EMS Field Guide ®

Basic & Intermediate Version

©2009, Seventh Edition – Informed ®

Airway Management
Cardiac Arrest / Basic ECGs
Medical Emergencies
Infectious Diseases
Poisons & Overdoses
Trauma / Triage / Burns
Pediatric Emergencies
New Prescription Drugs
Jon Tardiff, Paramedic
Paula Derr, RN, BSN, CCRN, CEN
Paul LeSage, EMT-P, Assistant Chief
 NOTICE & DISCLAIMER WARRANTY

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 Mnemonics

Patient Assessment Rapid Triage

A—Airway A—Alert
B—Breathing V—Responds to Verbal
C—Circulation P—Responds to Pain
D—Disability U—Unresponsive
E—Expose

Altered Mental Status Pain Questions

A—Alcohol/Drugs O—Onset
E—Endocrine P—Provoke/Palliative
I —Insulin/Infection Q—Quality/Character
O—Overdose R—Region or Radiation
U—Uremia S—Signs/Symptoms/
Severity
T—Trauma T—Time of Onset/
I —Infection Duration/Intensity
P—Psychiatric
S—Shock

History-taking Newborn Assessment

S—Signs & Symptoms A—Appearance
A—Allergies P—Pulse
M—Medications G—Grimace
P—Pertinent Past Hx A—Activity
L—Last meal R—Respirations
E—Events

2
Airway
Airway

3
Airway Management
Endotracheal Intubation

1 Immobilize C-spine if spinal trauma

Hyperventilate with 100% O2
(apply cricoid pressure p.r.n.)
2 Prepare equipment (BVM,
suction, ETT, oximeter)
Place Pt. in sniff position.
3 Insert laryngoscope in R side Hyperventilate with O2
of mouth, lift tongue up and
leftward (do not press on teeth with
blade)
4 Visualize vocal cords (apply
cricoid pressure p.r.n.)
5 Advance ET tube through
glottis (½"–1" past vocal cords) Lift tongue leftward &
visualize vocal cords
6 Inflate cuff with 5–10 cc air
(use minimum amount necessary)
7 Verify tube placement:
P Check chest expansion
P Check for equal lung sounds
P Check for breath condensation
on tube
8 Apply CO2 detector (if tube is inserted Vocal cords
too deeply, withdraw tube until equal
breath sounds are heard)
9 Secure with tape or tube
holder, Reverify tube placement
(and any time patient is moved)

Insert ETT; inflate cuff;

check breath sounds
 Combitube®
Contra—Gag reflex, esophageal disease, caustic ingestion
under 16 y.o. or <5' tall (use Combitube SA® for small adult).

1 Immobilize C-spine if spinal trauma;

hyperventilate with 100% O2—apply
cricoid pressure p.r.n.
2 Prepare equipment
Combitube, suction, oximeter.
3 Place head in neutral
position. Open patient's mouth
with jaw lift; insert device to
markings on tube. Teeth Hyperventilate with O2
should be between black
markings (A).
4 Inflate pharyngeal cuff (#1)
with 100 mL air (B).
5 Inflate distal cuff (#2) with
15 mL air (C).
6 Ventilate through longer,
blue tube (#1). Auscultate
lungs & stomach; If lung
sounds are present:
7 Continue ventilation through
blue tube.
8 If gastric sounds are heard
(and no lung sounds), ventilate
through short, clear tube (#2).
Verify lung sounds.
9 If lung sounds are present, continue
ventilation through short, clear
tube #2.
10 Secure tube with tape.
Reassess airway
periodically.

Check breath sounds

4
Airway
Airway

5
King LT™ Airway
Contra—Patients <4 feet tall. Does
not protect against aspiration. Step 2
1 C-Spine Immobilization p.r.n.
Preoxygenate with 100% O2.
2 Deflate cuff. Open mouth, apply
chin lift, insert tip into side of mouth.
3 Advance tip behind tongue while
rotating tube to midline.
4 Advance tube until base of
connector is aligned with teeth or Step 3
gums.
5 Inflate cuff with air: (use minimum
volume necessary).

Pt. Size LT Size Cuff Vol

4–5 feet Size 3 45–60 mL
5–6 feet Size 4 60–80 mL
>6 feet Size 5 70–90 mLl

6 Attach Bag-Valve device.

While ventilating, gently
withdraw tube until ventilation
Step 4
becomes easy.
7 Adjust cuff inflation if necessary
to obtain a good seal.
8 Verify Proper Placement:
• Check Cx Expansion & Lung
Sounds Step 6
• Apply CO2 Detector; oximeter
• Secure with tape or tube holder
• Reassess airway periodically
 Laryngeal Mask Airway (LMA)
Contra—Severe oropharyngeal trauma; step 2
poorly tolerated in conscious patients.
1. C-Spine immobilization p.r.n.
2. Deflate cuff. Lubricate
posterior (palatal) surface of LMA. step 3
3. Preoxygenate with 100% O2.
4. Extend head; flex neck; Place
LMA against hard palate.
5. Follow natural curve of patient's
airway, insert LMA until it is step 4
seated snugly.
6. Inflate cuff with just enough air
(see chart): Do not hold tube down
during inflation; allow LMA to
“seat itself.” step 5
7. Verify tube placement:
P Check Cx expansion & lung sounds
P Secure with tape or tube holder
P Apply CO2 detector; oximeter
P Reassess airway periodically
step 6

(Illustrations © 2003 LMA North America, Inc.)

Patient Size LMA Size Max. Cuff Vol.

Neonate/Infant: up to 5 kg 1 up to 4 mL
Infant: 5–10 kg 1½ up to 7 mL
Infant/Child: 10–20 kg 2 up to 10 mL
Child: 20–30 kg 2½ up to 14 mL
Child: 30–50 kg 3 up to 20 mL
Normal Adult: 50–70 kg 4 up to 30 mL
Large Adult: 70–100 kg 5 up to 40 mL
Large Adult: >100 kg 6 up to 50 mL
6
Airway
Cardiac

7
Cardiac

Defibrillation
HX—Obtain history simultaneously
while examining patient. Onset of
collapse? Downtime? Was CPR
started? Surroundings: Is this
drug or trauma-related?
Resuscitate unless obvious signs
of morbidity, e.g. rigor mortis.
Request further information as needed from family members:
Is patient DNR? Is current, valid, signed DNR order on
scene? Does patient have a Living Will specifying desired
emergency care?
NOTE: Penetrating Trauma Arrest? Transport immediately!

1. Determine unresponsiveness.
2. Check ABCs (Airway, Breathing, Circulation); if
pulseless:
3. Begin CPR (30 compressions, 2 ventilations). Try not to
interrupt chest compressions during resuscitation.
4. Apply defibrillator and analyze ECG rhythm; If V-Fib
or pulseless V-Tach:
5. Shock 1X @ 120–200 J biphasic energy
(or 360 J monophasic)
6. Immediately continue CPR. Perform five cycles of 30:2.
Then:
7. Analyze ECG rhythm and check patient's pulse. If
V-Fib, or pulseless, V-Tach:
8. Shock 1X @ 120–200 J biphasic energy
(or 360 J monophasic)
9. Immediately continue CPR. Perform five cycles of
30:2.
10. Consider other ACLS interventions such as airway
management, drug therapy, etc.
11. If pulse and good blood pressure return, consider
lidocaine 1.5 mg/kg IV (max. total dose: 3 mg/kg).
Cardiac Arrest
HX—Onset of collapse, downtime? Was CPR started?
Surroundings: Is this drug related or trauma related? Resuscitate
unless obvious signs of morbidity, e.g. rigor mortis. Request
further information from family members, physician, hospital.
NOTE: Penetrating Trauma? Transport immediately! Start CPR,
check ECG & vital signs. Treat per your local protocols.
Start CPR: Check ECG & vitals signs.
Treat per your local protocols.

Head-tilt/Chin lift Adult: lower 1/2 of sternum

CPR Ratio Rate Depth Check Pulse
Adult: 1 Person 30:2 100 1&1/2-2" Carotid
Adult: 2 Person 30:2 100 1&1/2-2" Carotid
Child: 1 Person 30:2 100 1/3–1/2 cx Carotid
Child: 2 Person 15:2 100 1/3–1/2 cx Carotid
Infant: 1 Person 30:2 100 1/3–1/2 cx Brachial, Fem.
Newborn: 2 Person 15:2 100 1/3–1/2 cx Brachial, Fem.

Adult, Child or Infant CPR

1. Determine unresponsiveness
2. Call for assistance (if child or infant, do CPR x1 minute first)
3. Position patient supine on hard, flat surface
4. Open airway, head-tilt/chin-lift (if trauma: jaw thrust)
5. Check breathing; if none, ventilate x 2
6. Check pulse; if none, begin chest compressions
7. Attach AED to adult (& child >1 y.o.); follow voice prompts
8. After shock perform 5 cycles of CPR, then recheck pulse
9. Continue CPR if no pulse
8
Cardiac
Cardiac

9
Cardiac Arrest Rhythms

Coarse Ventricular Fibrillation

(Note the chaotic, irregular electrical activity) Shock

Fine Ventricular Fibrillation

Shock
(Note the low-amplitude, irregular electrical activity)

Shock
Ventricular Tachycardia if no
(Note the rapid, wide complexes) pulse

CPR
Asystole
(Note the absence of electrical activity)

CPR
Pulseless Electrical Activity (PEA)
(Any organized ECG rhythm with no pulse)
Other Common ECG Rhythms

Normal Sinus Rhythm

(Note the regular PQRST cycles)
fibrillatory
waves

Atrial Fibrillation
(Note the irregular rate and atrial fibrillatory waves)
PVC
PAC PJC

 

(Normal QRS (Normal QRS complex;

complex; different inverted or no P wave) (Wide, bizarre
P wave) complex; no P wave)
Premature Atrial, Junctional, and Ventricular Complexes

QRS QRS
QRS QRS

P P P P
P
P 3° (complete) Heart Block
(The P waves are dissociated from the QRS complexes)

Supraventricular Tachycardia (SVT)

(Note the rapid, narrow QRS complexes)
10
Cardiac
Cardiac

11
Other Common ECG Rhythms



spikes
Electronic Ventricular Pacemaker
(Note the pacer spikes before each QRS)

1° AV Block
(Prolonged PR Interval Bundle Branch Block
>0.20 sec.) (Wide QRS >0.12 sec.)

P P P P P P P
 
dropped QRS
2° Heart Block, Wenckebach, Type I
(The PR interval lengthens, resulting in a dropped QRS)


dropped QRS

2° Heart Block, Mobitz, Type II

(The PR interval does not lengthen; but a QRS is dropped)

Inverted P Inverted P

 

Junctional Rhythm
(Normal QRS complexes; inverted, or no P waves)
Basic ECG Interpretation

.04 sec. .20 sec.

ECG Waves:
• P Wave: atrial depolarization
• QRS Complex: ventricular
depolarization
• T Wave: ventricular
repolarization

1 mm 1 cm

Ventricular contraction

Atrial Ventricular
contraction relaxation
& passive filling

12
Cardiac
 Medical

13
Medical Emergencies
ABBREVIATIONS USED IN THIS SECTION

HX—History, Signs & Symptoms

Green Type—Key Symptoms and Findings
—Prehospital Treatment
µ—Other Diagnoses to Consider
Italic—Intermediate procedures
Caution—Contraindications or Precautions
Blank Spaces—Write in your local protocols

General History for Most Patients

Events that led up to chief complaint? Past Hx? Medications?
Allergies? Known diseases? Dyspnea (SOB)? Previous
trauma or surgery? Nausea & Vomiting (N&V)? Fever (Fv)?
Medic Alert™?

Pain Questions

Location, radiation? Speed and time of onset, duration?

Nature, what type of pain, tenderness? What makes it better
or worse? Any associated symptoms? Ever had this pain
before—what was it?

