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Transcription:

table of contents drug reference ADULT DRUG REFERENCE...155 161 PEDIATRIC DRUG REFERENCE...162 164 PEDIATRIC WEIGHT-BASED DOSING CHARTS...165 180 Adenosine...165 Amiodarone...166 Atropine...167 Defibrillation...168 Dextrose 10%...169 Diphenhydramine... 170 Epinephrine 1:10,000...171 Epinephrine 1:1000... 172 Intranasal Fentanyl... 173 Fentanyl IV/IM...174 Fluid Bolus... 175 Glucagon... 176 Lidocaine... 177 Midazolam... 178 Naloxone... 179 Weight Conversion...180 Operational and Regulatory Reference 153

154

ADULT DRUG REFERENCE DRUG INDICATION ADULT DOSAGE PRECAUTIONS/ COMMENTS ADENOSINE Paroxysmal SVT 1 st Dose 6 mg rapid IV 2 nd Dose 12 mg rapid IV push Follow each dose with rapid bolus of 20 ml NS ALBUTEROL Bronchospasm 5 mg in 6 ml NS nebulized Crush Injury Hyperkalemia 5 mg in 6 ml NS nebulized continuously May cause transient heart block or asystole. Side effects include chest pressure/pain, palpitations, hypotension, dyspnea, or feeling of impending doom. Use caution when patient is taking carmbamazepine, dipyramidole, or methylxanthines. Do not administer if acute asthma exacerbation. Repeat as needed for bronchospasm Use with caution in patients taking MAO inhibitors (antidepressants Nardil and Parnate) AMIODARONE Ventricular Fibrillation or Pulseless VT Stable Ventricular Tachycardia 300 mg IV or IO bolus, repeat 150 mg bolus if rhythm persists 150 mg IV infusion or slow IV push over 10 minutes (15 mg/ minute) In patient with pulses, may cause hypotension. Do not administer if patient hypotensive. When creating infusion, careful mixing needed to avoid foaming of medication (do not use filter needle). Drug Reference 155

ADULT DRUG REFERENCE DRUG INDICATION ADULT DOSAGE PRECAUTIONS/ COMMENTS ASPIRIN Chest Pain Suspected ACS 4 81 mg tabs chewed Contraindicated in aspirin or salicylate allergy. Coumadin or Plavix use is not a contraindication ATROPINE Symptomatic Bradycardia (not to be used in wide QRS 2nd and 3rd degree blocks) 0.5 mg IV or IO every 3 5 minutes up to max. 3 mg Atropine can dilate pupils, aggravate glaucoma, cause urinary retention, confusion, and dysrhythmias, including V-tach and Vfib. Doses less than 0.5 mg can cause paradoxical bradycardia. Increases myocardial oxygen consumption. Organophosphate poisoning 1 2 mg IV or IO repeat every 3-5 min. as needed to decrease symptoms Remove clothing of victim of organophosphate poisonings, and flush skin to remove traces of poison 156 Drug Reference

ADULT DRUG REFERENCE DRUG INDICATION ADULT DOSAGE PRECAUTIONS/ COMMENTS CALCIUM CHLORIDE Hyperkalemia Arrest Hyperkalemia Crush Injury Hydrofluoric Acid Toxicity 500 mg IV or IO slowly May repeat in 5 10 minutes 1 gm IV or IO slowly over 60 seconds 500 mg IV or IO slowly Use cautiously or not at all in patients on digitalis. Avoid extravasation Rapid administration can cause dysrhythmias or arrest DEXTROSE 10% Hypoglycemia 10 g initially (100 ml). If glucose remains 60 or below, give additional 15 g (150 ml) DIPHENHYDRAMINE Allergy Hives/ Itching Dystonic Reaction 25 50 mg IV or IM Recheck glucose after administration For allergy, consider lower dose if patient has already taken po dose in past two hours for symptoms EPINEPHRINE 1:10,000 Cardiac Arrest Anaphylactic Shock 1 mg IV or IO every 3 5 minutes 0.1 mg increments IV or IO up to 0.5 mg IV total dose Use only if IM treatment ineffective Alpha & beta sympathomimetic. May cause serious dysrhythmias and exacerbate angina. Drug Reference 157

