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 Indication: Hypoglycemia (Adults <80mg/dL, Peds <40,  Dose: If temperature >101ºF and pt has not taken in last full term newborns <30, low birth weight infants <20) hour, give Acetaminophen 1000mg PO or Ibuprofen
and AMS or other signs such as
tremors/weakness/nausea/intense hunger. Oral glucose  Peds: See dosing chart (pg 27 of Protocols). Give Acetaminophen or Ibuprofen if pt has a fever and has not
 Dose: 25g (50mL) IV; repeat once in 15 mins if BGL taken within last 4 hrs; if temperature >102ºF, remains <80mg/dL; do NOT administer within 5 minutes Acetaminophen and Ibuprofen may be given together  Peds: Infants <10kg – D 25% at 0.5g/kg (2ml/kg) IV; Children >10kg – D50 at 0.5g/kg (1ml/kg) IV  Contraindication: no patent IV established, try to avoid use in suspected CVA (stroke) pt unless BGL and
 Indication: Bronchospasm, COPD, asthma, dyspnea  Side effect: tissue necrosis if IV not patent  Dose: 2.5mg/3ml saline nebulized (6 lpm) – for allergic  Remember to: administer thiamine before if suspicions
reaction, can repeat once after 15 mins if BP is stable; for of alcohol abuse or malnutrition; check IV patency respiratory distress due to asthma/COPD/pneumonia, can repeat once in 5 mins if dyspnea continues  Peds: for respiratory distress, give 2.5mg via nebulizer  Contraindication: hypersensitivity, caution with  Mechanism: Sympathomimetic – vasoconstricts and  Side effect: tachycardia, chest pain, anxiety, nausea, and  Indication: Allergic reaction (anaphylaxis) – Systolic BP <100 with dyspnea and hives/generalized edema
 Dose: 0.3mg Epipen IM (Conc: 1:1000) – if without Rx,  Peds 0.15mg Epipen-Jr (Conc: 1:1000) – if without Rx,  Indication: cardiac ischemia (non-traumatic chest pain).  Side effect: palpitations, tachycardia, N/V, dizziness, Associated symptoms include SOB, nausea, diaphoresis WITH systolic BP ≥110mmHg or within 30% of Epinephrine (for cardiac arrest) – IC admin only  Contraindication: Allergy, taken recently  Mechanism: vasoconstrictor, bronchodilator  Indication: Cardiac arrest (pulseless and apneic)  make sure you cover all the basics first (i.e. airway, CPR, etc)!  Dose: 1mg IV/IO (Conc 1:10,000); repeat 3-5 mins if still pulseless for a max of 2 doses. Use IO if IV fails in 2  Dose: Mild: 25 mg IV or IM; Mod/Severe: 50 mg IV.
 Peds: 1mg/kg IM for mild; 1mg/kg IV or IM for moderate; 1mg/kg IV or IO for severe (Single max dose  Mechanism: hormone that causes body to release sugar  Indication: Hypoglycemia where IV access unobtainable  Contraindication: nursing mothers, neonates/premies, and no gag reflex/oral glucose not tolerated
 Dose: 1mg reconstituted with 1 ml sterile water, IM or  Side effect: hypotension, sedation, blurred vision,  Peds Less than 6 y/o – 0.5mg SQ/IM; Greater than 6 y/o  Mechanism: Narcotic antagonist (blocks opiate receptors)  Indication: hypovolemia and other S/S of dehydration e.g.  Indication: opiate overdose (heroin, codeine, methadone, poor skin turgor, dry/cracked mucous membranes, morphine, fentanyl, vicodin); AMS of unknown etiology orthostatic hypotension, little or no urine output with respiratory compromise (e.g. can be used for
 Dose: IV large bore then bolus at 20ml/kg; if pt remains extended AMS in seizure or postictal pts) symptomatic and breath sounds remain clear, administer  Dose: 0.4-2mg slow IV push or IN titrated to respiratory
10ml/kg bolus increments thereafter every 15 mins. compromise; may repeat every 2-5 min if pt responds to Between boluses, maintain the IV at 200ml/hr. initial dose; maximum total dosage of 4mg  Peds: Fluid bolus 20ml/kg, may repeat every 5 mins if  Peds: 0.1 mg/kg slow IV push; may repeat every 10-15