General Treatment for Most Patients

• Follow your local protocols at all times
• Ensure ABCs (Airway, Breathing, Circulation)
• Treat life threatening injuries immediately
• Get Vital Signs (pulse, BP, respirations, effort, lung sounds)
• Monitor O2 sat; Give O2 as needed, Protect airway
• Perform Intermediate procedures as indicated (IV, ECG, etc.)
• Transport as soon as practical
• Monitor patient's condition en route
• Reassure and comfort your patient
 Abdominal Pain
HX—Ask PAIN QUESTIONS & GENERAL HISTORY. N&V?
(Color/quality of emesis) bowel movements, dysuria,
menstrual Hx, fv, postural hypotension, referred shoulder
pain? Is patient pregnant? Which trimester? Consider ectopic
pregnancy. Genitourinary, vaginal or rectal bleeding/discharge?
Examine all 4 quadrants: abdominal tenderness, guarding,
rigidity, bowel tones present? Distension, pulsatile mass?
Record recent intake and GI habits. Vitals (sitting & supine),
chemstrip. Peripheral pulses equal?
Position of comfort and NPO. Consider pulse oximetry. O2,
IV (adjusted to vitals), consider ECG for epigastric pain.
CAUTION—Consider aortic aneurysm; ectopic pregnancy,
DKA. Epigastric abdominal pain may be cardiac.
µ Abdominal Aortic Aneurysm: severe abdominal pain,
pulsatile mass, hypotension.
µ Acute MI: chest “pressure” or epigastric pain radiating to
L arm or jaw; diaphoresis, N&V, SOB, pallor, dysrhythmias.
µ Appendicitis: N&V, RLQ or periumbilical pain, fv, shock.
µ Bowel Obstruction: N&V (fecal odor), localized pain.
µ Cholecystitis: acute onset RUQ pain & tenderness (may
be referred to R shoulder/scapula)—may be related to
high fat meal; N&V, anorexia, fever. “Female, fat, 40.”
µ Ectopic Pregnancy: missed period, pelvic pain, abnormal
vaginal bleeding, dizziness.
µ Food Poisoning: N&V, diffuse abdominal pain and
cramping, diarrhea, fever, weakness, dizziness. Severe
symptoms: descending paralysis, respiratory compromise.
µ Hepatic Failure: jaundice, confusion/coma, edema, bleeding
and bruising, renal failure, fever, anorexia, dehydration.
µ Kidney Stone: c/o colicky severe flank pain, extreme
restlessness, hematuria, N&V.
µ Pancreatitis: severe, “sharp” or “twisting” epigastric or
LUQ pain radiating to back; N&V, diaphoresis, abdominal
distention, signs of shock, fever.
µ Ulcer: “burning”, epigastric pain, N&V, possible
hematemesis, hypotension, decreased bowel sounds.

14
Medical
 Medical

15

lung heart

diaphragm spleen
liver kidney
gall bladder stomach
kidney
RUQ LUQ
pancreas
large intestine
small intestine
RLQ LLQ
ovary
appendix uterus
bladder

Abdominal Pain—Common Causes

• Epigastric: AMI, gastroenteritis, ulcer, esophageal
disease, heartburn.
• RUQ: gall stones, hepatitis, liver disease, pancreatitis,
appendicitis, perforated duodenal ulcer, AMI, pneumonia.
• LUQ: gastritis, pancreatitis, AMI, pneumonia.
• LLQ: ruptured ectopic pregnancy, ovarian cyst, PID,
kidney stones, diverticulitis, enteritis, abdominal abscess.
• RLQ: appendicitis, ruptured ectopic pregnancy, enteritis,
diverticulitis, PID, ovarian cyst, kidney stones, abdominal
abscess, strangulated hernia.
• Midline: bladder infection, aortic aneurysm, uterine
disease, intestinal disease, early appendicitis.
• Diffuse Pain: pancreatitis, peritonitis, appendicitis,
gastroenteritis, dissecting/rupturing aortic aneurysm,
diabetes, ischemic bowel, sickle cell crisis.
ACLS—See EMS Field Guide®, ALS Version

Airway Obstruction—See “Choking” page 22

Allergic Reaction
HX—Mild reaction? (local swelling only);
or serious systemic reaction? (hives, pallor,
broncho­spasm, wheezing, upper airway
obstruction with stridor, swelling of throat,
hypotension. If cardiac arrest, treat per
ACLS).
µ If bee sting, remove stinger (scrape,
do not squeeze).
• For mild local reaction: wash area, apply cold pack.
• For serious reaction: secure airway, ventilate, O2;
large bore IV, titrate to BP >90; ECG;
Epinephrine: 1:1,000 SQ, (Adult: 0.3 mL–0.5 mL);
(Pediatric: 0.01 mL/kg; 0.3 mL max);
Caution—epinephrine may cause arrhythmias or angina.
Altered Mental Status
µ Consider: CVA/TIA/Stroke, hypoglycemia, postictal,
alcohol, drugs, hypovolemia, head injury,
hypothermia, HazMat, sepsis, shock, cardiogenic,
vasovagal.
HX—Ask PAIN QUESTIONS & GENERAL HISTORY.
Time of onset: slow or fast? Seizure activity? Was patient
sitting, standing, lying? Is patient pregnant? (consider ectopic
pregnancy). Any recent illness, or trauma? Current level
of consciousness? Neurological status and psychological
status? Any vomiting (bloody or coffee-ground)? Melena
(black tarry stool)? Any signs of recent trauma?
General treatment—Protect airway. Give O2 PRN,
Be prepared to assist ventilations. Monitor ECG, vitals.
Cardiac: Support ABCs. Vitals, O2, treat per ACLS.
(continued)

16
Medical
 Medical

17
Coma: (If multiple patients suspect toxins—protect
yourself!) Any odor at scene?—Consider HazMat.
Were there any preceding symptoms or H/A? Past Hx:
HTN, diabetes? Medications? Check scene for pill bottles
or syringes and bring along. Get vitals, LOC & neuro
findings, pupils; any signs of trauma, drug abuse?
Skin: color, temperature, rash, welts, facial or extremity
asymmetry, Medic Alert™ tag?
WARNING: Ensure your safety first, then safety of patient
and others.

Secure airway, ventilate with 100% O2, protect C-spine.

Start IV. Get chemstrip. Consider glucose, naloxone.
Monitor vital signs, O2 saturation, & ECG.
Caution—Protect airway, suction as needed.
Sepsis/Infection: O2, IV, Vitals. IV fluids for hypotension.
Syncope: Position of comfort, O2, IV, Vitals, ECG.
Consider IV fluids for hypotension.

Caution—Syncope in middle-aged or elderly patient is often

cardiac. Occult internal bleeding may cause syncope.
Chest Pain
Consider: AMI, CHF, APE, pneumothorax,
pneumonia, bronchitis, pulmonary embolus.
HX—Ask PAIN QUESTIONS & GENERAL HX.
Syncope, dizziness, weakness,
diaphoresis? Fever, pallor? Dyspnea?
Past Hx: chest trauma? cardiac or respiratory
problems, diabetes, high blood pressure, heart
failure? Lung sounds, JVD? Peripheral or
pulmonary edema, general appearance?
µ Position of comfort, reassure patient, vitals, Give O2,
Monitor ECG, Start IV, Consider nitroglycerine for
cardiac chest pain: 0.4 mg SL after 5 minutes (max: 3
doses). Consider aspirin for AMI. Notify ED if your
cardiac patient is a possible fibrinolytic candidate,
and transport ASAP.
µ Caution: Treat dysrhythmias according to ACLS.
µ Acute MI: severe, crushing chest pain, or substernal
“pressure,” radiating to the L arm, or jaw. N&V, SOB,
diaphoresis, pallor, dysrhythmias, HTN or hypotension.
µ Aortic Dissection: sudden onset “tearing” chest or
back pain, tachycardia, HTN or hypotension,
diaphoresis, possible unequal pulses or unequal BP in
extremities.
µ Cholecystitis: acute onset RUQ pain & tenderness
(may be referred to R shoulder/scapula)—may be
related to high fat meal; N&V, anorexia, fever. “Female,
fat, 40.”
µ Hiatal Hernia: positional epigastric pain.
µ Musculo-Skeletal: pain on palpation, respiration;
obvious signs of trauma.
µ Pleurisy: pain on inspiration, fever, pleural friction rub.
µ Pneumonia: fever, shaking, chills, pleuritic chest pain,
crackles, productive cough, tachycardia, diaphoresis.
µ Pulmonary Embolus: sudden onset SOB, cough,
chest pain which is sharp and pleuritic, tachycardia,
rapid respirations, O2 sat <94%, apprehension,
diaphoresis, hemoptysis, crackles.
µ Ulcer: “burning” epigastric pain, N&V, possible
hematemesis, hypotension, decreased bowel sounds.

18
Medical
 Medical

19
Childbirth
HX—Timing of contractions? Intensity? Does mother have
urge to push or to move bowels? Has amniotic sac ruptured?
Medications—any medical problems? Vital signs. Check for:
• Vaginal bleeding or amniotic fluid; note color of fluid
• Crowning (means imminent delivery)
• Abnormal presentation: foot, arm, breech, cord, shoulder
• Transport immediately if patient has had previous
C-section, known multiple births, any abnormal
presentation, excessive bleeding, or if pregnancy is not
full-term and child will be premature

Normal Childbirth

Control delivery using gloved

hand to guide head, suction mouth
& nose, liver, keep infant level with
perineum, clamp & cut cord 8-10
inches from infant, warm & dry
infant, stimulate infant by drying with towel, make sure
respirations are adequate.
Normal vital signs are:
• Pulse: >120
• Resp: >40
• BP: 70
• Weight: 3.5 kg
Give baby to mother to nurse at breast. Get APGAR scores
at 1 and 5 minutes after birth.
If excessive post-partum bleeding, treat for shock,
massage uterus to aid contraction, have mother nurse
infant, start large bore IV, transport without waiting for
placenta to deliver. Bring it with you to the hospital. Obtain
mother’s vital signs.
NOTE: Most births are normal—reassure the parents.
(continued)
 Breech
Call OLMC. If head won’t deliver, consider applying gentle
pressure on mother’s abdomen. If unsuccessful, insert two
gloved fingers in vagina between baby’s face and vaginal
wall to create airway. Rapid transport

Cord Presents

Call OLMC. Place mother in trendelenburg & knee-chest
position, hold pressure on baby’s head to relieve pressure
on cord, check pulses in cord, keep cord moist with saline
dressing, O2, rapid transport, start IV en route.

Foot/Leg Presents

Call OLMC. Support presenting part, place mother in
trendelenburg & knee-chest position, O2, Rapid
transport, start IV en route.

Cord Around Neck

Unwrap cord from neck and deliver normally, keep face
clear, suction mouth & nose, etc.

