ADULT CODE BLUE and RSI DRUGS ADULT CODE BLUE and RSI DRUGS ADULT CODE BLUE

ADULT CODE BLUE and RSI DRUGS ADULT CODE BLUE and RSI DRUGS ADULT CODE BLUE and RSI DRUGS
DRUG & CONC. DOSE FREQUENCY COMMENTS DRUG & CONC. DOSE FREQUENCY COMMENTS DRUG & CONC. DOSE FREQUENCY COMMENTS DRUG & CONC. DOSE FREQUENCY COMMENTS

x 1 dose; If no response Give VERY RAPID IVP Epinephrine Pulseless VT/VF, Actions depressed Reversal of opioid Standard drip =
Adenosine Every 3-5 min PRN Repeat every 2-3 MAX total dose = x 1 dose pre-intubation
6 mg IVP after 1-2 min, may repeat over 1-3 sec. followed 0.1 mg/ml PEA: 1 mg IVP in acidosis overdose: Propofol 1000 mg in 100 ml
3 mg/ml vial Naloxone minutes. 10 mg 1-2.5 mg/kg IVP Continuous infusion:
12 mg IV x1 dose. by 20 ml saline flush (1 mg/10 ml syringe) 2 mg IVP 10 mg/ml vial (pre-mix in glass
1 mg/mL 5-50 mcg/kg/min
AND 1 mg/ml Continuous infusion: Standard drip = (2 mg syringe) bottle)
Pulseless VT or May repeat with 150 mg Standard drip = 0.1-1 mcg/kg/min Respiratory Repeat every 30-60 Dilute 0.4 mg with
(1:1000) vial Titrate to response. 4 mg/250 ml NS AND
VF: 300 mg IVP. IVP if needed. Flush with Load: 150 mg/ depression in seconds; if no response 9 ml NS in 10 ml
100 ml D5W 0.4 mg/ml Rocuronium 0.6-1.2 mg/kg Neuromuscular
20 ml of D5W/NS. chronic opioid use: after 1 mg consider other syringe to give 40 x1 dose pre-intubation
After IVP, Flush Infusion: 450 mg/ Etomidate 40-80 mcg IVP causes. mcg/ml conc 10 mg/ml vial IVP blocker
Amiodarone Continuous infusion: 0.3 mg/kg IVP x1 dose pre-intubation
with 20 ml of 250 ml D5W (Braun 2 mg/ml vial
50 mg/ml vial Bolus 150 mg over 10
D5W or NS. bag) Sodium
min, then start drip. Standard drip = May repeat < 0.5 mEq/kg INCOMPATIBLE
Stable VT: 1 mg/min for first 6 hrs, 100 mg/250 ml D5W Bicarbonate 1 mEq/kg
MAX CUMULATIVE Isoproterenol Continuous infusion Standard drip = 0.25-3 mcg/kg/min Continuous infusion: IVP every 10 min. during with many other
150 mg IV over then decrease to 2-10 mcg/min Nitroglycerin (pre-mix in glass 1 mEq/ml IVP
DOSE = 2.2 gm in 0.2 mg/ml amp Titrate to response. 1 mg/ 500 ml D5W or Can increase every 5-10 continued cardiac arrest medications.
10 min 0.5 mg/min X 18 hrs. 400 mcg/ml bottle bottle) (50 mEq syringe)
24 hrs 10-20 mcg/min minutes as needed.
MAX RATE =
Atropine Symptomatic Ketamine 200 mcg/min Succinylcholine 1-1.5 mg/kg Neuromuscular
May repeat dose every MAX CUMULATIVE 1-2 mg/kg IVP x1 dose pre-intubation Sedative x1 dose pre-intubation
0.1 mg/ml bradycardia: 50 mg/mL vial 20 mg/ml vial IVP blocker
3-5 min. DOSE = 3 mg
(1 mg syringe) 0.5 mg IVP
Continuous infusion: Standard drip = May repeat Epi if
May repeat Norepinephrine Usual dose
Calcium DO NOT MIX WITH Pulseless Titrate to response every 4 mg/250 ml NS x1 dose (to replace no response after
May repeat every 10 min 0.5-0.75 mg/kg 1 mg/ml vial 0.1-2 mcg/kg/min
Chloride 1-2 g IVP SODIUM BICARB. Lidocaine VT or VF: Standard drip = 2-3 min. (16 mcg/ml) Vasopressin 1st or 2nd Epi dose) 10-20 min
