Quick Reference Guide for: Cardiac Arrest Medicines Box (BLUE) Please Note: Any medicines given must form part of an Airway, Breathing, Circulation, Disability and Exposure (ABCDE) Assessment (9)999 must be telephoned, followed by doctor on call The administration of Medicines must NOT delay (9)999 or transfer to definitive care Medicines Included in Cardiac Arrest Box (BLUE): Medicine Page Adrenaline 1mg in 10mL (1:10,000) Pre-filled syringe 3 Amiodarone 300mg/10mL Pre-filled syringe 5 Further information can be gained from National Poisons Information Service (www.toxbase.org) Phone No 0344 892 0111. This service is only available to NHS professionals, and is staffed 24-hours a day, 365 days a year. Quick Reference Guide v2.0 (Pharmacy & Resuscitation Departments) Page 1 of 6
Medicines that can be administered IN AN EMERGENCY without a prescription by a competent clinician.* Medicines that must be administered against a PRESCRIPTION, Patient Group Direction (PGD) or Protocol by a competent clinician. For administration by a Doctor, who in their professional opinion is competent to use it safely. *Reference: The Human Medicines Regulations 2012- Schedule 19 Further Medicine information can be obtained from the BNF or the OHFT website MEDICINES (Green) Button. Quick Reference Guide v2.0 (Pharmacy & Resuscitation Departments) Page 2 of 6
Adrenaline 1mg/10mL (1:10,000) Pre-filled syringe for Cardiorespiratory Arrest Indications: Cardiopulmonary resuscitation in adults Adult Dose: 1mg/10mL pre-filled syringe Instruction for Dilution: None required Route: Intravenous (IV) bolus Instruction for Administration: Twist box to open. Give during cardiorespiratory arrest. See algorithm overleaf. Flush with sodium chloride 0.9%. Do not interrupt chest compressions to administer. How to open a Pre-filled syringe Protocol: Only to be administered by a DOCTOR who, in their professional opinion, is competent to use it safely. Caution: This is not the the strength to be used in Anaphylaxis. See Adrenaline 1mg/1mL (1:1,000) for Anaphylaxis section. Side Effects: Arrhythmias, tachycardia, hypertension and myocardial ischaemia following cardiorespiratory arrest Contraindications: None when used in cardiorespiratory arrest Further Medicine information can be obtained from the BNF or the OHFT website MEDICINES (Green) Button. Quick Reference Guide v2.0 (Pharmacy & Resuscitation Departments) Page 3 of 6
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Amiodarone 300mg/10mL Pre-filled syringe Indications: In cardiopulmonary resuscitation for ventricular fibrillation (VF) or pulseless ventricular tachycardia (pvt) resistant to defibrillation Adult Dose: 300mg/10mL IV after 3 defibrillation attempts (shocks delivered) Instruction for Dilution: None required. Route: Intravenous (IV) administration must be via an antecubital vein Instruction for Administration: The vein must be flushed with Glucose 5% before and after administration. Using amiodarone requires monitoring/aed. Amiodarone is very irritant to the veins. Administered through a large bore canula inserted via the antecubital vein. Give 300mg IV prefilled syringe bolus during chest compressions after three defibrillation attempts Protocol: Only to be administered by a DOCTOR who, in their professional opinion, is competent to use it safely. There is no expectation for other medical staff of any grade or any other clinician to use it. Caution: None when used in cardiorespiratory arrest Side Effects: Following Return of Spontaneous Circulation (ROSC) patient could have Hypotension, vomiting, inflammation/ discomfort at IV site. Dose dependent bradycardia can occur. Rapid IV administration has been associated with anaphylactic shock, hot flushes, sweating and nausea. Contraindications: None when used in cardiorespiratory arrest Further Medicine information can be obtained from the BNF or the OHFT website MEDICINES (Green) Button. Quick Reference Guide v2.0 (Pharmacy & Resuscitation Departments) Page 5 of 6
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