ADULT DRUG REFERENCE DRUG INDICATION ADULT DOSAGE PRECAUTIONS/ COMMENTS EPINEPHRINE 1:1000 Allergy/ Anaphylactic Shock Asthma 0.3 0.5 mg IM Use lower dose in smaller, older patients 0.3 mg subcutaneously 0.3 mg IM if respiratory arrest from asthma or bronchospasm FENTANYL Pain Control 50 200 mcg IV (25-50 mcg increments) Sedation Pacing 100 mcg Intranasally 50 100 mcg IM 25 100 mcg IV in 25 50 mcg increments Never administer intravenously! Do not use in asthma patients with a history of hypertension or coronary artery disease. May cause serious dysrhythmias and exacerbate angina. Can cause hypotension and respiratory depression. Recheck VS between each dose. Hypotension more common in patients with low cardiac output or volume depletion. Respiratory depression reversible with naloxone. Additional IV doses (titration) can be given every 5 minutes. IM and intranasal doses can be repeated once in 15 minutes. 158 Drug Reference

ADULT DRUG REFERENCE DRUG INDICATION ADULT DOSAGE PRECAUTIONS/ COMMENTS GLUCAGON Hypoglycemia 1 mg IM Effect may be delayed 5 20 min LIDOCAINE IO Anesthesia 40 mg IO Repeat dose 20 mg MIDAZOLAM Seizure Titrate 1 5 mg IV in 1 2 mg increments Sedation for pacing or cardioversion Sedation transfer of intubated patient Behavioral Emergency 0.1 mg/kg IM (max. dose 5 mg IM) Titrate 1 5 mg IV in 1 2 mg increments Titrate 2 5 mg IV in up to 2 mg increments 5 mg IM 1 3 mg IV in 1 mg increments if IV available Administer slowly over 1 minute Not needed in arrest situations With IV dosing, begin with 1 mg dose. IV increments should not exceed 2 mg. Observe respiratory status Use with caution in patients over age 60 Drug Reference 159

ADULT DRUG REFERENCE DRUG INDICATION ADULT DOSAGE PRECAUTIONS/ COMMENTS NALOXONE NITROGLYCERIN ONDANSETRON Respiratory Depression (Respiratory rate less than 12) or Apnea Chest Pain Suspected ACS Pulmonary Edema Vomiting and Severe Nausea 2 mg intranasally (IN) 1 2 mg IV or IM For careful titration in chronic pain or terminal patients, dilute 1:10 and give 0.1 mg increments 0.4 mg sl or spray up to 3 doses 0.4 mg sl or spray if systolic BP 90 149 0.8 mg sl or spray if systolic BP 150 or over Max.dose 4.8 mg 4 mg IV, IM or po (ODT) May repeat q 10 min X 2 Intranasal administration preferred unless patient in shock or has copious secretion/blood in nares. Shorter duration of action than that of most narcotics. Abrupt withdrawal symptoms and combative behavior may occur. Can cause hypotension and headache. Do not give if BP less than 90 systolic or heart rate below 50. Perform 12-lead ECG before administration. Do not give if STEMI detected. Do not give if Viagra, Levitra, Staxyn or Stendra taken within 24 hours or if Cialis taken within 36 hours. Give IV over 1 minute may cause syncope if administered too rapidly 160 Drug Reference

ADULT DRUG REFERENCE DRUG INDICATION ADULT DOSAGE PRECAUTIONS/ COMMENTS SODIUM BICARBONATE Cardiac arrest 1 meq/kg IV or IO Assure adequate ventilation. Can precipitate or inactivate other drugs. In cardiac arrest, indicated for treatment of suspected pre-existing acidosis (e.g. kidney failure), hyperkalemia or arrest due to tricyclic antidepressant overdose Tricyclic Antidepressant OD Crush injury 1 meq/kg IV Use only if lifethreatening, hemodynamically significant dysrhythmias 1 meq/kg IV For crush injury, consider additional 1 meq/ kg added to 1L NS using second IV line Drug Reference 161