PRN. 1-1.5 mg/kg IV every 5-10 min 40 units IVP
100 mg/ml vial Contraindicated in Vfib 20 mg/ml 2 g/250 ml D5W 20 units/ml vial Continuous infusion: Standard drip =
(Max dose 3 mg/kg) 100 units /100 ml
(100 mg syringe) Stable VT: (pre-mix) Continuous infusion: Standard drip = 0.04 units/min
Continuous infusion: NS or D5W
Standard drip = 0.5-0.75 mg/kg IV 1-4 mg/min Usual maintenance dose 10 mg/250 ml NS
May repeat in 15 min at Initial:
Afib/SVT: Add 125 mg to 100 ml Phenylephrine is 0.15-1 mcg/kg/min or (40 mcg/ml) Neuromuscular
Diltiazem 0.35 mg/kg IV . 0.5-3 mcg/kg/min
0.25 mg/kg IV D5W 10 mg/ml vial 40-60 mcg/min. Titrate MAX RATE = blocker Recon. with
5 mg/ml vial Continuous infusion: or 50-200 mcg/min Vecuronium
over 2 min Total volume = 125 ml Magnesium 1-2 g in May follow with to response every 10 3 mcg/kg/min or 0.1 mg/kg IVP x1 dose 10 ml NS
5-15 mg/hr. Available as 1g or 2g minutes. 200 mcg/min 10 mg vial
(Final Conc. = 1 mg/ml) Sulfate 10 ml D5W slow Continuous infusion: (concentration =
pre-mix IVPB
500 mg/ml vial IVP over 5 min 0.5-1 g/hr 1 mg/ml)
Continuous infusion: Standard drip = Use 0.22 micron
Dobutamine Initial: May give 1 gm in 100 mL CAUTION WITH
Titrate to effect up to 500 mg/250 ml D5W in-line filter for IVPB
12.5 mg/ml vial 2-5 mcg/kg/min Standard drip: Phenytoin Loading Dose NS over 20-60 min BETA BLOCKER
20 mcg/kg/min. (pre-mix) administration. Verapamil 2.5-5 mg IV May repeat 5-10 mg
20 mg in 100 mL 50 mg/ml vial 20 mg/kg IV Usual Maintenance USE
MAX RATE = 2.5 mg/ml vial over 2-3 min every 15-30 min
Continuous infusion: (pre-mix) Dose: 100 mg IV Q8H MAX total dose =
Standard drip = Loading dose*: Continuous infusion: 50 mg/min
5-10 mcg/kg/min to Milrinone Inotrope & 20 mg
800 mg/250 ml D5W 50 mcg/kg over 0.375-0.75 mcg/kg/min
Dopamine increase cardiac output; 1 mg/mL vial vasodilator
5-20 mcg/kg/min (pre-mix) 10 min Titrate to effect.
40 mg/ml vial 10-20 mcg/kg/ *Avoid loading dose Continuous infusion:
MAX RATE = in patients with Continue 20 mg/min until Standard drip =
NOTE: Please use clinical judgment when making treatment decisions.
min for peripheral
vasoconstriction.
50 mcg/kg/min hypotension arrhythmia suppressed, 1 g/250 ml D5W While every attempt has been made to ensure the accuracy of the information
Procainamide
100 mg/ml vial
20 mg/min hypotension, QRS provided on this card, the user of this card assumes all responsibility for its use.
widens by 50%, OR total MAX RATE =
of 17 mg/kg given, then 20 mg/min.
Approved by Resuscitation Services Committee (2/13) NOTE: Intraosseus (IO) doses are the same as IV doses. All drugs that can be administered
and Pharmacy & Therapeutics Committee (2/13) IV may be administered IO. IO route is preferred over ET tube administration.
decrease to 1-4 mg/min. Rev 3/13
 Y- Site Injectable Drug Compatibility Table PEDIATRIC CODE BLUE and RSI DRUGS PEDIATRIC CODE BLUE and RSI DRUGS PEDIATRIC CODE BLUE and RSI DRUGS
DRUG & CONC. DOSE FREQUENCY COMMENTS DRUG & CONC. DOSE FREQUENCY COMMENTS DRUG & CONC. DOSE FREQUENCY COMMENTS

