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Tracheal Administration of Resuscitation Medications
Certain medications can be administered via the tracheal tube if unable to obtain intravenous access. Tracheal doses of medications should be 2 to 4 times higher than the intravenous route. Resuscitation medications that can be given via tracheal tube are the “ALE” drugs.
Medication Tracheal Administration
Atropine 2 to 3 mg diluted in 10 ml normal saline
Lidocaine 2 to 4 mg/kg
Epinephrine 2 to 2.5 mg diluted in 10ml normal saline
Recommended Technique for Tracheal Drug Administration
Prepare medication according to tracheal administration guidelines Stop chest compressions and inject the medication via the ETT
Flush the ETT with 10 ml of normal saline when indicated
Immediately attach the ventilation bag to the tracheal tube and ventilate forcefully 3 to 4 times to circulate the drug
Equipment Used in Codes
Crash Cart
All adult crash carts in the hospital contain the same basic emergency equipment and medications. To open the crash cart, turn the red plastic lock located on the bottom drawer until it breaks. Flip up the bottom panel of the crash cart and push it back firmly until it stops to be able to open the remaining drawers on the cart.
Summary of Crash Cart Contents/Location
1st drawer: 1st line drugs
2nd drawer: 2nd line drugs
3rd drawer: equipment, central line trays
Bottom drawer: equipment, ambu bag & intubation box
What is not in the crash cart?
No Narcotics
No Sedatives
No Paralytics
Location Medication/Equipment Quantity
Top of Cart Monitor/Defibrillator 1
Quik combo redi-pak 1
Equipment Electrodes 1 Pouch
Suction Machine/ Canister 1
Clip board with Dr. Blue sheets and gray charge slips 1
Back of Cart Cardiac Back Board 1
Extension cord 1
* Oxygen tank is located on the side of the cart
Drawer 1 Lidocaine 2% 100mg/5ml 2
1st line resuscitation drugs Atropine 1mg (0.1mg/ml) 3
12 Epinephrine 1:10,000 syringe
1mg/10ml (0.1mg/ml) 1
Procainamide 1 gm
Vasopressin 20 units/1 ml 2
1 Dopamine 800mg/250ml D5W
5 Adenosine (Adenocard) 6mg/2ml (3mg/ml)
3 Amiodarone 150mg/3ml (50mg/ml)
1 D5W 250ml
20 NaCl 0.9% Flush Syringes 10ml
2 Labels I.V.
Drawer 2 Calcium Chloride 10% 10ml 2
NaCl0.9% 20 ml 20
2nd line emergency drugs Furosemide (Lasix) 40mg/4ml 2
2 Norepinephrine (Levophed) 4mg/4ml (in plastic
bag with D5W 250ml to mix) 4
Verapamil (Calan) 5mg/2ml
1 Hydrocortisone (Solu-Cortef) 250mg/2ml
1 Romazicon 0.5mg/5ml
2 Narcan 0.4mg/ml
1 Epinephrine 1:1,000 (1mg/ml)
1 Benadryl 50mg/ml
1 Regitine 5mg
2 50% Dextrose 25 grams
1 8.4% Sodium Carbonate 50meq 4
Dilantin 250mg/5ml 4
Mag SO4 50% 2ml
Drawer 3 Needles: 19 gauge 1 ½ inch 6
20 gauge 1 ½ inch 8
Vascular Access Syringes: 60cc 2
60cc Cath Tip 1
Equipment; pacemaker
20cc 4
wire, multilumen catheter
10cc 6
5cc 4
3cc 8
Salem sump #18 1
Alcohol sponges 8
Topper sponges 4
Tapes: Non-allergenic 1 inch 2
Dermaclear 1 inch 1
IV equipment: 2
Tourniquets 1 inch
Jelco 14 gauge 2
16 gauge 2
18 gauge 2
20 gauge 4
22 gauge 2
Scalp vein set 19 gauge 1
21 gauge 1
PRN adaptor 6
Exam gloves 6
Face mask with shield 3
Disposable eye protector 1
#11 Scalpel with handle 3
Temporary pacing kit 5 Fr. 1
Multilumen Cath 1
Pacemaker Kit includes: 1
Disposable pacing kit 6 Fr.
8.5 Introducer cath 2
Stop cock
EKG monitor electrodes 9
Vacutainer tubes (yellow, blue, gray, purple, red) 1 each
Lower shelf Sterile gloves (6 1/2, 7, 7 1/2, 8) 2 each
IV tubing (primary, secondary, extension) 3 each
IV fluids & tubing/other IV Fluids (0.9 N.S. 500cc & 1000cc) 2 each
Lidocaine 2 Gms.500cc D5W 1
equipment
Needle box 1
Suction trays 14 Fr. 2
Ambu respiratory bag: RED box 1
Intubation tray: GRAY box 1