PEDIATRIC DRUG REFERENCE DRUG INDICATION PEDIATRIC DOSAGE ADENOSINE Paroxysmal SVT 1 st Dose 0.1 mg/kg rapid IV (max. 6 mg) 2 nd Dose 0.2 mg/kg rapid IV (max 12 mg) Follow each dose with rapid 10 20 ml NS bolus ALBUTEROL Bronchospasm 5 mg in 6 ml NS nebulized AMIODARONE ATROPINE Ventricular Fibrillation or Pulseless VT Symptomatic Bradycardia 5 mg/kg IV or IO bolus Maximum dose 300 mg 0.02 mg/kg IV or IO Minimum dose 0.1 mg Maximum dose 0.5 mg DEXTROSE 10% Hypoglycemia 0.5 g/kg IV (5 ml/kg) Maximum 250 ml DIPHENHYDRAMINE Allergy Hives/ Itching 1 mg/kg IV or IM Maximum dose 50 mg PRECAUTIONS/ COMMENTS Base Order Required: May cause transient heart block or asystole. Side effects include chest pressure/ pain, palpitations, hypotension, dyspnea, or feeling of impending doom. Do not administer if acute exacerbation of asthma. Repeat as needed Bradycardia in pediatric patients primarily related to respiratory issue assure adequate ventilation first Recheck glucose after administration Consider lower dose (0.5 mg/kg) if patient has already taken po dose in the past two hours for symptoms 162 Drug Reference

PEDIATRIC DRUG REFERENCE DRUG INDICATION PEDIATRIC DOSAGE EPINEPHRINE 1:10,000 EPINEPHRINE 1:1000 Cardiac Arrest Anaphylactic Shock Allergy/ Anaphylactic Shock 0.01 mg/kg IV or IO every 3 5 minutes Max. dose 1 mg Titrate in up to 0.1 mg increments slow IV or IO to a max. of 0.01 mg/kg 0.01 mg/kg IM Max single dose 0.3 mg PRECAUTIONS/ COMMENTS In anaphylactic shock, IM epinephrine 1:1000 should be administered first and epinephrine 1:10,000 IV should only be used if IM is ineffective Never administer intravenously! Asthma 0.01 mg/kg subcutaneously Maximum dose 0.3 mg FENTANYL Pain Control See drug chart for exact dosage. 1 mcg/kg IV or IM 1.5 mcg/kg Intranasal GLUCAGON Hypoglycemia Weight less than 24 kg: 0.5 mg IM Weight 24 kg or more: 1 mg IM If respiratory arrest from asthma or bronchospasm, administer IM Can cause hypotension and respiratory depression. Hypotension is more common in patients with volume depletion. Nausea may occur. Effect may be delayed 5 20 minutes if patient responds, give po sugar Drug Reference 163

PEDIATRIC DRUG REFERENCE DRUG INDICATION PEDIATRIC DOSAGE LIDOCAINE IO Pain 0.5 mg/kg IO. Maximum dose 20 mg MIDAZOLAM Seizure Titrate in up to 1 mg increments IV up to 0.1 mg/kg NALOXONE ONDANSETRON Sedation for Cardioversion Respiratory Depression or Apnea Vomiting and Severe Nausea 0.1 mg/kg IM Maximum dose 5 mg IM 0.1 mg/kg IV or IO titrated in 1 mg increments 0.1 mg/kg IM or IV Maximum dose 2 mg May repeat as needed 4 mg IV, IM, or po (ODT) In patients 40 kg and over, may repeat q 10 min X2 PRECAUTIONS/ COMMENTS Give slowly over one minute. Not needed in arrest situations Observe respiratory status carefully Maximum IV dose dependent on patient weight (e.g. for 20 kg patient, maximum dose 2 mg). For patients 50 kg and above, maximum IV dose 5 mg Sedation and cardioversion only with base hospital order only. Maximum dose dependent on patient weight (see above). Use IM route initially unless shock present. Shorter duration of action than that of most narcotics. For use in patients 4 years and up. Administer IV over 1 minute. Rapid administration may cause syncope. 164 Drug Reference

