Emergency Medications Approved for Use at VAPAHCS

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Table 1: Medications (PAD GM&S) Emergency Medications Approved for Use at VAPAHCS PAD GM&S (See HCSM 11-12-35 Attachment A CPR Committee Atropine 1mg/10ml syringe X 3 Normal saline 1000ml bag X 2 Sodium bicarbonate 50 meq/50ml syringe X 2 Sodium chloride 0.9% 10ml syringes X 4 Sterile water for inj 10ml vial X 2 (PAD PACU/OR) (Outlying Sites) PAD PACU & OR (See HCSM 11-1235 Attachment A Livermore Monterey (See HCSM 11-12-35 Attachment A Medication Box: CPR Committee Atropine 1mg/10ml syringe X 3 Normal saline 1000ml bag X 2 Sodium bicarbonate 50 meq/50ml syringe X 2 Sodium chloride 0.9% 10ml syringes X 4 Sterile water for inj 10ml vial X 2 Medication Box: Adenosine 6mg x 2 Amiodarone 150mg/3cc x 5 Vasopressin 20 or 40 units x 2 Intralipid 20% 500cc x1 CPR Committee Adenosine 6mg/2ml vial X 3 Albuterol inhaler X 1 Amiodarone 150mg/3ml amp X 4 Atropine 1mg/10ml syringe X 3 CaCl 1g/10ml vial X 1 Diphenhydramine 50mg/1ml vial X 1 Epinephrine 1mg/ml 30ml vial X 1 Hydrocortisone 100mg vial X 1 Lidocaine 2g/250ml bag X 1 Magnesium sulfate 1g/2ml vial X 4

Metoprolol 5mg/5ml amp X 3 Nitroglycerin 0.4mg tabs (#100) Normal saline 500ml bag X 1 Normal saline 1000ml bag X 1 Sodium bicarb 50 meq/50ml syringe X 2 Sodium chloride 0.9% 10ml vial X 2 SWFI 10 ml vial X 2 Vasopressin 20U/1ml vial X 2 Pediatric (Blue Trays) Emergency Room CPR Committee Adenosine 3mg/ml 2ml Vial X3 Amiodarone 50mg/ml 3ml Vial X2 Atropine 0.1mg/ml 10ml syringe X1 Atropine 0.4mg/ml 1ml Vial X3 Calcium Chloride 10% 10ml syringe X1 Dextrose 25% 10ml syringe X 5 Epinephrine 1:1000 1ml ampule X4 Epinephrine 0.1mg/ml 10ml Syringe X2 Etomindate 4mg/ml 10ml Vial X1 Flumezinil 0.1mg/ml 10ml X1 Furosemide 10mg/ml 2ml Vial X2 Glucagon 1mg Vial X2 Lidocaine 1% 50mg/5ml X2 lidocaine 2% jelly 30 gram X1 Lidocaine 5% 30gram Tube X1 Magnesium Sulfate 4mEq/ml 2ml Vial X2 Naloxone 0.4mg/ml ampule X 2 Sodium Bicarbonate 4.2% 10ml Syringe X4 Vecuronium 10mg vial X 1

Table 2: Pharmacy Code Tackle Box Medications Emergency Medications Approved for Use at VAPAHCS Tackle Box Adult (Grey) PAD only (4): Pharmacy ICU Satellite Med Satellite Bldg 7 Satellite Building 520 Satellite CPR Committee Adenosine 6mg/2ml vial X 3 Amiodarone 150mg/3ml vial X 6 Atropine 1mg/10ml syringe X 2 CaCl 1g/10ml vial X 1 Ciprofloxacin 400mg IV X1 Dextrose 50% 25gm/50ml syringe X 1 Dextrose 5% in water (non-pvc) 100ml bag X 1 Dextrose 5% in water (non-pvc) 250ml bag X 1 D5W 50ml Add-Vantage bag X1 D5W 250ml Add-Vantage bag X1 Diazepam 5mg/ml, 2ml tubex X 2 Diltiazem 25mg/5ml X 3 (in refrigerator) Diphenhydramine 50mg/ml vial X 2 EPHEdrine 25mg/ml, 1ml ampule X 1 Epinephrine 1:1000 1 ml ampule X 1 Epinephrine 1mg/10ml syringe X 2 Epinephrine 1mg/ml, 30ml vial X 1 Epinephrine (PF) 10mcg/mL, 10mL syringe x2 Esmolol 10mg/ml 10ml vial X 2 Esmolol 2.5gm/250mL bag x1 Etomidate 40 mg syringe X 1 Flumazenil 1mg/10ml vial X 1 Furosemide 20mg/2ml vial X 4 Glucagon 1mg vial X 5 Glucose gel 30g tube Isoproterenol 1mg/5ml amp Ketamine 500mg/10mL vial X 1 Lidocaine 100mg/5ml syringe X 2 Lidocaine 2% topical jelly X 1 Lorazepam 2mg/mL, 2mL x3 Magnesium sulfate 1g/2ml X 4 Midazolam 5mg/mL, 10mL x1 Midazolam 1mg/mL, 2mL X 2 Naloxone 0.4mg/ml amp X 2 Nitroglycerin 0.4mg tab (#25) Norepinephrine 4mg/4ml amp X 1 Phenylephrine 10 mg/ml 1ml vial X 2 Phenylephrine 10mg/ml 5ml vial X 1 Phenylephrine 1mg/10ml (100mcg/ml) x3 Propofol 10mg/ml 50ml vial X 1 Rocuronium 100mg vial X 1 (in refrigerator) Scopolamine 0.4mg/ml 1 ml vial X 2 Sodium bicarbonate 50mEq syringe X 1 Sodium chloride 0.9% 10ml flush syringes X 6 Sodium chloride 0.9% 100ml bag X 1 Sodium chloride 0.9% 250ml bag X 1 Succinylcholine 200mg/10ml vial (in refrigerator) Thiopental sodium 500 mg kit X 1 Vancomycin 1gm Add-Vantage x1 (in refrigerator) Vasopressin 20 U/ml 1ml vial X 5 vials (bolus and drip) Zosyn 3.375gm Add-vantage x1 (in refrigerator)

