml (5-20mcg) q2-5 min PRN

Phenylephrine/NeoSynephrine

  • Mix: Add 1ml (10mg phenyl) to 100 ml NS bag

    • Draw up 1ml (10mg) of phenylephrine into empty syringe

    • Inject 10mg phenylephrine 100ml normal saline bag

    • Draw up 10ml from 100ml bag into empty syringe

    • LABLE SYRINGE

    • Final Concentration: 100mcg/1ml

  • Administer: 0.5-2ml (50-200mcg) q2-5min PRN

Drips

Levophed/Norepinephrine

  • Mix: Add 4mg to 250mL bag NS (bag=16 mcg/mL)

  • Administer: 5-30mcg/min

    • Titrate: ***

Epinephrine

  • Mix: Add ***

  • Administer: ***

Dobutamine

  • Mix: Add 500mg to 250mL bag NS (bag=2000mcg/mL)

  • Administer: 2-20mcg/kg/min

    • Titrate: ***

Dopamine

  • Mix: Add 400mg to 250mL bag NS (bag=1600mcg/mL)

  • Administer: 2-20mcg/kg/min

    • Titrate: ***

Nicardipine

  • Mix: Add 50mg to 250mL bag NS (bag=0.2mg/mL)

  • Administer: 5-15mg/hr (25-75 ml/hr)

    • Titrate: 2.5mg/hr (12.5ml/hr) q 15min*** (q 5min for rapid titration)

Esmolol

  • Mix: Add ***

  • Administer: ***

Ketamine

  • Mix: Add ***

  • Administer: ***

TXA

  • Mix: Add 1g (1 vial) to 100mL bag NS

  • Administer: entire 100mL bag/1g TXA via dedicated IV/IO line over 10 minutes

Cyanokit

  • Indications:

    • Evidence of smoke inhalation from fire in enclosed space OR Industrial exposure (KCN, HCN, etc)

      AND

    • Altered Mental Status OR Hemodynamic instability

  • Mix: Add Cyanokit vial to 200cc NS

  • Administer: via dedicated IV/IO line over 15min

    • Adults: Hydroxycobalamin 5g

    • Children: Hydroxycobalamin 70mg/kg

See blog post and podcast for key pearls regarding Cyanokit administration and Cyanide Poisoning!

RSI

Post-intubation Sedation/Analgesia

Other

PCC (Kcentra)

  • Dosing: based on units of Factor IX

    • INR 2.0-3.99: 25 units/kg (max 2500 units)

    • INR 4.0-6.0: 35 units/kg (max 3500 units)

    • INR >6.0: 50 units/kg (max 5000 units)

  • Administer: via dedicated line @ 0.12 ml/kg/min (max 8.4 mL/min)