1 / 10

January 2002 Protocol Updates

2002 Protocol Updates. Phenergan (Promethazine)Anti-nauseant, enhance narcoticNorcuron (Vecuronium)Long acting paralyticVersed (Midazolam)Anticonvulsant, CNS depressant, amnestic. Phenergan (Promethazine). Phenothiazine derivativeEffectsH1 receptor antagonistAntiemeticSedating agentAnticholinergic effectsIndicationsAntiemeticPotentiate narcotics.

Mercy
Download Presentation

January 2002 Protocol Updates

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. January 2002 Protocol Updates Lynn K. Wittwer, MD, MPD Clark County EMS

    2. 2002 Protocol Updates Phenergan (Promethazine) Anti-nauseant, enhance narcotic Norcuron (Vecuronium) Long acting paralytic Versed (Midazolam) Anticonvulsant, CNS depressant, amnestic

    3. Phenergan (Promethazine) Phenothiazine derivative Effects H1 receptor antagonist Antiemetic Sedating agent Anticholinergic effects Indications Antiemetic Potentiate narcotics

    4. Phenergan (Promethazine) Side effects CNS depression EPS Arteriospasm (if inadvertent arterial injection) Vascular irritation May lower seizure threshold Not recommended for patients less than 2 years Not to be given SC. May cause temporary sexual dysfunction

    5. Phenergan (Promethazine) Administration/Dosage Can be given deep IM or IV Dose is 12.5 – 25 mg (1/2 – 1 cc) Use lower dose for IV administration. Follow IV dose with fluid flush to prevent local irritation Peds dose (2-12 years) ˝ adult dose

    6. Norcuron (Vecuronium) Pharmacology Non-depolarizing neuromuscular blocker Competes for cholinergic receptor sites Indications Identified need for long term paralysis Patient INTUBATED and arousing and/or combative Risk of losing patent airway Continued transport time

    7. Norcuron (Vecuronium) Contraindications Known hypersensitivity Initial induction agent Use as a sedative Side Effects Looooooonnnnngggg term paralysis in Myasthenia Gravis Malignant hyperthermia (book says so)

    8. Norcuron (Vecuronium) Administration/Dosage 0.1mg/kg IV bolus Ensure adequate oxygenation/ventilation Capnography mandated Patient clinical response Provide necessary sedation per protocol Valium/Versed Notify receiving physician of long-term paralytic use

    9. Versed (Midazolam) Pharmacology Benzodiazepine, short acting CNS depressant, anticonvulsant, amnestic Indications Seizures Sedating agent for TCP, Cardioversion, RSI, long term paralytic use Stimulant OD

    10. Versed (Midazolam) Side Effects Respiratory depression Hypotension Ataxia Administration/Dosage 2.5 – 5mg IV/IM Max 10 mg Peds dose 0.1mg/kg IV, 0.2mg/kg IM,IO

More Related