Infant Not Breathing

Stimulate with dry towel, rub back, flick soles of feet with
finger. Suction mouth and nose. Ventilate with BVM &
100% O2 (this will revive most infants). Begin chest
compressions if HR <60. Ventilate with 100% O2.
If child does not respond, contact OLMC and reassess
ventilation, lung sounds (pneumothorax? obstruction?)
O2 connected?
Ventilate. Consider intubation, IV fluids 10 mL/kg, glucose
2 mL/kg D25%W, Epinephrine 0.01 mg/kg IV/IO, or 0.1
mg/kg 1:1000 ET.
Rapid transport. Failure to respond usually indicates
hypoxia.
(continued)

20
Medical
 Medical

21
APGAR Scale
1 5
0 point 1 point 2 points Min. Min.
Heart rate Absent <100 >100
Respiratory Absent Slow, Strong
Effort Irregular cry

Muscle Flaccid Some Active

Tone flexion motion
Irritability No Some Vigorous
response
Color Blue, pale Body: pink Fully pink
Ext. blue
TOTAL:

l Infantswith scores of 7–10 usually require supportive

care only.
l A score of 4–6 indicates moderate depression.
l Infants with scores of 3 or less require aggressive
resuscitation.
Also See: Pediatric Vital Signs Chart, page 31

Other OB/GYN Emergencies—Also see pg. 36

Abruptio Placenta: painful 3rd trimester bleeding; look

for hypovolemic shock; give O2, start IV, Rapid transport.
Placenta previa: painless 3rd trimester bleeding; start
IV, O2, Rapid transport.
Toxemia: transport quietly & gently. Monitor vitals, IV.
Caution—Anticipate seizures.
Choking

For Responsive Choking Adult Or Child

1. If patient can not talk or has stridor, or cyanosis:
2. Perform Heimlich Maneuver—(use chest
thrusts if patient is pregnant or obese)
repeat until successful or patient is
unconscious:
3. Begin CPR/Call for assistance
4. Open airway; head-tilt/chin-lift: (look
and remove object if visible)
5. Ventilate with two breaths—if unable:
6. Reposition head; attempt to ventilate—
if unable:
7. Perform chest compressions (30:2).
8. Repeat: inspect mouth g remove object g ventilate
g chest compressions until successful.
9. Consider laryngoscopy and removal of object by
forceps, ET intubation, transtracheal ventilation,
cricothyrotomy
10. If patient resumes breathing, place in the recovery
position.
For Unresponsive Choking Adult or Child
1. Determine unresponsiveness
2. Call for assistance
3. Position patient supine on hard,
flat surface
4. Open airway—head-tilt/chin-lift;
(look and remove object if visible)
5. Attempt to ventilate—if unable:
6. Reposition head & chin, attempt
to ventilate, if unable:
7. Begin chest compressions 30:2
8. Repeat: inspect mouth g remove object g ventilate g
chest compressions until successful.
9. Consider laryngoscopy and removal of object by forceps,
ET intubation, transtracheal ventilation, cricothyrotomy
10. If patient resumes breathing, place in the recovery position.

22
Medical
 Medical

23
For Choking Infant
1. Confirm obstruction: if infant can
not make sounds, breathe, or cry or is
cyanotic:
2. Invert infant on arm. Support head
by cupping face in hand. Perform 5
back slaps & 5 chest thrusts until
object is expelled.
3. Repeat until successful.
4. If patient becomes unconscious, start CPR.
5. Open airway & ventilate x 2; if unable;
6. Reposition head and chin, attempt to ventilate again;
7. Begin chest compressions 30:2
8. Consider laryngoscopy and removal of object by
forceps, ET intubation, transtracheal ventilation,
cricothyrotomy.
9. If patient resumes breathing, place in the recovery position.

Drowning & Near Drowning

HX—How long was patient submerged? Fresh or salt water?
Cold water (<40°F)?
Diving accident? Immobilize spine.
S/S: Vitals, pulse oximetry, Neurological status, GCS,
Crackles or pulmonary edema with respiratory distress?
Open airway, suction, assist ventilations, start CPR.
C-Spine: stabilize before removing patient from water.
O2, IV, Monitor ECG. If hypothermic: use heated O2 and
follow hypothermia protocols. Conserve heat with
blankets.
Caution—All unconscious patients should have C-spine
immobilization. All near-drowningpatients should be
transported. Many deteriorate later and develop pulmonary
edema.
Prepare for vomiting; intubate if unconscious.
Crime Scene—Medical Response
CAUTION: Consider the safety of your crew first!
1. Consider staging out of sight until scene is secure
2. Make a mental note of physical and weather conditions
3. Do not park your vehicle over visible tire tracks
4. Limit the number of personnel allowed on scene
Crime Scene—Access and Treatment
1. Consult with police regarding best
access
2. To avoid destroying evidence, select
a single route to and from the victim
3. When moving the victim, it is
important to note:
a Location of furniture prior to moving
a Position of victim prior to moving
a Status of clothing
a Location of any weapons or other articles
a Name of personnel who moved items
4. Consult with police regarding whether to pick up
medical debris left over from treatment
5. Be conscious of any statements made
6. Do NOT cut through any holes in patient's clothing
7. Place victim on a clean sheet for transport. After transport,
obtain the sheet, fold it onto itself & give to the police
8. Write a detailed report regarding your crews actions
Scene Safety
CAUTION: Wait until police secure the scene before entering
any scene of domestic violence, assault, shooting or stabbing.
a As you approach, scan the area for hazards such as:
hostile persons, dogs, uncontrolled traffic, spilled
chemicals, gas, oil, down power lines.
a Keep your exit routes open.
a Any weapons present at the scene should be secured.
a Wear protective gear. Call for more resources if needed.

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25
Glasgow Coma Scale
Patient with a score of 3–8 is in a coma.

Infant Eye Opening Child/Adult

4 Spontaneously Spontaneously 4
3 To speech To command 3
2 To pain To pain 2
1 No response No response 1
Best Verbal Response
5 Coos, babbles Oriented 5
4 Irritable cries Confused 4
3 Cries to pain Inappropriate words 3
2 Moans, grunts Incomprehensible 2
1 No response No response 1

Best Motor Response

6 Spontaneous Obeys commands 6
5 Localizes pain Localizes pain 5
4 Withdraws from pain Withdraws from pain 4
3 Flexion (decorticate) Flexion (decorticate) 3
2 Extension (decerebrate) Extension (decereb.) 2
1 No response No response 1

= TOTAL
(GCS <8? g Intubate!) TOTAL =
Hyperglycemia
HX—Slow onset, excessive urination, thirst. When
was insulin last taken? Abdominal cramps, N&V? Mental
status, high glucose on chemstrip, skin signs, dehydration?
Respirations: deep & rapid? Breath odor: acetone, fruity?
Secure patient airway, get vital signs, give O2, large bore
IV, fluid challenge (balanced salt solution). Monitor ECG.

Hypoglycemia/Insulin Shock
HX—Sudden onset, low blood glucose on chemstrip. Last
insulin dose? Last meal? Mental status? Diaphoresis, H/A,
blurred vision, dizziness, tachycardia, tremors, seizures?
Support ABCs, give O2, take vitals, start IV. Give 50mL
D50%W if patient comatose (perform chemstrip). Do not
give oral glucose if airway is compromised.
Caution—Hypoglycemia can mimic a stroke or intoxication.
Seizures, coma, and confusion are common symptoms.
When in doubt about the diagnosis, give glucose IV or PO.
Hypoglycemia vs. Hyperglycemia
HYPOGLYCEMIA HYPERGLYCEMIA
Also known as “Insulin Shock” “DKA” “Ketoacidosis”
Incidence Much more common Less common
Blood sugar Low (< 80 mg%) High (≥180 mg%)
Onset Rapid (minutes) Gradual (days)
Skin Moist, pale Dry, warm
Respirations Normal Deep or rapid
Pulse Normal or fast Rapid, weak
Blood Pressure Normal or high Normal or low
Breath odor Normal Ketone/Acetone odor
Seizures Common Uncommon
Dehydration No Yes
Urine Output Normal Excessive
Thirst Normal Very Thirsty
Mental Status Disoriented, Coma Awake, weak, tired
Treatment Glucose IV or PO IV Fluids, Insulin, K+
Recovery Rapid (minutes) Gradual (days)
When in doubt about the diagnosis, give glucose IV or PO.

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27
Hyperthermia/Heat Stroke
HX—Onset? Exercise- or drug- (cocaine) induced?
Vitals, temperature, skin: warm, dry?
Remove from hot environment. Secure airway.
Give O2. Undress and begin cooling patient,
Consider cold packs to groin, armpits.
Evaporation and convection measures work best
(but avoid causing shivering as this may increase
patient's temp.) Start large bore IV. Consider fluid
challenge. Monitor ECG. Reassess vital signs en route.
Caution—Rapid cooling is key. Don’t delay transport.

Hypothermia
HX—Vital signs, mental status. Is patient cold? Shivering?
Evidence of local injury?
Mild hypothermia: shivering, hHR, hRR, lethargy,
confusion.
Moderate hypothermia: irespirations, iHR, rigidity,
iL.O.C., “J wave” on ECG.
Severe hypothermia: coma, iBP, iHR, acidosis, VF,
asystole.
Secure airway. Remove patient from cold environment.
Give heated O2. A severely hypothermic patient may
breathe slowly. Monitor ECG, large bore IV.
If cardiac arrest: start CPR. Contact OLMC.
Cut wet clothing off (do not pull off) wrap patient with blankets.
Record vital signs, including temperature.
Caution—Handle patient gently. Jostling can cause cardiac
arrest. If patient is not shivering, do not ambulate.
Stimulating the airway can cause cardiac arrest.
 Infectious Diseases
Disease Spread by Risk to you
AIDS/HIV IV/Sex/Blood iImmune function,
products Pneumonias, Cancer
Anthrax Cutaneous: contact Infection= 25% mortality,
with skin lesions but much lower if treated
Ingestion: eating Infection= high mortality,
contaminated meat unless treated with antibiotics
Pulmonary: inhaled Infection= 95% mortality,
spores but much lower if treated
C-diff Secretions/Excretions C-diff Colonization or
Hand to nose infection
Hepatitis A* Fecal-oral Acute hepatitis
Hepatitis B* IV/Sex/Birth/Blood Acute & chronic hepatitis,
hCirrhosis, Liver CA
Hepatitis C Blood Chronic hepatitis, Cirrhosis,
Liver CA
Hepatitis D IV/Sex/Birth Chronic liver disease
Hepatitis E Fecal-oral hMortality to pregnant
women and fetus
Herpes Skin contact Skin lesions, shingles
Influenza Droplet/Airborne Influenza
MRSA Secretions/ Antibiotic-resistant
Excretions colonization or infection
Hand to nose
Meningitis* Nasal secretions Low risk to rescuer
Norovirus Fecal to oral n/v, diarrhea
Hand to mouth
Tuberculosis Sputum/cough/ TB, infection
Airborne

Universal Precautions/BSI
P Wear gloves for all patient contacts and for all contacts
with body fluids.
P Wash hands after patient contact.
P Wear a mask for patients who are coughing or sneezing.
Place a mask on the patient too.
P Wear eye shields or goggles when body fluids may
splash.
P Wear gowns when needed.
P Wear utility gloves for cleaning equipment.
P Do not recap, do not cut, do not bend needles.
P *Get vaccinated against Hepatitis A, B, and Meningitis
A, C, W, Y.
CAUTION: Report every exposure, get immediate treatment!

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29
Pediatric Emergencies
General Assessment
Airway: Look for obstruction, drooling, trauma.
Breathing: Retractions? Respiratory rate?
Good air movement?
Circulation: Heart rate? Capillary refill?

Bradycardia means hypoxia. Ventilate!

Mental Status: Is child acting normally?

Get History:
• Present illness/onset
• Intake
• GI habits
Perform Exam:
• Fever?
• Skin color?
• Other findings?
Kids in shock need aggressive treatment.
• Ventilate. Reassess the airway, especially during transport.
• IV fluid challenge (20 mL/kg—repeat if necessary).
• Do not wait for BP to drop—hypotension is a late sign.
• Rapid transport to a pediatric intensive care facility.
Not every seizure with fever is a febrile seizure.

a Consider meningitis, especially in children <2 y.o.

(check for a rash that does not blanch).
a Early signs of sepsis are subtle: grunting respirations,
temperature instability, hypoglycemia, poor feeding, etc.
ABUSE— CHILD, DOMESTIC, ELDER
Child Maltreatment (Child Abuse)
HX—Any unusual MOI, one that does not match the child’s
injury/illness. Parents may accuse the child of hurting himself/
herself, or may be vague/contradictory in providing history.
There may be a delay in seeking medical care. The child
may not cling to mother. Fracture in any child <2 y.o.;
multiple injuries in various stages of healing, or on many
parts of the body; obvious cigarette burns or wire marks;
malnutrition; insect infestation, chronic skin infection,
unkempt patient.
Remove the child from the environment. Transport to
hospital; report possible abuse to police, ED staff, and
Child Welfare office. Call for police assistance if needed
to remove child from the scene. Do not confront the
parents. Document your findings, any statements made
by child, parent, others. Provide medical care as needed.
If sexual abuse, do not allow patient to wash.