still symptomatic and breath sounds are clear min if pt responds to initial dose, max single dose of 2mg  Newborns: if persistently obtunded and suspicion of
evidence of maternal narcotic use, give 0.1mg/kg IV/IO  Side effect: electrolyte imbalance, fluid overload  with a max single dose of 2mg and can repeat every 2-3 hypertension, heart failure, pulmonary edema  Remember to: assess VS before and after each bolus;  Contraindication: intubated pt, use caution with assess breath sounds often; stop fluid admin when a systolic BP of ≥ 90 mmHg with HR of ≤ 100 is reached
 Side effect: vomiting, withdrawal symptoms  IV Normal Saline (for heat related emergencies)  Indication: Heat cramps - environmental evidence and
cramps in extremities without heat exhaustion
 Indication: non traumatic chest pain; BP systolic ≥110 signs/symptoms; Heat exhaustion – environmental mmHg; prescription (IC can give to over 40 y/o without evidence and weakness/vertigo/nausea/syncope, profuse
sweating, tachycardia, temperature normal or 1-2 degrees  Dose: 0.4 mg SL; repeat up to 3 doses total every 3-5 elevated; Heat stroke – temperature of ≥ 105ºF and AMS
minutes if systolic BP remains ≥110 mmHg  Contraindication: Viagra (past 24hrs), Levitra or Cialis  Dose: IV large bore - bolus at 20ml/kg then TKO (past 48 hrs); BP systolic lower than 110 mmHg; no  Remember to: use extreme caution prior to  Indication: BGL > 180 with one of the following: AMS,
administration  have IV established TKO NS, get HFD, tachypnea, abdominal pain, hypotension, tachycardia, evaluate BP in both arms, monitor vitals  Dose: IV large bore - bolus at 20ml/kg. May repeat twice  Mechanism: Antiemetic – works on vagus nerve to  Indication: Systolic BP <90 – usually associated with  Contraindication: long QT segment, hypokalemia, other conditions, make sure to treat those (e.g. hypersensitivity / contact MD for pregnant female  Dose: 4-8 mg slow IVP over 2-5 min
 Dose: IV large bore - bolus at 20ml/kg and titrate to a  Peds: = Adult for >8 yrs, for <8 y/o call MD systolic BP of > 90mmHg (shoot for 100mmHg)  Newborns: if there are S/S of hypoperfusion, hypovolemia, or dehydration, give an initial bolus of 10ml/kg within 10 mins. Repeat if needed.  Mechanism: glucose absorbed in GI tract and increases  Indication: Hypoglycemia (Adults <80mg/dL, Peds <40mg/dL) and AMS or other signs such as
 Mechanism: anti - inflammatory glucocorticoid (steroid)  Indication: For Asthma or COPD after 2 breathing  Dose: 15g PO (pt must be conscious with a gag reflex); treatments still significant difficulty breathing (wheezing repeat once in 15 mins if BGL remains <80mg/dL  Contraindication: unconscious patent, no patent airway,  Other Indication: Severe anaphylaxis  Dose: 125mg adult IV (follow by flush); 1mg/kg  Contraindication: sensitivity/allergy


Doi: 10.1016/s0000-0000(07)43620-8

Principales urgences iatrogènes médicamenteuses Les effets indésirables médicamenteux responsables d’une urgence restent une éventualité rare qui nenécessite pas toujours une hospitalisation. Les tableaux cliniques rencontrés ne posent pas de problèmediagnostique, mais leur caractère habituellement peu spécifique fait que dans certains cas une originemédicamenteuse n’est pas im

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DECISIONI DELLA COMMISSIONE DISCIPLINARE La Commissione Disciplinare della Lega Professionisti Serie C, costituita dal dott. Daniele Propato, Presidente, dal dott. Vincenzo Basso e dal dott. Raimondo Genco, Componenti, e con la partecipazione, per quanto di competenza, del Rappresentante dell'A.I.A. sig. Roberto Calabassi, nella sua riunione del 7 Aprile 2006 ha assunto le seguenti deci

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