Calcium Chloride

Norepinephrine

Sodium Bicarb
Phenylephrine
Procainamide
Nitroprusside
Isoproterenol

Nitroglycerin

Vasopressin
Amiodarone

Dobutamine

Epinephrine
x 1 dose; If no Continuous infusion: Naloxone* < 5 y or < 20 kg: Do not give to newborns

Magnesium
 

Dopamine
Give VERY RAPID

Lidocaine
Diltiazem

Labetalol
Adenosine 0.1 mg/kg IV/IO response after 1-2 5-10 mcg/kg/min Standard PEDI drip = 0.4 mg/mL AND 0.1 mg/kg IV* Repeat every 2-3 of narcotic dependent
Atropine

Propofol
Heparin
IV bolus over 1-3 sec.

Insulin
3 mg/mL vial (max 6 mg) min, may repeat 0.2 to increase cardiac ≤ 5kg: 50 mg/50 mL D5W 1 mg/mL > 5 y or > 20 kg: minutes as needed mothers, may precipitate
followed by saline flush. Dopamine
mg/kg (max 12 mg) 5-20 mcg/kg/min output; (syringe) (2mg syringe) 2 mg IV* seizures
40 mg/mL vial
Amiodarone C C C C C C C I C C C C C C C C I C 10-20 mcg/kg/min > 5kg: 800 mg/250 mL
May repeat dose x Monitor ECG and for peripheral D5W (premixed) Standard PEDI drip =
Atropine C C C C C C C C C C C C C C C C C C C Amiodarone
5 mg/kg IV/IO 2 up to max total 15 blood pressure. vasoconstriction ≤ 5kg: 2 mg/50 mL NS
50 mg/mL vial Continuous
Calcium Chloride C C C C C C C C C C C C I C C C C C I I C mg/kg MAX single dose: 300 mg Norepinephrine (conc = 40 mcg/mL)
0.1-2 mcg/kg/min infusion:
Diltiazem C C C C C C C C C C C C C C C 0.01 mg/kg IV/IO 1 mg/mL vial > 5kg: 4 mg/50 mL NS
MIN dose: 0.1 mg MAX single dose: Titrate to response.
Epinephrine* (0.1 mL/kg Every 3-5 min PRN (conc = 80 mcg/mL)
Dobutamine C C C C C C C C C C C C C C C C I C MAX single dose: 1 mg IV/IO
0.1 mg/mL 1:10000) (syringe)
Dopamine C C C C C C C C C C C C C C C C C C C Atropine* child 0.5 mg
0.02 mg/kg IV/IO repeat x 1 if needed syringe
Epinephrine 0.1 mg/mL adolescent 1 mg Standard PEDI drip = Monitor for hypotension
C C C C C C C C C C C C C C C C C C I C (0.2 mL/kg) (1:10000) Procainamide 15 mg/kg IV/IO
syringe MAX total dose: ≤ 5kg: 1 mg/50 mL D5W prolongation of QT
Heparin I C C C C C C C C C C C C C C C C C AND 100 mg/mL vial over 30-60 min
child 1 mg Continuous infusion: (conc = 20 mcg/mL) interval, heart block
Insulin 1 mg/mL vial 0.1-1 mcg/kg/min
C C C C C I I C C C C I C C C adolescent 3 mg Titrate to response. > 5kg: 2 mg/50 mL NS
(1:1000) (conc = 40 mcg/mL) Propofol x1 dose Sedative. May cause
Isoproterenol C C C C C C C C I C C C C C C C C C C I C 1-2 mg/kg IVP
Calcium DO NOT MIX WITH (syringe) 10 mg/mL vial pre-intubation hypotension.
Labetalol C C C C C C C I C C C C C C C C C C C C CHLORIDE 20 mg/kg IV/IO SODIUM BICARB.
Lidocaine C C C C C C C C C C C C C C C C C C C C C (10%) (0.2 mL/kg) Central line preferred. Etomidate x1 dose Rocuronium x1 dose Neuromuscular blocker
0.3 mg/kg IVP Sedative 0.6-1.2 mg/kg IVP
100 mg/mL vial MAX single dose: 2000 mg 2 mg/mL vial pre-intubation 10 mg/mL vial pre-intubation Refrigerate
Magnesium C I C C C C C C C C C C C C C C C C C C