Croup
HX—Hx of a cold or flu which develops into a “barking
cough” at night. Relatively slow onset. Low fever.
Cool, moist air; contact OLMC regarding transport.
Caution—Do not examine the upper airway.

Epiglottitis
HX—Hx of a cold or flu which develops into a high fever at
night. Drooling, difficulty swallowing, relatively rapid onset.
Inspiratory stidor may be present in severe cases.
Cool, moist air. If airway if completely obstructed,

ventilate with BVM & O2.
Caution—Do not examine the upper airway. This may
cause total airway obstruction.

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31
Normal Pediatric Vital Signs
Age Resp. Pulse BP Weight Weight
Preterm 40–60 140 50–60 3 lbs 1.5 kg
Term NB 40–60 125 70 7 lbs 3.5 kg
6 mos. 24–36 120 90 15 lbs 7 kg
1 y.o. 22–30 120 95 22 lbs 10 kg
3 y.o. 20–26 110 100 33 lbs 15 kg
6 y.o. 20–24 100 100 44 lbs 20 kg
8 y.o. 18–22 90 105 55 lbs 25 kg
10 y.o. 18–22 90 110 66 lbs 30 kg
12 y.o. 16–22 85 115 88 lbs 40 kg
14 y.o. 14–20 80 115 99 lbs 45 kg

Intraosseous Infusion
(most medications, blood products, or solutions
that can be given IV, can be given IO)
1. Locate anterior medial (flat) surface of tibia, 2 cm
below tibial tuberosity, below growth plate
(other sites: distal anterior femur, medial malleolus,
iliac crest).
2. Prep area with iodine
3. Advance IO needle at 90° through skin,
fascia, and bone with constant pressure
and twisting motion. Direct needle
slightly away from epiphyseal plate.
4. A popping sensation will occur
(& a lack of resistance) when you have
reached the marrow space.
5. Attempt to aspirate marrow
(you may or may not get marrow).
6. Infuse fluids and check for
infiltration. Discontinue if site
becomes infiltrated with fluid or
medications; apply manual
pressure to site followed by a pressure dressing.
7. Secure IO needle, tape in place and attach to IV pump.
 Pediatric Trauma Score
+2 +1 -1 points
Pt. Size >20 kg 10–20 kg <10 kg
Maintainable Not
Airway Normal without maintainable
invasive NEEDS invasive
procedures procedures
CNS Awake Obtunded Comatose
Systolic >90 50–90 <50 mm Hg
BP (radial) (femoral) (or no pulse)
(or pulse)
Open None Minor Major or
wounds Penetrating
Skeletal None Closed Fx Open/Multiple
Fx
12 = <1% mortality, minimal or no injury
­< 8 = Critical injury: transport to Pediatric
Trauma Center
4 = Predicts 50% mortality Total =
<1 = Predicts >98% mortality

Psychiatric Emergencies
HX—Hx recent crisis? Emotional trauma, suicidal, changes
in behavior, drug/alcohol abuse? Toxins, head injury,
diabetes, seizure disorder, sepsis or other illness? Ask about
suicidal feelings, intent; does patient have a plan? Make
judgement about whether patient will act on plan. Vitals, with
pupil signs, Mental status, oriented? Any odor on breath?
Medic alert tags? Any signs of trauma?
Make sure scene is safe—protect yourself! Contact
OLMC or psychiatric hospital. ABCs, Restrain patient as
needed. If patient is suicidal do not leave alone. Remove
dangerous objects (weapons, pills, etc). Transport in
calm, quiet manner, if possible. Consider: O2, IV, check
blood sugar. If low, consider glucose, PO or IV.
Caution—Always suspect hypoglycemia, and look
for other medical causes: ETOH, drugs, sepsis, CVA, etc.
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33
Respiratory Distress
Disease Lung Sounds Other S/SX; Notes

Asthma Wheezing; Hx allergies, Hx asthma; patient

Crackles takes bronchodilator
Bronchitis Wheezes; Crackles Recent respiratory tract
infection, Smoker
Congestive Crackles; Wheezes Pedal edema, Hx CHF,
Heart Failure patient takes Lanoxin, Lasix
Emphysema Wheezing, Smoker; Barrel Chest;
(COPD) Rhonchi Patient takes Theophylline, O2
Foreign Body Stridor; Wheezing Heard best right over the site
Obstruction of the obstruction
Pneumonia Scattered crackles; Fever, brown, green or yellow
Wheezing sputum; Dehydration. Patient
takes antibiotics
Pneumothorax Decreased on one Deviated trachea (late);
side Hyperresonant percussion
NOTE: When in doubt about the cause of the patient's respiratory
distress, give oxygen. Hyperventilation of unknown origin can be
shock, sepsis, stroke drug OD.

HX—Ask PAIN QUESTIONS & GENERAL HISTORY.

Onset of event: was it slow or fast? Fever? Cough? Is
cough productive? Recent respiratory infection? Does patient
smoke? (how much?) Record patient's medications.
Assess severity of dyspnea (mild, moderate, severe); & tidal
volume. Single word sentences? Is cyanosis present? Level
of consciousness? Lung sounds: any wheezing, crackles,
rhonchi, diminished sounds? Vitals? Pulse oximetry; Is
patient exhausted? Candidate for intubation? Upper airway
obstruction? (stridor, hoarseness, drooling, coughing?) Cx
pain? Itching, hives? Numbness of mouth and hands? Signs
of CHF: JVD, wet lung sounds (crackles), peripheral edema?
General treatment: Position of comfort (usually upright)
Give O2 as needed. Be prepared to assist ventilations.
Monitor ECG, vitals. Start IV.
Caution—High flow O2 can depress respirations in a
patient with COPD. Prepare to assist respirations.
(continued)
 Anaphylaxis: See ALLERGIC REACTION, Page 16.
Asthma: Consider nebulized bronchodilator, and/or
epinephrine 1:1,000 SQ (0.3 mg–0.5 mg).
COPD: Consider nebulized bronchodilator.
Pulmonary edema: Consider nebulized bronchodilator,
furosemide, sublingual nitroglycerine, and morphine.
Tension Pneumothorax: Contact OLMC. Lift occlusive
dressing, needle thoracentesis. Rapid transport.

Seizures

Consider epilepsy, hypoxia, CVA, cardiac origin,

ETOH/drug withdrawal, hypoglycemia.
HX—onset, length of seizure, type? previous Hx? Seizure
meds? Compliance? Recent head trauma? What was patient
doing before seizure? Did patient fall? Bite tongue?
Dysrhythmias? Incontinent? Is seizure drug-induced
(antidepressant, cocaine)? Medic Alert™? Level of
consciousness, head or oral trauma? Focal neurologic signs?
H/A? Respiratory status?
Treatment for Status epilepticus: Keep airway open,
consider NPA (do not use EOA/EGTA), O2, suction, IV,
test blood glucose, consider IV glucose. Transport on
side, Monitor ECG, vitals.
Caution—Restrain patient only to prevent injury—protect
patient's head. Do not force anything into the mouth. Always
check for a pulse after a seizure stops. Most seizures are
self-limiting, lasting less than 1–2 minutes.

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35
Shock
HX—Ask PAIN QUESTIONS & GENERAL HISTORY.
Onset? Associated symptoms: hives, edema, thirst, weakness,
dyspnea, chest pain, dizziness when upright, abdominal pain?
Trauma? Bloody vomitus or stools? Delayed capillary refill?
Tachypnea? Syncope? N&V? Mental status: confusion,
restlessness? Tachycardia, hypotension? Skin: pale, sweaty,
cool. Signs of pump failure: JVD while upright, crackles,
peripheral edema.
Stop hemorrhage if any, Apply direct pressure to wound.
Consider pressure point. Place patient supine, O2
high flow, assist ventilations as needed. Do not delay
transport to start IV (consider intraosseous infusion if
unable to start IV). Give IV fluid challenge. Prevent heat
loss. Try to determine the type of shock (hypovolemic,
cardiogenic, anaphylactic, septic, neurogenic, etc.).
If trauma, enter patient in Trauma System. Assess
lung sounds. Monitor ECG, O2 sat, vitals, level of
consciousness.
Caution—Check lung sounds for crackles before giving IV fluids.

Stroke/CVA

HX—Ask PAIN QUESTIONS & GENERAL HISTORY. Onset,

progression, preceding symptoms (i.e. headache, seizures,
confusion, etc.) Past Hx: hypertension? Diabetes? Meds,
medic alert tag? Level of consciousness, GCS, O2 sat,
chemstrip. Neurological status: paralysis? Pupils, facial droop,
unequal hand grips? Slurred speech, difficulty understanding?
Keep airway open, O2, assist ventilations if needed.
Start IV. Monitor ECG: CVA may be 2° to cardiac
event, Record Glasgow Coma Score, vitals, Consider
hypoglycemia and give glucose only if indicated. Patient
may be a candidate for fibrinolysis. Consider rapid
transport
Caution—Keep airway open, suction & ventilate if needed.
Vaginal Bleeding (see also page 19)
Consider: miscarriage, ectopic pregnancy, CA, trauma.
HX—Ask PAIN QUESTIONS & GENERAL HISTORY.
Cramping? Clots, tissue fragments (bring to ER),
dizziness, weakness, thirst; (painless bleeding with
pregnancy suggests placenta previa). Duration, amount;
last menstrual period (normal?). If patient is pregnant:
due date? Past Hx: bleeding problems, pregnancies,
medications? Vitals and orthostatic change? Fever?
Evidence of blood loss; Signs of shock? vasoconstriction,
sweating, altered mental status.
General Treatment: O2, IV large bore, titrated to vitals,
assess vitals, O2 sat, ECG.
Caution—If miscarriage is suspected, field vaginal exam is
generally not indicated.
Postpartum bleeding: treat for shock, massage uterus
to aid contraction, have mother nurse infant, start large
bore IV, transport without waiting for placenta to deliver.
Bring it with you to the hospital. Get vital signs.
Abruptio Placenta: painful 3rd trimester bleeding;
look for hypovolemic shock; give O2, start IV, rapid
transport.
Placenta previa: painless 3rd trimester bleeding;
start IV, O2, rapid transport.

36
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 Poisons

37
Poisons & Overdoses
Please note: this section lists only some of the:
• AKA—Common brand®,™, & “street names”
• Substance Type
• SE—Common Toxic Side Effects
• Caution—Primary Cautions
• Rx—Prehospital care [ALS treatments are in italics]
Before administering treatment, consult your Poison Center,
the product label or insert, your protocols, and/or your
on-line Medical Resource.
HX—Type, time, quantity of ingestion? Bring pill bottle
and emesis sample to ED. Is patient showing signs of
toxicity? Beware of HazMat—are there several patients
with the same symptoms? Is patient suicidal? Is this a
case of child neglect? Medications? Diseases? Psychiatric
Hx? Hx drug abuse? Vital signs, LOC with neuro status,
chemstrip and O2 saturation. Breath odor? Vomitus? Needle
marks or tracks?
General Treatment—External Contamination.
Follow appropriate Decon procedures. Protect yourself
and your partner. Remove patient from toxic environment.
Remove contaminated clothing. Flush contaminated skin
and eyes with copious amounts of water. Contact Poison
Control Center.
General Treatment—For Internal Ingestion. Contact
Poison Control Center or OLMC. ABCs. Place comatose
patient on L side. O2, IV, Give glucose if chemstrip shows
hypoglycemia. ECG. Consider naloxone for narcotic OD.
Caution—Inhalation poisoning is particularly dangerous
to rescuers. Extricate rapidly using properly trained
and equipped personnel. Do not contaminate your
ambulance.
Acids
•caustic
AKA—rust remover; metal polish
SE—pain, GI tract chemical burns, lip burns,
vomiting.
Rx—Give milk or water, milk of magnesia,
egg white, prevent aspiration. Transport patient
in sitting position, if possible.
Caution—Do not induce vomiting. Contact Poison Control
Center for more advice.
Acetaminophen •analgesic
AKA—Tylenol , APAP, many OTC cold remedies
®

SE—there may be no S/Sx, but acetaminophen is toxic to

the liver. N&V, anorexia, RUQ pain, pallor, diaphoresis.
Rx—ABCs, O2, IV, ECG, fluids for hypotension.
Activated charcoal 50–100 gm orally.
Acetylcysteine may be given in ED.
Caution—Contact Poison Control Center for advice.