Table 3: Emergency Drug Kit Medications NOTE: An emergency medication kit can only be accessed when: 1. A Licensed Independent Practitioner (LIP) is ONSITE and directly overseeing the care provided to the patient, OR 2. A Licensed Independent Practitioner (LIP) is off site and both the LIP and onsite staff follow the requirements for Verbal Orders outlined in HCSM 11-12-01. Cyanide Kit Emergency Room Manufacturer Available as commercial unit Pharmacy Emergency Medication Kit All Inpatient Wards & Clinics* Interdisciplinary Group Activated Charcoal, 240ml 50% Dextrose IV, 50ml Dexamethasone inj 4mg/ml, 5ml Diphenhydramine 50mg vial Epinephrine inj (1:1000), 1ml Flumazenil 0.1mg/ml, 10ml Glucagon, 1mg vial Hydrocortisone inj 100mg Instant Glucose, 30g Methylprednisolone inj 125mg Naloxone inj 0.4mg/ml, 1ml Nitroglycerin 0.4mg sublingual tab ICU Transport Medication Kit MSICU (x3) Sandy Cardoza 2 epinephrine 1mg/10ml syringes atropine 1mg/10ml syringe 1 lidocaine 100mg/5ml syringes 1 Neosynephrine 1mg/10ml syringe (tagged so that we don t confuse it with NS) Amiodarone 50mg/3ml vial (?) Vasopressin 20 units/ml vial - Syringes 5ml Alcohol wipes 3 Sodium chloride 0.9% 10ml syringe flushes Needlestick Kit/ Blood Exposure PEP 3- Day Kit Rapid Intubation Kit PAD/SJC/Mont/LVD/MPD: Pharmacy MPD: 331B AcuDose LVD: Bldg 90 CLC1 AcuDose Mod/Stk/Son/Cap/Fre: Med room Emergency Room Bronchoscopy Suite Mark Holodniy Aarthi Chary Nancy Nguyen Tonia Fox Kevin Fish Mylinh Ho Syringe caps emtricitabine 200mg/ tenofovir 300mg (1 tab daily x3 days), #3 raltegravir 400mg (1 tab twice daily x 3 days), #6 Etomidate 40mg/20ml Ketamine 50mg/ml Lidocaine 100mg/5ml Propofol 10mg/ml Sodium Chloride 0.9% Rocuronium 100mg vial Tenecteplase (TNK) 50mg vial Enoxaparin 30mg/0.3ml syringe STEMI Kit ER EDOU Stephen Scherr John Giacomini *Except ER, PACU, ICU, IICU, OR, and anesthesia. These locations have emergency medications available in their medication cart/room.

Table 4: Emergency Drip Kit Medications Cath Lab Drip Kits Cath Lab Pharmacy Amiodarone 450mg/250ml drip Bivalirudin 250mg drip ICU Drip Kits MSICU & IICU Omnicell Pharmacy Amiodarone 150mg IVPB Amiodarone 450mg/250ml drip Amiodarone 600mg/100ml drip Diltiazem 100mg/100ml drip Dobutamine 500mg/250ml drip Dopamine 400mg/250ml drip Epinephrine 4mg/250ml drip Esmolol 2.5G/250ml drip Lidocaine 2G/250ml drip Nitroglycerin 100mg/250ml drip Sodium Nitroprusside 100mg/250ml drip Norepinephrine 4mg/250ml drip Phenylephrine 40mg/250ml drip Propofol 1000mg/100ml drip Stroke Kit Pharmacy Pharmacy 2 bottles of alteplase (TPA) 50mg 2 bottles of sterile water for inj (50 ml) 2 60 ml syringes 20 ml syringe needles syringe cap empty IV bag (100ml) alcohol wipes label for the alteplase bolus label for the alteplase infusion Quick reference on reconstituting and dosing Quick reference for administration DUC for alteplase for Acute Stroke