EMS drug cards.

Antiplatelet

Indications

Suspected ACS / chest pain of cardiac origin

Contraindications

Allergy, active GI bleed, children with viral illness

Adult dose

324 mg (4 × 81 mg) chewed

Route

PO

Vasodilator (nitrate)

Indications

Chest pain of cardiac origin, CHF/pulmonary edema

Contraindications

SBP < 100, PDE-5 inhibitor in 24–48 h, suspected RV/inferior MI, HR < 50

Adult dose

0.4 mg every 5 min, max 3 doses

Route

SL

Carbohydrate

Indications

Suspected hypoglycemia with intact airway

Contraindications

Unresponsive, unable to protect airway

Adult dose

15–25 g

Route

PO (buccal)

Sympathomimetic

Indications

Anaphylaxis, severe asthma

Contraindications

None in true anaphylaxis (relative: cardiac disease)

Adult dose

Adult 0.3 mg; peds 0.15 mg (0.01 mg/kg)

Route

IM lateral thigh

Beta-2 agonist

Indications

Bronchospasm (asthma, COPD)

Contraindications

Known hypersensitivity; caution with tachydysrhythmia

Adult dose

2.5 mg in 3 mL NS, may repeat

Route

Nebulized

Opioid antagonist

Indications

Opioid overdose with respiratory depression

Contraindications

Hypersensitivity

Adult dose

0.4–2 mg, titrate to respirations; repeat q2–3 min

Route

IN / IM / IV

Adsorbent

Indications

Select recent oral poisonings per medical direction

Contraindications

Altered mental status, caustics/hydrocarbons, unprotected airway

Adult dose

1 g/kg (adult 25–50 g)

Route

PO

Analgesic gas

Indications

Moderate to severe pain, isolated extremity injury

Contraindications

Altered mentation, suspected pneumothorax, bowel obstruction, COPD

Adult dose

50:50 self-administered

Route

Inhaled

Carbohydrate

Indications

Symptomatic hypoglycemia (BGL < 60)

Contraindications

Intracranial hemorrhage (relative)

Adult dose

12.5–25 g (125–250 mL of D10)

Route

IV / IO

Hormone

Indications

Hypoglycemia without IV access

Contraindications

Pheochromocytoma; ineffective with depleted glycogen

Adult dose

1 mg

Route

IM / IN

Isotonic crystalloid

Indications

Hypovolemia, hypotension, medication route

Contraindications

Fluid overload, CHF, pulmonary edema

Adult dose

250–500 mL boluses; peds 20 mL/kg

Route

IV / IO

Antiemetic (5-HT3)

Indications

Nausea and vomiting

Contraindications

Known QT prolongation, hypersensitivity

Adult dose

4 mg

Route

IV / IM / ODT

Antihistamine (H1)

Indications

Allergic reaction, dystonic reaction, adjunct in anaphylaxis

Contraindications

Narrow-angle glaucoma, asthma exacerbation (relative)

Adult dose

25–50 mg

Route

IV / IM

Opioid analgesic

Indications

Moderate to severe pain

Contraindications

Hypotension, respiratory depression, MAOI use

Adult dose

1 mcg/kg (usually 50–100 mcg)

Route

IV / IN / IM

Sympathomimetic

Indications

Cardiac arrest, profound bradycardia/hypotension

Contraindications

None in arrest

Adult dose

1 mg every 3–5 min

Route

IV / IO

Antiarrhythmic (III)

Indications

VF / pulseless VT, stable wide-complex tachycardia

Contraindications

2nd/3rd degree block, bradycardia, polymorphic VT with long QT

Adult dose

300 mg then 150 mg (arrest); 150 mg over 10 min (stable)

Route

IV / IO

Antiarrhythmic

Indications

Stable narrow-complex SVT

Contraindications

2nd/3rd degree block, WPW with irregular wide complex, asthma (relative)

Adult dose

6 mg → 12 mg → 12 mg

Route

Rapid IV push + flush

Anticholinergic

Indications

Symptomatic bradycardia, organophosphate poisoning

Contraindications

None in life threat; ineffective in Mobitz II/3rd degree

Adult dose

1 mg q3–5 min, max 3 mg

Route

IV / IO

Benzodiazepine

Indications

Seizure, sedation, agitated delirium

Contraindications

Hypotension, respiratory depression, hypersensitivity

Adult dose

0.1 mg/kg (max 5 mg IV / 10 mg IM)

Route

IV / IM / IN

NMDA antagonist

Indications

Analgesia, sedation, RSI induction, excited delirium

Contraindications

Known hypersensitivity; caution in severe HTN/ACS

Adult dose

0.3 mg/kg (pain), 1–2 mg/kg IV (RSI)

Route

IV / IM / IN

Electrolyte

Indications

Hyperkalemia, calcium-channel blocker OD, hypocalcemia

Contraindications

Digoxin toxicity (relative); never with bicarbonate in same line

Adult dose

1 g (10 mL of 10%)

Route

Slow IV / IO

Alkalinizer

Indications

TCA overdose (wide QRS), hyperkalemia, severe acidosis

Contraindications

Alkalosis, hypokalemia, inadequate ventilation

Adult dose

1 mEq/kg

Route

IV / IO

Electrolyte

Indications

Torsades, eclampsia, refractory bronchospasm

Contraindications

Heart block, hypermagnesemia, renal failure (relative)

Adult dose

1–2 g over 10 min (arrest: 1–2 g IV push)

Route

IV / IO

Vasopressor

Indications

Transient hypotension, peri-arrest, post-ROSC bridge

Contraindications

Uncorrected hypovolemia (give fluid too)

Adult dose

5–20 mcg (0.5–2 mL of 10 mcg/mL) q2–5 min

Route

IV / IO