Alkalis
•caustic
AKA—Drano ; drain & oven cleaners; bleach
®

SE—pain, GI tract chemical burns, lip burns,

vomiting.
Rx—Give milk or water, prevent aspiration.
Transport patient in sitting position, if possible
Caution—Do not induce vomiting. Call Poison Control Center.

Amphetamines/Stimulants •stimulant
AKA—methamphetamine, “speed,” “crank”
SE—anxiety, hHR, arrhythmias, diaphoresis,
Sz, N&V, H/A, CVA, HTN, hyperthermia,
dilated pupils, psychosis, suicidal.
Rx—ABCs, O2, ECG, IV fluids for hypotension.
Activated charcoal 50–100 gm orally. Maintain normal body
temp. Benzodiazepine as adjunct.
Caution—Protect yourself against the violent patient.

38
Poisons
 Poisons

39
Antidepressants (TCA) •mood elevator
AKA—Norpramin®, Sinequan®, amitriptyline
SE—hypotension, PVCs, cardiac arrhythmias, QRS complex
widening, seizures, coma, death.
Rx—ABCs, O2, IV, ECG, IV fluids, 1 mEq/kg NaHCO3 IV,
Intubate and ventilate.
Caution—Onset of coma and seizures can be sudden.
Do not give ipecac.
Aspirin •analgesic
AKA—Bayer®, ASA, salicylates
SE—GI bleeding, N&V, LUQ pain, pallor,
diaphoresis, shock, tinnitus, hRR.
Rx—ABCs, O2, IV, ECG, fluids for hypotension.
Activated charcoal 50–100 gm orally.
Caution—Contact Poison Control Center for advice.
Barbiturates/Sedatives •hypnotic
AKA—phenobarbital, “barbs,” “downers”
SE—weakness, drowsiness, respiratory
depression, apnea, coma, hypotension,
bradycardia, hypothermia, APE, death.
Rx—ABCs, O2, ventilate, IV fluids for
hypotension.
Caution—Protect the patient's airway.
Carbon Monoxide •odorless toxic gas
Causes—any source of incomplete combustion, such as
car exhaust, fire suppression, and stoves
SE—H/A, dizziness, DOE, fatigue, tachycardia, visual
disturbances, hallucinations, cherry red skin color,
i respirations, N&V, cyanosis, altered mental status, coma,
blindness, hearing loss, convulsions.
Rx—Remove patient from toxic environment, ABCs,
High Flow O2, transport. Hyperbaric treatment in severe
cases.
Caution—Protect yourself from exposure!
Cocaine •stimulant/anesthetic
AKA—“coke,” “snow,” “flake,” “crack”
“speedball” is cocaine + heroin.
SE—H/A, N&V, iRR, agitation,hHR,
arrhythmias, cx pain, vasoconstriction,
AMI, HTN, Sz, vertigo, euphoria, paranoia,
vomiting, hyperthermia, tremors, paralysis,
coma, dilated pupils, bradycardia, death. APE with IV use.
Rx—ABCs, O2, IV, ET intub­ation. Consider: benzodiazepine
for Sz, lidocaine for PVCs, calcium blocker or beta blocker
(labetalol) and nitrates for AMI. Control HTN. Monitor VS
and core temp: cool patient if hyperthermic. Minimize sensory
stimulation.
Caution—Protect yourself from the violent patient.
Ecstasy/MDMA (methylenedioxymethamphetamine)

•stimulant/hallucinogen
AKA—“XTC,” “X,” “love drug,” “MDMA,” “Empathy”
SE—euphoria, hallucinations, agitation, teeth grinding (use
of pacifiers), nausea, hyperthermia, sweating, HTN,
tachycardia, renal and heart failure, dilated pupils, seizures,
rhabdomyolysis, DIC, APE, CVA, coma, electrolyte imbalance.
Rx—ABCs, O2, vitals, ECG, IV, cool patient if hyperthermic,
intubate if unconscious; benzodiazepine for Sz.
Caution—Do not give beta blockers.
GHB (Gamma Hydroxy Buterate) •depressant
AKA—“G,” “easy lay,” “liquid X,” “Blue Nitro”
SE—euphoria, sedation, dizziness, myoclonic jerking,
N&V, H/A, coma, bradycardia, apnea.
Rx—ABCs, manage airway, ventilate.
Caution—A common “date rape” drug.

40
Poisons
 Poisons

41
Hallucinogens •alter perception

AKA—LSD, psilocybin mushrooms
SE—anxiety, hallucinations, panic, disorientation, N&V.
Rx—Calm and reassure the patient. Be supportive.
Caution—Watch for violent & unexpected behavior.

Hydrocarbons •fuel, oil

AKA—gasoline, oil, petroleum products
SE—breath odor, SOB, Sz, APE,
coma, bronchospasm.
Rx—ABCs, O2, gastric lavage.
Caution—Do not induce vomiting.
Ketamine •dissociative anesthetic
AKA—“Special K,” “Vitamin K,” “horse tranquilizer”
SE—nystagmus, hallucinations, sedation, babbling,
tachycardia, respiratory depression, N&V, ego-centrism,
paranoia, increased salivation, coma, Sz.
Rx— ABCs, protect airway, monitor VS.
Caution—hallucinations, confusion, hypotension, and
respiratory depression

Mushrooms (Amanita) •deadly mushroom

AKA—Death Angel
SE—N&V, Sz, death.
Rx—ABCs, O2, IV, benzodiazepine for seizures.
Caution—Protect the patient's airway.

Opiates •narcotic analgesic

AKA—Dilaudid®, heroin, morphine, codeine, fentanyl
SE—irespirations, apnea, iBP, coma, bradycardia, pinpoint
pupils, vomiting, diaphoresis.
Rx—ABCs, O2, ventilate, intubate, IV fluids for hypotension,
naloxone 2 mg IV, IM, SQ, ET, IL.
Caution—Consider other concurrent overdoses.
Organophosphates •insecticide
AKA—Malathion®, Diazinon®
SE—SLUDGE (Salivation, lacrimation,
urination, defecation, GI, Emesis), pinpoint
pupils, weakness. Bradycardia, sweating,
N&V, diarrhea, dyspnea.
Rx—Extricate patient, ABCs, O2, Atropine 1–2 mg IV every
5 minutes for bradycardia, hypotension.
Caution—Protect yourself first! Do not become contaminated.
PCP—Phencyclidine •tranquilizer
AKA—“Peace Pill,” “angel dust,” “horse
tranquilizer”
SE—nystagmus, disorientation, HTN,
hallucinations, catatonia, sedation, paralysis,
stupor, mania, tachycardia, dilated pupils,
status epilepticus.
Rx—ABCs, O2, vitals, IV, ECG.
Caution—Protect yourself against violent patient. Examine
patient for trauma which may have occurred due to anesthetic
effect of PCP.

Rohypnol (Flunitrazepam) •benzodiazepine

AKA—“roofies,” “Mexican Valium,” “Row-shay”
SE—anterograde amnesia, hypotension, sedation,
dizziness, confusion, coma.
Rx—ABCs, manage airway, ventilate, monitor vitals;
Flumazenil IV.
Caution—One of several “date rape” drugs.

42
Poisons
 Poisons

43
Tranquilizers (Major) •antipsychotic

AKA—Haldol®, Navane®, Thorazine®,

Compazine®
SE—EPS, dystonias, painful muscle spasms,
resp. depression, hypotension, torsades de
pointes.
Rx—50 –100 mg diphenhydramine for EPS. ABCs, O2, vitals,
ECG. Consider activated charcoal 50 –100 gm orally. IV fluids
for hypotension. Consider intubation for the unconscious
patient.
Caution—Protect the patient's airway.
Tranquilizers (Minor) •anxiolytic
AKA—Valium , Xanax , diazepam, midazolam
® ®

SE: sedation, weakness, dizziness, tachycardia,

hypotension, hypothermia, (6respirations with IV use).
Rx—ABCs, monitor vitals; Flumazenil IV.
Caution—Coma usually means some other substance or
cause is also involved. OD is almost always in combination
with other drugs. Protect the patient's airway.
 Trauma
Abbreviations Used in This Section
HX—History, Signs & Symptoms
Green text—Key Symptoms and Findings
—Prehospital Treatment
µ—Other Diagnoses to Consider
Italic—Intermediate procedures
Caution—Contraindications or Precautions

Amputation
HX—Time of amputation, MOI. Vitals, hemorrhage?
Control bleeding. Cover stump with sterile dressing,

saturate with sterile saline, cover with DSD, elevate.
Place severed part in plastic bag, keep severed part dry,
place bag in ice water. If partial amputation: cover with
sterile dressing, splint in anatomical position, saturate
with saline, cover with DSD. O2, large bore IV, titrate to
vitals; ECG.
Caution—Time is of the essence. Transport patient and
severed part to trauma center. Document PSM with times.
Activate Trauma Team if amputation above wrist or ankle.

44
Trauma
 Trauma

45
Burns (See Burn Chart, page 46)

HX—Airway burns? (soot in mouth, red mouth, singed

nasal hairs, cough, hoarseness, dyspnea)? Was patient in
enclosed space? How long? Did patient lose conscious­
ness? Was there an explosion? Toxic fumes? Hx cardiac or
lung disease? Estimate % of burns & depth. Other trauma?
Significant burns = blistered or charred areas, or burns
of the hands, feet, face, airway, genitalia.

Stop the burning—extinguish clothing if smouldering.

• Remove clothing if not adhered to skin; remove jewelry.
• Vitals, give high flow O2, assist ventilations if needed.

Superficial burns: If < 20%, apply wet dressings.

Moderate to severe burns: Cover with DSD &/or burn
sheet. Leave blisters intact. Start large bore IV, treat for
shock or % burn. Monitor ECG.
Chemical burns: Brush off any dry chemical then flush with
copious amounts of water or saline.
For lime: brush off excess, then flush
For phosphorus: use alcohol or copious amounts of water.
Electrical burns: Apply DSD to entry and exit wounds.
Start large bore IV, titrate for shock. Monitor ECG—treat
dysrhythmias per ACLS.
Caution—Consider child abuse in pediatric patients. Do
not apply ointments to burns. Avoid starting IV in burned area
if possible.

Remember: burned firefighters may be having an AMI.

Burn Chart
(count only partial or full thickness burns)

INFANT ADULT
>8 y.o. age

IV FLUID RESUSCITATION*
% Burn Area x Pt. Wt. in Kg = mL/hr. NS
4
Give this amount over the first 8 hrs.;
Give an equal amount over the next 16 hrs.
Example: 20% burned area, patient weighs 70 kg:
20 x 70 = 1400 = 350 mL/hr. for 8 hrs†. Then
4 4 give 175 mL/hr. over the next 16 hrs.
†
(calculated from time of injury)
*Patient in shock needs more aggressive IV fluid replacement
and should be treated according to your shock protocol.

Major burns should be treated in a burn center,

including: >25% body surface; hands, feet, face or
perineum; electrical burns; inhalation burns; other
injuries; or severe preexisting medical problems.

46
Trauma
 Trauma

47
Major Bones of the Skeleton
Fractures & Dislocations
HX—Mechanism of injury. Localized pain, point tenderness,
guarding, swelling, deformity, angulation, discoloration,
crepitus, limited range of motion? Lacerations, exposed
bone fragments? Distal pulses, sensation and capillary refill?
ABCs, control bleeding, immobilize spine as indicated

by pain or mechanism of injury. Check for additional
injuries. Treat those with higher priority immediately.
Consider large bore IV—treat shock as indicated. Apply
dressings to open wounds and splint fractures (obtain
PSM before and after splinting). Elevate simple extremity
fractures. Apply cold pack as needed. Monitor pulses,
sensation & movement while en route. Apply pulse
oximeter to affected extremity.
Caution—Activate trauma team for >2 proximal long bone
fractures. Extremity fractures are lower priority when treating
the multisystem trauma patient.