ADENOSINE INDICATION: SUPRAVENTRICULAR TACHYCARDIA Concentration = 3 mg/ml 1 st Dose = 0.1 mg/kg IV 2 nd Dose = 0.2 mg/kg IV Base Order Only COLOR DOSES (mg) GIVE (ml) Gray (3-5 kg) 0.45 mg 1 st - 0.15 ml 0.9 mg 2 nd - 0.3 ml Pink (6-7 kg) 0.66 mg 1 st - 0.22 ml 1.35 mg 2 nd - 0.45 ml Red (8-9 kg) 0.9 mg 1 st - 0.3 ml 1.8 mg 2 nd - 0.6 ml Purple (10-11 kg) 1 mg 1 st - 0.33 ml 2 mg 2 nd - 0.67 ml Yellow (12-14 kg) 1.35 mg 1 st - 0.45 ml 2.7 mg 2 nd - 0.9 ml White (15-18 kg) 1.7 mg 1 st - 0.6 ml 3.4 mg 2 nd - 1.2 ml Blue (19-23 kg) 2.1 mg 1 st - 0.7 ml 4.2 mg 2 nd - 1.4 ml Orange (24-29 kg) 2.7 mg 1 st - 0.9 ml 5.4 mg 2 nd - 1.8 ml Green (30-36 kg) 3.3 mg 1 st - 1.1 ml 6.6 mg 2 nd - 2.2 ml 40 kg 4 mg 1 st - 1.3 ml 8 mg 2 nd - 2.7 ml 45 kg 4.5 mg 1 st - 1.5 ml 9 mg 2 nd - 3 ml Note: Follow with rapid bolus 10-20 ml NS Drug Reference 165

AMIODARONE INDICATION VENTRICULAR FIBRILLATION Concentration = 50 mg/ml Dose = 5 mg/kg IV COLOR DOSE (mg) GIVE (ml) Gray (3-5 kg) Not given Pink (6-7 kg) 35 mg 0.7 ml Red (8-9 kg) 45 mg 0.9 ml Purple (10-11 kg) 50 mg 1 ml Yellow (12-14 kg) 65 mg 1.3 ml White (15-18 kg) 80 mg 1.6 ml Blue (19-23 kg) 100 mg 2 ml Orange (24-29 kg) 130 mg 2.6 ml Green (30-36 kg) 170 mg 3.4 ml 40 kg 200 mg 4 ml 45 kg 225 mg 4.5 ml 166 Drug Reference

ATROPINE INDICATION SYMPTOMATIC BRADYCARDIA Concentration = 0.1 mg/ml Dose = 0.02 mg/kg IV Minimum Dose 0.1 mg IV Maximum Dose 0.5 mg IV COLOR DOSE (mg) GIVE (ml) Gray (3-5 kg) 0.1 mg 1 ml Pink (6-7 kg) 0.13 mg 1.3 ml Red (8-9 kg) 0.17 mg 1.7 ml Purple (10-11 kg) 0.2 mg 2 ml Yellow (12-14 kg) 0.25 mg 2.5 ml White (15-18 kg) 0.35 mg 3.5 ml Blue (19-23 kg) 0.42 mg 4.2 ml Orange (24-29 kg) 0.5 mg 5 ml Green (30-36 kg) 0.5 mg 5 ml 40 kg 0.5 mg 5 ml 45 kg 0.5 mg 5 ml Assure adequate ventilation before considering atropine Not indicated for asystole Drug Reference 167