Nitroglycerin C C C C C C C C C C C C C C C C C C C C C Calcium Ketamine x1 dose Sodium After adequate ventilation.
DO NOT MIX WITH 1-2 mg/kg IVP Sedative 1 mEq/kg
Nitroprusside C C C C C C GLUCONATE 60 mg/kg IV/IO 50 mg/mL vial pre-intubation Bicarbonate INCOMPATIBLE with
C C C C C C C C C C C C C
SODIUM BICARB. slow IVP/IO
(10%) 0.6 mL/kg 1 mEq/mL syringe many other medications.
Norepinephrine C C C C C C C C C C C C C C C C C C I C MAX single dose: 2000 mg
100 mg/mL vial Standard drip =
Phenylephrine Lidocaine* Continuous Continuous
C C C C C C C C I C C C C C C C C C C C 2 g/250 mL D5W (Pre-mix) Sodium
20 mg/mL 1 mg/kg IV/IO infusion: infusion:
Procainamide C C C C C C C C C C C C C C C C C C C 0.5-1 g/kg IV/IO MAX single dose: Nitroprusside 0.3-1 mcg/kg/min Prepare only in D5W
D25W*(preferred): *Prepare D25W by mixing syringe 20-50 mcg/kg/min Titrate to response up
Propofol 100 mg IV/IO 25 mg/mL vial
I C C C C C C C C C C C C C C
Dextrose 50% 2-4 mL/kg 50% dextrose 1:1 with to 8 mcg/kg/min
Sodium Bicarb May repeat as sterile water for injection. Magnesium 25-50 mg/kg IV/IO Available as 1g or 2g
I C I I I C C I C C C C C I C C C C C 50 mL prefilled D10W:
5-10 mL/kg needed Sulfate over 10-20 min pre-mix IVPB. Children:
Vasopressin C C C C C C C C C C C C C C C C C C C syringe Use only D10W in
Neonates: 500 mg/mL vial (faster in torsades) MAX single dose: 2 g Succinylcholine 1-1.5 mg/kg IVP x1 dose Neuromuscular blocker
neonates.
D10W: 2 mL/kg 20 mg/mL vial Infants: pre-intubation Refrigerate
C = Compatabile I = Incompatible = No Info / Variable Sedative. May cause 2 mg/kg IVP
Standard PEDI drip = Midazolam x1 dose hypotension.
Continuous 0.1-0.3 mg/kg IVP
≤ 5kg: 50 mg/50 mL D5W 1 mg/mL vial pre-intubation Neuromuscular blocker
Dobutamine infusion: MAX single dose:10 mg Vecuronium x1 dose
2-20 mcg/kg/min (syringe) 0.1-0.3 mg/kg IVP Recon. with 10 mL NS
Drip Rate Calculation 12.5 mg/mL vial Titrate to effect up to
> 5kg: 500 mg/250 mL Standard PEDI drip =
10 mg vial pre-intubation
(Conc = 1 mg/mL)
20 mcg/kg/min
ml/hr = weight (kg) x dose (mcg/kg/min) x 60 min D5W (premixed) Continuous ≤ 5kg: 5 mg/50 mL D5W
concentration (mcg/ml) hr Milrinone 50 mcg/kg bolus infusion: (conc = 100 mcg/mL) * Atropine, lidocaine, naloxone, and vasopressin may be given via endotracheal tube
NOTE: Please use clinical judgment when making treatment decisions. Doses 1 mg/mL vial over 10 min 0.25-0.75 mcg/ > 5kg: 10 mg/50 mL NS (ETT) at 2-3 times the IV/IO dose and epinephrine at 10 times the IV/IO dose.
provided are guidelines only. Actual dosing may vary depending on patient’s clinical kg/min (conc = 200 mcg/mL)
*** Caution: Use patient’s weight only if drug is dosed as mcg/kg/min *** Following administration, flush with 5 mL NS and provide 5 ventilations.
status. While every attempt has been made to ensure the accuracy of the information (syringe)
provided on this card, the user of this card assumes all responsibility for its use. *** NOTE: For head injuries, prepare drips in Normal Saline. ***