Trauma—General
HX—Mechanism of injury, location of trauma, penetrating vs.
blunt injury? Assess level of consciousness (Alert, Verbal,
Pain, Unconscious.) Airway obstruction? Pulses, BP,
capillary refill; severe bleeding? Disability/neuro assessment,
Glasgow coma score, expose and perform exam, check
pupils. Tracheal deviation? Sub-Q air? Jugular venous
distension? Assess chest: look for trauma, pneum­o, check
lung sounds, Evaluate abdomen, pelvis, extremities, back.
Abdominal guarding, distension, rigidity, hypotension, pallor,
bruising? Are there medical causes? (e.g. diabetes, CVA,
MI, etc.)
Assess scene safety. Protect C-Spine; give O2,
check respiratory rate, adequacy—ventilate if needed.

48
Trauma
 Trauma

49
Trauma—Abdominal
HX—Mechanism of injury, associated trauma, penetrating
vs. blunt injury? Suspect internal hemorrhage. Guarding,
distension, rigidity, hypotension, pallor, bruising?
RUQ: liver, gall bladder, duodenum, head of pancreas, R
kidney (posteriorly), ascending colon,transverse colon.
LUQ: stomach, tail of pancreas, liver, L kidney
(posteriorly), spleen, transverse colon, descending colon.
LLQ: small intestine, descending colon, L ovary, fallopian
tube.
RLQ: appendix, cecum, R ovary, fallopian tube, small
intestine.
Midline: great vessels (aorta, vena cava), bladder, uterus.
Back: kidneys, spleen on L side.
Vitals, O2 , IV, treat for shock, transport.

Traumatic Cardiac Arrest

Penetrating trauma? Transport rapidly to trauma center.

HX—Mechanism of injury, associated trauma, penetrating
vs. blunt injury? Any vital signs upon arrival? If blunt trauma
(MVA, crush injury) survival = <1%; consider pronouncing
patient dead in the field, especially if there are other patients
who need medical care (contact OLMC).
Rapid extrication and transport immediately.
Secure airway, do CPR (shock VF). O2, IVs, en route.
Splint fractures en route.
Trauma—Chest
Suspect cardiac, pulmonary, or great vessel trauma.
HX—MOI: estimate forces involved. Lung disease?
Respiratory distress? Pain? Use of accessory muscles?
Level of consciousness, color? GCS? Is patient anxious?
Tracheal shift? Symmetrical cx expansion? JVD? Lung
sounds? Hemoptysis? Sub-Q emphysema and/or crepitus?
Life threatening chest injuries:
• Flail segment
• Open chest wounds
• Tension pneumothorax

Secure airway, high flow O2, intubate if necessary

and assist ventilations.
Open chest wound: cover with occlusive dressing.
Look for exit wounds.
Tension pneumothorax: Evaluate and decompress.
Impaled objects: stabilize in place. Do not delay
transport if patient is unstable. Consider IV fluids for
shock (2 large bore IVs), monitor ECG, vitals. Full spinal
immobilization.
Caution—Consider other causes for respiratory distress.

50
Trauma
 Trauma

51
Trauma—Head
HX—MOI, estimate forces involved. Any changes in LOC?
Amnesia? Was seat belt, helmet worn? Respiratory rate,
pattern, quality; chest or trunk injuries? Vitals, pupils, Neuro
deficits? Posturing? Reflexes? Blood or CSF from ears,
nose? Scalp, skull depression, associated facial trauma?
Secure airway while providing C-spine immobilization.

Control bleeding with direct pressure. Do not stop bleeding
from nose, ears if CSF leak is suspected. Give O2, start
large bore IV (TKO unless patient is in shock). Monitor
vitals & neuro status. ECG, Pulse oximetry; Consider
intubation and ventilation if GCS <8.
Caution—Always suspect C-spine injury in the head
injury patient. Assess and document LOC changes. Be
alert for airway problems and seizures. Restlessness
and/or agitation can be due to hypoxia or hypoglycemia.
Check chemstrip.

hypothalamus

corpus
pituitary collosum
gland
ventricles
pons
thalamus

medulla mid brain

brain stem
Spinal Injury
HX—MOI, helmet worn? Suspect C-spine injury with
head or neck trauma, and with multi-system trauma, or
diving/drowning. Altered mental status? Is there paralysis,
weakness, numbness, tingling? Spinal pain with or without
movement; point tenderness, deformity, or guarding?
Keep airway open. Consider nasopharyngeal airway.
Splint neck with C-collar & immobilize the entire spine.
Move the patient as a unit and only as necessary.
Give O2, start large bore IV. Vitals. Place patient in
Trauma System.
Caution—Be prepared to suction and/or move the patient
as a unit while immobilized. Consider internal bleeding.

Spinal Innervation

Cervical 1–8


C-3, 4, 5: diaphragm
 C-6, 7, 8: fingers




Thoracic 1–12
T-4: nipple
T-10: umbilicus






Lumbar 1–5
L-1,2: hip
L-5: great toe
 

Sacral 1–5
S-1: knee flexion
S-2,3,4: anal sphincter


52
Trauma
 Trauma

53
Trauma Triage Criteria
(For Patient Entry into the Trauma System)
Physiological
• Systolic BP less than 90 mm/Hg
• Respiratory Distress—Rate <10 or >29
• Altered mental status, or Glasgow Coma Score ­<12
Anatomical
• Flail chest
• Two or more proximal long bone fractures (humerus, femur)
• Penetrating injury to the head, neck, torso, or groin that
is associated with significant energy transfer (bullet, knife,
impalement, etc.)
• Partial or full thickness burns to the face or airway
• Amputation proximal to the wrist or ankle
• Paralysis of any limb associated with trauma injury
Mechanism
• Extrication taking >20 minutes using heavy tools
• Death of any occupant in the patient's vehicle
• Ejection of patient from an enclosed vehicle
• Falls greater than 15 feet

Comorbid Factors
(Any combination of high-energy transfer in comorbid factor
should increase the index of suspicion for severe trauma injury)
• Age <12 or >60
• Pregnancy
• Significant pre-existing medical problems
• Extremes of environment: Hot or Cold
• Presence of intoxicants

INDEX OF SUSPICION—The reason for system entry must

be fully documented. You may enter any patient into the
Trauma System suspected of having experienced significant
trauma regardless of physical findings. Any combination
of co-morbid factors and high energy transfer is
dangerous.
Rapid Triage
PRIORITY COLOR CONDITION NOTES
1 Red Immediate Life threatening
2 Yellow Urgent Can delay up to 1 hr.
3 Green Delayed Up to 3 hrs
4 Black Deceased No care needed
Priority 1—Immediate Transport
Unconscious, disoriented, very confused, rapid respirations,
weak irregular pulse, severe uncontrolled bleeding, other
signs of shock (cold, clammy skin, low blood pressure, etc.)

Priority 2—Urgent, Can Delay Transport up to 1 Hour:

Conscious, oriented, with any significant fracture or other
significant injury, but without signs of shock.
Priority 3—Delayed Transport up to 3 Hours

Walking wounded, CAO x3, minor injuries.

Priority 4—Deceased, No Care Needed

No pulse, no respirations (open airway first), obvious mortal
wounds (e.g., decapitation).
NOTES: Assessment of patients should be <1 minute each.
(Have someone else control bleeding during your survey.)
• All unconscious patients are RED—Immediate.
• “Walking wounded” are usually GREEN—Priority 3.
• All pulseless patients are BLACK—Priority 4.
Mentation/LOC Assessmentnt
A—Alert: Able to answer questions
V—Verbal: Responds to verbal stimuli
P—Pain: Responds only to pain stimuli. Protect airway
U—Unconscious: Protect airway, consider intubation

54
Trauma
 Trauma

55
Multiple Patients

1. Strategically park vehicle and stay in one place.

2. Establish Command, and identify yourself as
Command to dispatch (use a calm, clear voice).
3. Size up the scene and advise dispatch of:
• Exact location and type of incident
• Any hazardous conditions
• The location of the command post
• The best routes of access to the scene
• Estimated number and severity of patients
4. Designate an EMT to perform rapid triage (see
Rapid Triage, Pg. 54), tag and number multiple
patients. (“Immediate,” “Urgent,” “Delayed”).
5. Order resources (Fire, Police, Ambulances, HazMat,
Extrication, Air Units, Tow vehicles, Buses, etc.).
6. Set up staging areas (clearly state the location of
staging/assembly areas, and think of access
and egress).
7. Coordinate access of incoming units to the scene.
8. Assign patients to incoming medical units.
9. Maintain communications with On Line Medical
Control (OLMC).
10. Keep patient log indicating patient number, severity,
treating and transporting units, medical interventions,
and destination hospitals.
 EMERGENCY MEDICATIONS
Please note: this section lists only some of the:
• Drug Type for these medications.
• Rx—Primary Indications Dosages
• Contra—Primary Contraindications
• SE—Common Toxic Side Effects
Pediatric doses (Peds) are in italics
NOTE: For complete information, please consult the drug
product insert, or an appropriate medical resource.

Activated Charcoal •adsorbent

Rx—Poisoning/overdose: 1 gm/kg PO or by NG tube.
(Mix with water to make a slurry).
Contra—do not give before or together with ipecac. Contact
Poison Control Center for more advice.
SE—constipation.
Albuterol 0.5% (Ventolin®) •bronchodilator
Rx—Bronchospasm 2° COPD, Asthma: 1.25-2.5 mg
(0.25 –0.5 mL); mixed in 3 mL saline in nebulizer.
Contra—tachydysrhythmias.
SE—tachydysrhythmias, anxiety, nausea & vomiting.
Peds: 0.03 mL/kg nebulized; max: 1 mL.

Aspirin (ASA) •antiplatelet

Rx—Acute Myocardial Infarction: 160–325 mg PO
(2–4 chewable children’s aspirin).
Contra—allergy. Use caution with: asthma, ulcers, GI
bleeding, other bleeding disorders.
SE—GI bleeding, may exacerbate bleeding disorders. Use
caution in renal failure, Vitamin K deficiency.

56
Medications
 Medications

57
Atropine Sulfate •vagolytic

Rx—Asystole, PEA: 1 mg IVP, (2–3 mg ET); every 3–5
minutes; up to 0.04 mg/kg total dose.
Rx—Symptomatic Bradycardia: 0.5–1 mg IVP every 3–5
minutes; up to 0.04 mg/kg total dose.
SE—dilated pupils, hHR, VT, VF, H/A, dry mouth.
Contra—tachycardia, glaucoma.
Dextrose 50% •nutrient
Rx—Coma, Hypoglycemia: 25 gm (50 mL) IV.
SE—tissue necrosis if extravasation occurs.
Contra—intracerebral bleeding, hemorrhagic CVA.
Peds: 2 mL/kg of 25%W.

Epinephrine •sympathomimetic
Rx—Allergic Reaction: 0.3–0.5 mg (0.3–0.5 mL 1:1000) SQ.
Rx—Cardiac Arrest: 1 mg IV every 3–5 minutes.
Endotracheal: 2–2.5 mg every 3–5 minutes.
SE—tachydysrhythmias, VT, VF, angina, HTN.
Peds: 0.01 mg/kg—Max. single dose 0.5 mg.

Glucagon • hblood glucose

Rx—Hypoglycemia: 0.5–1 mg (or Unit) IM, SQ, IV.
Give carbohydrate (prompt meal, orange juice, D50%, etc.)
as soon as the patient is alert and can eat.
Peds: 0.1 mg/kg IV, IO, IM, SQ up to 1 mg.

Oral Glucose (Glutose®) •nutrient

Rx—Hypoglycemia: 15–25 gm (one tube) PO.
SE—Patient may aspirate if no gag reflex present.
Contra—Patient must be awake enough to swallow. Protect
patient's airway.