DEFIBRILLATION Energy Selection PHYSIO-CONTROL LP-12 and LP-15 COLOR First Second Maximum Gray (3-5 kg) 8 J 15 J 30 J Pink (6-7 kg) 15 J 30 J 50 J Red (8-9 kg) 15 J 30 J 70 J Purple (10-11 kg) 20 J 30 J 100 J Yellow (12-14 kg) 30 J 50 J 125 J White (15-18 kg) 30 J 70 J 175 J Blue (19-23 kg) 30 J 70 J 200 J Orange (24-29 kg) 50 J 100 J 250 J Green (30-36 kg) 70 J 125 J 300 J 40 kg 70 J 150 J 360 J 45 kg 100 J 175 J 360 J 168 Drug Reference

DEXTROSE 10% INDICATION HYPOGLYCEMIA Concentration = 0.1 g/ml Dose = 0.5 g/kg IV up to 10g initially COLOR DOSE (g) GIVE (ml) Gray (3-5 kg) 2 g 20 ml Pink (6-7 kg) 3.5 g 35 ml Red (8-9 kg) 4.5 g 45 ml Purple (10-11 kg) 5.5 g 55 ml Yellow (12-14 kg) 6.5 g 65 ml White (15-18 kg) 8.5 g 85 ml Blue (19-23 kg) 10 g 100 ml* Orange (24-29 kg) 10 g 100 ml* Green (30-36 kg) 10 g 100 ml* 40 kg 10 g 100 ml* 45 kg 10 g 100 ml* * Additional dosage of up to 150 ml (15g) may be required based on repeat blood glucose determination. Administer in 50 ml (5g) increments. Drug Reference 169

DIPHENHYDRAMINE INDICATION: ALLERGIC REACTION (URTICARIAL RASH or ITCHING) Concentration = 50 mg/ml Dose = 1 mg/kg Give IV or IM COLOR DOSE (mg) GIVE (ml) Gray (3-5 kg) 5 mg 0.1 ml Pink (6-7 kg) 6.5 mg 0.13 ml Red (8-9 kg) 8.5 mg 0.17 ml Purple (10-11 kg) 10 mg 0.2 ml Yellow (12-14 kg) 12.5 mg 0.25 ml White (15-18 kg) 17.5 mg 0.35 ml Blue (19-23 kg) 20 mg 0.4 ml Orange (24-29 kg) 25 mg 0.5 ml Green (30-36 kg) 35 mg 0.7 ml 40 kg 40 mg 0.8 ml 45 kg 45 mg 0.9 ml Utilize epinephrine 1:1000 IM first if serious systemic reaction (anaphylaxis) Consider giving one-half dosage diphenhydramine if patient has taken/been given full dose within 1 hour 170 Drug Reference

EPINEPHRINE 1:10,000 FOR CARDIAC ARREST Concentration = 0.1 mg/ml Dose = 0.01 mg/kg IV COLOR DOSE (mg) GIVE (ml) Gray (3-5 kg) 0.04 mg 0.4 ml ** Pink (6-7 kg) 0.06 mg 0.6 ml ** Red (8-9 kg) 0.08 mg 0.8 ml ** Purple (10-11 kg) 0.1 mg 1 ml Yellow (12-14 kg) 0.13 mg 1.3 ml White (15-18 kg) 0.17 mg 1.7 ml Blue (19-23 kg) 0.21 mg 2.1 ml Orange (24-29 kg) 0.27 mg 2.7 ml Green (30-36 kg) 0.33 mg 3.3 ml 40 kg 0.4 mg 4 ml 45 kg 0.45 mg 4.5 ml Epinephrine 1:10,000 IV is also used in anaphylactic shock if IM treatment ineffective ** In anaphylactic shock: Patients under 10 kg receive smaller increments (same as single dose for cardiac arrest) For patients 10 kg and up, give 0.1 mg increments (1 ml) Drug Reference 171

EPINEPHRINE 1:1000 Anaphylaxis use IM Route Asthma use Subcutaneous (SC) Route NEVER GIVE EPINEPHRINE 1:1000 VIA IV ROUTE Concentration = 1 mg/ml Dose = 0.01 mg/kg IM or SC Maximum Dose 0.3 mg IM / SC COLOR DOSE (mg) GIVE (ml) Gray (3-5 kg) 0.04 mg 0.04 ml IM / SC Pink (6-7 kg) 0.06 mg 0.06 ml IM / SC Red (8-9 kg) 0.08 mg 0.08 ml IM / SC Purple (10-11 kg) 0.1 mg 0.1 ml IM / SC Yellow (12-14 kg) 0.13 mg 0.13 ml IM / SC White (15-18 kg) 0.17 mg 0.17 ml IM / SC Blue (19-23 kg) 0.21 mg 0.21 ml IM / SC Orange (24-29 kg) 0.27 mg 0.27 ml IM / SC Green (30-36 kg) 0.3 mg 0.3 ml IM / SC 40 kg 0.3 mg 0.3 ml IM / SC 45 kg 0.3 mg 0.3 ml IM / SC 172 Drug Reference

INTRANASAL FENTANYL (IN) INDICATION PAIN MANAGEMENT Concentration = 50 mcg/ml Dose = 1.5 mcg/kg INTRANASAL (IN) Intranasal dosing is single dose only base contact required for repeat doses COLOR DOSE (mcg) GIVE (ml) Gray (3-5 kg) Not given Pink (6-7 kg) 9 mcg 0.18 ml Red (8-9 kg) 12.5 mcg 0.25 ml Purple (10-11 kg) 15 mcg 0.3 ml Yellow (12-14 kg) 20 mcg 0.4 ml White (15-18 kg) 25 mcg 0.5 ml Blue (19-23 kg) 30 mcg 0.6 ml Orange (24-29 kg) 40 mcg 0.8 ml Green (30-36 kg) 50 mcg 1 ml 40 kg 60 mcg 1.2 ml* 50 kg 75 mcg 1.5 ml* 60 kg 90 mcg 1.8 ml* 70 kg or over 100 mcg 2 ml* * DIVIDE DOSAGE OVER 1 ML BETWEEN BOTH NARES Drug Reference 173

FENTANYL IV / IM INDICATION PAIN MANAGEMENT Concentration = 50 mcg/ml Dose = 1 mcg/kg IV or IM Single dose only base contact required for repeat doses COLOR DOSE (mcg) GIVE (ml) Gray (3-5 kg) Not given Pink (6-7 kg) 6 mcg 0.12 ml Red (8-9 kg) 8 mcg 0.16 ml Purple (10-11 kg) 10 mcg 0.2 ml Yellow (12-14 kg) 12.5 mcg 0.25 ml White (15-18 kg) 15 mcg 0.3 ml Blue (19-23 kg) 20 mcg 0.4 ml Orange (24-29 kg) 25 mcg 0.5 ml Green (30-36 kg) 35 mcg 0.7 ml* 40 kg 40 mcg 0.8 ml* 45 kg 45 mcg 0.9 ml* *IV doses above 25 mcg can be titrated to effect beginning with 25 mcg increment. 174 Drug Reference

FLUID BOLUS INDICATION SHOCK / HYPOTENSION NORMAL SALINE BOLUS = 20 ml/kg IV Maximum single bolus = 500 ml COLOR GIVE (ml) Gray (3-5 kg) 80 ml Pink (6-7 kg) 130 ml Red (8-9 kg) 170 ml Purple (10-11 kg) Yellow (12-14 kg) 210 ml 260 ml White (15-18 kg) 340 ml Blue (19-23 kg) 420 ml Orange (24-29 kg) Green (30-36 kg) 500 ml 500 ml 40 kg 500 ml 45 kg 500 ml Drug Reference 175