Ipratropium 0.02% (Atrovent®) •bronchodilator
Rx—Bronchospasm, COPD, Asthma: 0.5 mg (2.5 mL)
nebulized (with albuterol).
Contra—glaucoma, allergy to soy products or peanuts.
SE—dry mouth, H/A, cough.
Peds: 25 mcg/kg.

Lidocaine 2% (Xylocaine®) •antiarrhythmic

Rx—Cardiac Arrest VT/VF: 1–1.5 mg/kg IVP; May repeat
with 0.5–0.75 mg/kg IVP every 5 –10 mins. Max: 3 mg/kg.
Start drip ASAP. ET dose: 2–4 mg/kg.
Rx—VT with Pulse: 1–1.5 mg/kg IVP; then 0.5–0.75 mg/kg
every 5–10 min. up to 3 mg/kg. Start drip ASAP.
Rx—PVCs: 0.5–1.5 mg/kg IV then 0.5–1.5 mg/kg every
5–10 minutes up to 3 mg/kg. Start drip ASAP.
Drip: 1–4 mg/min. Mix 1 gm in 250 mL D5W & run at:

Lidocaine Drip (4 mg/mL) g 1 mg 2 mg 3 mg 3 mg

microdrops/minute (mL/hr) g 15 gtt 30 gtt 45 gtt 60 gtt

IM dose: 300 mg IM (4 mg/kg) of 10% solution.

Contra—2°, 3° block, hypotension, Stokes-Adams Synd.

Reduce maintenance infusion by 50% if patient is >70 y.o.,
has liver disease, or is in CHF or shock.
SE—Sz, slurred speech, altered mental status.

Naloxone (Narcan®) •narcotic antagonist

Rx—Opiate Overdose; Coma: 2 mg IV, IM, SQ, ET.
Repeat if needed up to 10 mg total dose.
Contra—do not use on a newborn if the mother is addicted
to narcotics; may cause withdrawal.
SE—withdrawal symptoms in the addicted patient.
Peds: 0.1 mg/kg IV, IM, IO, ET

58
Medications
 Medications

59
Nitroglycerine •vasodilator
Rx—Acute angina, Hypertension, CHF with APE.
Contra—Hypotension, hypovolemia, intracranial bleeding,
recent use of Viagra®, Cialis® or Levitra®.
SE—H/A, hypotension, syncope, tachycardia,
flushing.
Nitro tablets (NITROSTAT®): 0.3–0.4 mg SL, may
repeat in 3–5 minutes, (max: 3 doses).
Nitroglycerin spray (NITROLINGUAL®): 1–2 sprays
(0.4–0.8 mg) under the tongue.
Nitroglycerin paste (NITRO-BID®): 1–2 cm of paste
(6–12 mg) topically.
 Oxygen
LITERS/MIN. O2 Delivered

Nasal Cannula 1 24%

2 28%
4 36%
6 44%
NRB Mask 10 80%
15 90%
Pocket Mask Mouth-to-Mask 17%
10 50%
15 80%
30 100%
Bag-Valve-Mask Room air 21%
(with reservoir) 10 90%
15 95%
Positive Pressure 100 100%
Contra—COPD patients may become apneic with high flow O2.

60
Medications
 Medications

61
Pulse Oximetry

RANGES PREHOSPITAL TREATMENT

Normal: 95%–99%

Mild hypoxia: 91%–94% Give oxygen

Moderate hypoxia: Give 100% oxygen

86%–90%

Severe hypoxia: < 85% 100% oxygen, ventilate

Falsely low SpO2 readings may be caused by:

• Cold extremities
• Hypothermia
• Hypovolemia
Falsely high SpO2 readings may be caused by:
• Anemia
• Carbon monoxide poisoning
If in doubt, give oxygen in spite of a normal SpO2

O2 Tank capacities
Tank Capacity @15 Lpm 10 Lpm 6 Lpm 2 Lpm

C 240 L 16 min. 24 min. 40 min. 2 hr.

D 360 L 24 min. 36 min. 1 hr. 3 hr.

E 625 L 41 min. 1:02 hr. 1:44 hr. 5:12 hr.

M 3,000 L 3:20 hr. 5:00 hr. 8:20 hr. 25 hr.

G 5,300 L 5:53 hr. 8:50 hr. 14:43 hr. 44:10 hr.

H 6,900 L 7:40 hr. 11:30 hr. 19:10 hr. 57:30 hr.

 IV Fluid Rates in Drops/Minute
Drip Set 10 12 15 20 60*
30 mL/hr. 5 6 8 10 30
60 mL/hr. 10 12 15 20 60
100 mL/hr. 17 20 25 33 100
200 mL/hr. 33 40 50 67 200
300 mL/hr. 50 60 75 100 300
400 mL/hr. 67 80 100 133 400
500 mL/hr. 83 100 125 167 500
1000 mL/hr. 167 200 250 333 1000

*Standard “microdrip” IV tubing has 60 gtt/mL. (Note that with

a microdrip IV set, mL/hr.=drops/min.). A normal “TKO” or
“KVO” rate is 30–60 mL/hr.

62
Medications

63
Prescription Drugs
A
ABILIFY: schizophrenia
Acarbose: diabetes
ACCOLATE: asthma
ACCUNEB: asthma, COPD
ACCUPRIL: HTN, CHF
ACCURETIC: HTN
ACCUTANE: acne
Acebutolol: HTN, angina, ALEVE: analgesic
arrhythmias
ACEON: HTN, CAD
Acetaminophen: analgesic
Acetazolamide: diuretic/
anticonvulsant
Acetylcysteine: mucolytic
ACIPHEX: ulcers, GERD
ACLOVATE: topical steroid
ACTICIN CRÈAM: scabies
ACTIFED: allergies, cold
ACTIGALL: gallstones
ACTIQ: cancer pain
ACTIVELLA: menopause
ACTONEL: osteoporosis
ACTOS: diabetes
ACULAR OPTH: analgesic
Acyclovir: herpes, shingles
ADALAT: angina, HTN
ADDERALL: ADHD, narcolepsy
ADIPEX-P: obesity
ADVAIR DISKUS: asthma, COPD
ADVICOR: lowers cholesterol
ADVIL: analgesic
AEROBID, AEROBID M:
asthma, bronchitis
AEROLATE, AEROLATE III,
AEROLATE Jr.: asthma
AGGRENOX: antiplatelet
AGRYLIN: thrombocythemia
ALAMAST OPTH: anti-
inflammatory
Albendazole: tapeworm
Drugs
ALBENZA: tapeworm
Albuterol: asthma, COPD
ALDACTAZIDE: diuretics
ALDACTONE: diuretic
ALDOMET: HTN
Alendronate: osteoporosis
ALESSE: oral contraceptive
ALLEGRA, ALLEGRA D:
allergies
Allopurinol: gout
ALORA: menopause
Alosetron: irritable bowel
ALPHAGAN P OPTH:
glaucoma
Alprazolam: hypnotic
ALTACE: HTN
ALUPENT: COPD, asthma
Amantadine: Parkinson’s
disease, antiviral
AMARYL: diabetes
AMBIEN: insomnia
AMBISOME: antifungal
AMERGE: migraine HA
AMEVIVE: psoriasis
Amikacin: antibiotic
AMIKIN: antibiotic
Amiloride: diuretic
Aminophylline: COPD,
asthma
Aminosalicylic Acid: TB
Amiodarone: antiarrhythmic
AMITIZA (lubiprostone):
chronic constipation
Amitriptyline: antidepressant
Amlodipine: HTN, angina
Amoxapine: antidepressant
Amoxicillin: antibiotic
AMOXIL: antibiotic
Amoxicillin/claculanate:
antibiotic
Amphetamine: ADHD
Amphotericin B: antifungal
Ampicillin: antibiotic
ANAFRANIL: antidepressant
Anagrelide: thrombocythemia
ANALPRAM HC: topical
anesthetic/steroid
ANAPLEX DM, HD: antitussive/
antihistamine/decongestant,
ANAPROX, ANAPROX DS:
analgesic
Anastrozole: breast CA
ANCOBON: antifungal
ANDRODERM: hypogonadism
ANEXSIA: narcotic analgesic
ANTABUSE: alcohol addiction
ANTIVERT: vertigo
ANUSOL HC: rectal steroid
anti-inflammatory
ANZEMET: antiemetic
APAP: analgesic
APRI: contraceptive
AQUAMEPHYTON: bleeding
disorders
APTIVUS: HIV
ARALEN: malaria
ARANESP: increases RBCs
ARAVA: rheumatoid arthritis
ARICEPT: Alzheimer’s
ARIMIDEX: breast CA
ARISTOCORT: topical steroid
ARIXTRA: anticoagulant
ARMOUR THYROID:
hypothyroidism
AROMASIN: breast CA
ARTHROTEC: arthritis
ASA: aspirin, analgesic
ASACOL: colitis
Ascorbic Acid: vitamin C
ASTELIN: allergic rhinitis
ASTRAMORPH PF: narcotic
analgesic
ATACAND: HTN, CHF
ATARAX: sedative/tranquilizer/
antihistamine
64
Atenolol & Chlorthalidone:
HTN
Atenolol: HTN, acute MI, angina
ATIVAN: hypnotic, seizures
Atovaquone: P. carinii
pneumonia
ATRIPLA: HIV/AIDS
ATROVENT: COPD
AUGMENTIN: antibiotic
AURALGAN: otic analgesic
AVALIDE: HTN
AVANDAMET: diabetes
AVANDIA: diabetes
AVAPRO: HTN, diabetic
nephropathy
AVELOX: antibiotic
AVIANE: contraceptive
AVINZA: narcotic analgesic
AVODART: benign prostatic
hypertrophy
AVONEX: multiple sclerosis
AXERT: migraine headaches
AXID: ulcers
AYGESTIN: endometriosis
AZACTAM: antibiotic
Azathioprine: immuno-
supressant
Azelastine OPTH: allergies
AZILECT: Parkinson’s disease
Azithromycin: antibiotic
AZMACORT: asthma, COPD
AZOPT OPTH: glaucoma
AZT: HIV
Aztreonam: antibiotic
AZULFIDINE-EN: colitis,
arthritis
B
B&O SUPPRETTES: ureteral
spasm/pain
Bacitracin: topical antibiotic
Bacitracin/Polymyxin: topical
antibiotics
Baclofen: muscle relaxant
Drugs