GLUCAGON INDICATION HYPOGLYCEMIA Concentration = 1 mg/ml Dose = 0.5 1 mg/ml IM COLOR DOSE (mg) GIVE (ml) Gray (3-5 kg) 0.5 mg 0.5 ml Pink (6-7 kg) 0.5 mg 0.5 ml Red (8-9 kg) 0.5 mg 0.5 ml Purple (10-11 kg) 0.5 mg 0.5 ml Yellow (12-14 kg) 0.5 mg 0.5 ml White (15-18 kg) 0.5 mg 0.5 ml Blue (19-23 kg) 0.5 mg 0.5 ml Orange (24-29 kg) 1 mg 1 ml Green (30-36 kg) 1 mg 1 ml 40 kg 1 mg 1 ml 45 kg 1 mg 1 ml 176 Drug Reference

LIDOCAINE INDICATION PAIN MANAGEMENT FOR IO (PATIENTS NOT IN ARREST) Concentration = 2% (100 mg / 5 ml) Dose = 0.5 mg/kg IO 20 mg max COLOR DOSE (mg) Gray (3-5 kg) Not given GIVE (ml) Pink (6-7 kg) 3 mg 0.15 ml Red (8-9 kg) 4 mg 0.2 ml Purple (10-11 kg) 5 mg 0.25 ml Yellow (12-14 kg) 7 mg 0.35 ml White (15-18 kg) 9 mg 0.45 ml Blue (19-23 kg) 10 mg 0.5 ml Orange (24-29 kg) 14 mg 0.7 ml Green (30-36 kg) 16 mg 0.8 ml 40 kg 20 mg 1 ml 45 kg 20 mg 1 ml Drug Reference 177

MIDAZOLAM INDICATION SEIZURE Concentration = 5 mg/ml Dose = 0.1 mg/kg IV or IM Titrate IV dosage in 0.5-1 mg (0.1-0.2 ml) increments to desired effect (seizure cessation) or maximum dose listed IM administration - single dose only COLOR DOSE (mg) GIVE (ml) Gray (3-5 kg) 0.5 mg 0.1 ml Pink (6-7 kg) 0.75 mg 0.15 ml Red (8-9 kg) 0.85 mg 0.17 ml Purple (10-11 kg) 1 mg 0.2 ml Yellow (12-14 kg) 1.25 mg 0.25 ml White (15-18 kg) 1.75 mg 0.35 ml Blue (19-23 kg) 2 mg 0.4 ml Orange (24-29 kg) 2.75 mg 0.55 ml Green (30-36 kg) 3.25 mg 0.65 ml 40 kg 4 mg 0.8 ml 45 kg 4.5 mg 0.9 ml 178 Drug Reference

NALOXONE INDICATION RESPIRATORY DEPRESSION Concentration = 1 mg/ml Dose = 0.1 mg/kg IV or IM Maximum single dose = 2 mg (may be repeated) Naloxone is available in other concentrations This chart is correct for 1 mg/ml concentration COLOR DOSE (mg) GIVE (ml) Gray (3-5 kg) 0.4 mg 0.4 ml Pink (6-7 kg) 0.7 mg 0.7 ml Red (8-9 kg) 0.9 mg 0.9 ml Purple (10-11 kg) 1 mg 1 ml Yellow (12-14 kg) 1.3 mg 1.3 ml White (15-18 kg) 1.7 mg 1.7 ml Blue (19-23 kg) 2 mg 2 ml Orange (24-29 kg) 2 mg 2 ml Green (30-36 kg) 2 mg 2 ml 40 kg 2 mg 2 ml 45 kg 2 mg 2 ml Drug Reference 179

WEIGHT CONVERSION Always Document Weight in kg COLOR Kg Pounds Gray 3-5 kg 6-11 lbs Pink 6-7 kg 13-15 lbs Red 8-9 kg 17-20 lbs Purple 10-11 kg 22-25 lbs Yellow 12-14 kg 27-32 lbs White 15-18 kg 34-41 lbs Blue 19-23 kg 42-52 lbs Orange 24-29 kg 54-65 lbs Green 30-36 kg 67-80 lbs 40 kg 40 kg 90 lbs 45 kg 45 kg 101 lbs 180 Drug Reference