65
BACTROBAN: topical antibiotic
Balsalazide: ulcerative colitis
BARACLUDE: hepatitis B
Beclomethasone: steroid anti-
inflammatory
BECONASE AQ: nasal steroid/
allergies
Belladonna: irritable bowel
Benadryl: antihistamine
Benazepril: HTN
BENICAR: HTN
BENTYL: irritable bowel
BENZAMYCIN: acne
Benzonatate: antitussive
Benzoyl Peroxide: acne
Benztropine: Parkinson’s
disease
BETAGAN OPTH: glaucoma
Betamethasone: steroid anti-
inflammatory
BETAPACE: arrhythmias
BETASERON: multiple sclerosis
Betaxolol: HTN
Bethanechol: urinary retention
BETOPTIC: glaucoma
BIAXIN: antibiotic
BICILLIN: antibiotic
BIDIL: heart failure
Bisacodyl: laxative
Bisoprolol: HTN
Bisoprolol/HCTZ: HTN
BLEPHAMIDE OPTH: antibiotic
BONIVA: osteoporosis
BONTRIL PDM, BONTRIL
Slow Release: appetite
suppressant
BRETHINE: COPD, asthma
BREVICON: contraceptive
Brimonidine OPHT: glaucoma
Brinzolamide OPHT: glaucoma
Bromocriptine: Parkinson’s
disease, hyperprolactinemia
Brompheniramine: allergies
BROVANA: COPD
Budesonide: allergic rhinitis
Bumetanide: edema, CHF
Drugs
Buprenorphine: narcotic
analgesic
Bupropion: depression,
smoking cessation
BuSpar: anxiety disorders
Buspirone: anxiety disorders
Butalbital/Acetaminophen/
Caffeine: tension HA
Butalbital/Aspirin/Caffeine:
tension HA
Butenafine: topical antifungal
Butoconazole: vaginal
candidiasis
Butorphanol: narcotic
analgesic
BYETTA: diabetes
BYSTOLIC: HTN
C
CADUET: HTN/cholesterol
reducer
CAFERGOT: migraine HA
CALAN, CALAN SR: angina,
HTN, PSVT, H/A
CALCIFEROL: Vitamin D
CALCIJEX: Vitamin D
Calcipotriene: topical
Vitamin D
Calcitonin-Salmon:
osteoporosis
Calcitriol: Vitamin D
CAMILA: contraceptive
CAMPRAL: alcohol
dependence
CANASA: ulcerative proctitis
CANDESARTAN: HTN
CAPITAL w/CODEINE:
narcotic
analgesic
Capsaicin: topical analgesic
Captopril: HTN, CHF
CARAFATE: ulcers
Carbamazepine: epilepsy,
bipolar, trigeminal neuralgia
CARBATROL: epilepsy, bipolar,
trigeminal neuralgia
Carbidopa & Levodopa:
Parkinson’s disease
CARDIZEM, CARDIZEM CD:
angina, HTN, PSVT
CARDURA: HTN, prostatic
hypertrophy
Carisoprodol: muscle relaxant
CARTIA XT: angina, HTN
Carvedilol: angina, HTN, heart
failure
CASODEX: prostate CA
Caspofungin: antifungal
CATAPRES, CATAPRES TTS:
HTN
CECLOR: antibiotic
CEDAX: antibiotic
Cefaclor: antibiotic
Cefadroxil: antibiotic
Cefazolin: antibiotic
Cefdinir: antibiotic
Cefixime: antibiotic
CEFIZOX: antibiotic
Cefotaxime: antibiotic
Cefotetan: antibiotic
Cefoxitin: antibiotic
Cefpodoxime: antibiotic
Cefprozil: antibiotic
Ceftazidime: antibiotic
Ceftibuten: antibiotic
CEFTIN: antibiotic
Ceftizoxime: antibiotic
Ceftriaxone: antibiotic
Cefuroxime: antibiotic
CEFZIL: antibiotic
CELEBREX: analgesic
CELEXA: antidepressant
CellCept: organ transplants
CELONTIN: absence
seizures
CENESTIN: menopause
Cephalexin: antibiotic
CEREBYX: seizures
Cetirizine: rhinitis, urticaria
CHANTIX: smoking cessation
66
Chloral Hydrate: sedative/
hypnotic
Chlordiazepoxide: hypnotic
Chlorhexidine: gingivitis
Chloroquine: malaria
Chlorothiazide: diuretic
Chlorpheniramine:
antihistamine
Chlorpromazine:
schizophrenia
Chlorthalidone: diuretic
Chlorzoxazone: skeletal
muscle
relaxant
Cholestyramine: lowers
cholesterol
CIALIS: male erectile
dysfunction
Ciclopirox: antifungal
Cidofovir: cytomegalovirus in
AIDS
Cilostazol: intermittent
claudication
Cimetidine: ulcers
CIPRO: antibiotic
Ciprofloxacin: antibiotic
Citalopram: antidepressant
CLAFORAN: antibiotic
CLARINEX: allergies
Clarithromycin: antibiotic
CLEOCIN: antibiotic
CLIMARA patch: menopause
Clindamycin: antibiotic
CLINORIL: arthritis
Clobetasol: topical steroid
Clomipramine: obsessive
compulsive disorder
Clonazepam: anticonvulsant,
panic disorders
Clonidine: HTN
Clopidogrel: antiplatelet
Clorazepate: antianxiety/
anticonvulsant
Clotrimazole: antifungal
Clozapine: schizophrenia
CLOZARIL: schizophrenia
Drugs

67
Codeine: narcotic analgesic
COGENTIN: Parkinson’s
disease, extrapyramidal
disorders
COGNEX: Alzheimer’s disease
COLACE: stool softener
COLAZAL: ulcerative colitis
Colchicine: gout
Colesevelam: lowers cholesterol
COLESTID: lowers cholesterol
Colestipol: lowers cholesterol
COMBIPATCH: menopause
COMBIVENT: asthma, COPD
COMBIVIR: HIV
COMPAZINE: antiemetic
COMTAN: Parkinson’s disease
CONCERTA: ADHD, narcolepsy
COPAXONE: MS
COPEGUS: Hepatitis C
CORDARONE: antiarrhythmic
CORDRAN: topical steroid anti-
inflammatory
COREG: HTN, CHF, angina
CORGARD: HTN, angina
CORTEF: steroid anti-
inflammatory
CORTIC Ear Drops: antifungal/
anti-inflammatory
CORTIFOAM: proctititis
CORTISOL: steroid anti-
inflammatory
CORTISPORIN: antibiotic/
steroid anti-inflammatory
CORVERT: antiarrhythmic
COSOPT OPTH: glaucoma
COUMADIN: anticoagulant
COVERA HS: HTN, angina
COZAAR: HTN, diabetic
nephropathy
CREON: pancreatic enzymes
CRESTOR: lowers cholesterol
CRIXIVAN: HIV
Cromolyn: asthma, allergies
CRYSELLE: contraceptive
CUTIVATE: dermatoses
Cyanocobalamin: anemia
Drugs
CYCLESSA: contraceptive
Cyclobenzaprine: muscle
relaxant
CYCLOCORT: topical steroid
anti-inflammatory
Cyclosporine: organ
transplants
CYMBALTA: depression,
diabetic neuropathy
Cyproheptadine:
antihistamine
CYTOMEL: hypothyroidism
CYTOTEC: gastric ulcers
CYTOVENE: cytomegalovirus
D
d4T stavudine: HIV
DALMANE: insomnia
DANTRIUM: skeletal muscle
relaxant
Dantrolene: skeletal muscle
relaxant
Dapsone: leprosy, PCP
prophylaxis
DARAPRIM: malaria,
toxoplasmosis
DARVOCET-N: narcotic
analgesic
DARVON: narcotic analgesic
DAYPRO: arthritis
DDAVP: nocturia, diabetes
insipidus
DECADRON: steroid anti-
inflammatory
DECLOMYCIN: antibiotic
Deferoxamine: iron toxicity
Delavirdine: HIV
Deltasone: steroid anti-
inflammatory
DEMADEX: diuretic
Demeclocycline: antibiotic
DEMEROL: narcotic analgesic
DEMULEN: contraceptive
DENAVIR: herpes
DEPACON: seizures, bipolar,
migraine
DEPAKENE: seizures
DEPAKOTE: seizures
DEPO-MEDROL: steroid anti-
inflammatory
DEPO-PROVERA: contraceptive/
anticancer
Desipramine: antidepressant
Desmopressin: nocturia,
diabetes insipidus
DESOGEN: contraceptive
Desonide: topical steroid anti-
inflammatory
Desoximetasone: dermatoses
DESOXYN: ADHD, obesity
DETROL: overactive bladder
Dexamethasone: steroid anti-
inflammatory
DEXEDRINE: ADHD, narcolepsy
Dextroamphetamine: ADHD,
narcolepsy
Dextroamphetamine &
Amphetamine: ADHD,
narcolepsy
Dextromethorphan: non-
narcotic cough suppressant
DEXTROSTAT: ADHD, narcolepsy
DIABETA: diabetes
DIAMOX: glaucoma, CHF, Sz
Diazepam: anxiety, Sz
Diclofenac: arthritis
Dicyclomine: irritable bowel
Didanosine: HIV
DIDREX: obesity
DIDRONEL: Paget’s dis., total
hip replacement
DIFFERIN: acne
Diflorasone: topical steroid
anti-inflammatory
DIFLUCAN: antifungal
Diflunisal: arthritis
DIGITEK: CHF, arrhythmias
Digoxin: CHF, arrhythmias
Dihydroergotamine: migraine
HA
DILANTIN: anticonvulsant
68
DILATRATE SR: angina
DILAUDID: narcotic analgesic
Diltiazem, Diltiazem CD:
angina, HTN, PSVT
Dimenhydrinate: allergies
DIOVAN: HTN, CHF, post MI
DIOVAN HCT: HTN
DIPENTUM: ulcerative colitis
Diphenhydramine:
antihistamine
Diphenoxylate & Atropine:
diarrhea
DIPROLENE, DIPROLENE
AF: dermatoses
Dipyridamole: antiplatelet
Disopyramide: antiarrhythmic
Disulfiram: alcoholism
DITROPAN, DITROPAN XL:
incontinence, dysuria
DIURIL: diuretic
Divalproex: seizures, bipolar,
migraines
Docusate: stool softener
Dolasetron: antiemetic
DOLOBID: arthritis
DOLOPHINE: narcotic
analgesic
Donepezil: Alzheimer’s dis.
DONNATAL: irritable bowel
syndrome
Dornase Alfa: cystic fibrosis
Dorzolamide OPTH: glaucoma
Dorzolamide & Timolol
OPTH:
glaucoma
DOVONEX: psoriasis
Doxazosin: HTN, prostatic
hypertrophy
Doxepin: antidepressant
DOXIL: AIDS-related tumors
Doxorubicin: AIDS-related
tumors
Doxycycline: antibiotic
Doxylamine: sedative
DRAMAMINE: antinauseant
Dronabinol: appetite stimulant
Drugs
 Drugs

69
DUONEB: asthma, COPD Ergocalciferol: Vitamin D
DURAGESIC: narcotic analgesic ERRIN: contraceptive
DURAMORPH: narcotic ERYC: antibiotic
analgesic ERYGEL: antibiotic
DYAZIDE: HTN ERYPED: antibiotic
DYNACIRC CR: HTN ERY-TAB: an antibiotic
DYRENIUM: diuretic Erythromycin: antibiotic
ESGIC, ESGIC-PLUS:
E headache
ESKALITH: bipolar disorder
Estazolam: insomnia
Econazole: topical antifungal ESTRACE: menopause
EDECRIN: diuretic ESTRADERM: menopause
EES: antibiotic Estradiol: menopause
Efavirenz: HIV ESTRATEST: menopause
EFFEXOR, EFFEXOR XR: ESTRING: menopause
antidepressant Estropipate: menopause
ELDEPRYL: Parkinson’s disease ESTROSTEP: contraceptive
ELIDEL: atopic dermatitis Ethacrynate: diuretic
ELIMITE: scabies, lice Ethambutol: tuberculosis
ELOCON: dermatoses Ethosuximide: absence
EMGEL: acne seizures
EMSAM patch: depression Etidronate: Paget’s disease
EMTRIVA: HIV Etodolac: arhtritis
ENABLEX: overactive bladder EULEXIN: prostate cancer
Enalapril: HTN, CHF EVISTA: osteoporosis
Enalapril & HCTZ: HTN EXELON: Alzheimer’s &
Enalaprilat: HTN Parkinson’s dementia
ENBREL: arthritis, psoriasis EXTENDRYL: allergies
ENDOCET: narcotic analgesic
ENJUVIA: menopause F
symptoms
ENPRESSE: contraceptive
Entacapone: Parkinson’s dis. FACTIVE: antibiotic
ENTEREG: postoperative Famciclovir: herpes
ileus Famotidine: ulcers
ENTOCORT EC: Crohn’s FAMVIR: herpes
disease FARESTON: breast CA
EPIFOAM: dermatoses FAZACLO: schizophrenia
EPI-PEN: allergic reaction FELBATOL: seizures
EPIVIR: HIV FELDENE: arthritis
EPIVIR HBV: hepatitis B Felodipine: HTN
Epoetin Alfa: anemia FEMARA: breast cancer
EPOGEN: anemia FEMHRT: menopause
EPZICOM: HIV/AIDS Fenofibrate: reduces
EQUETRO: bipolar disorder cholesterol
Fenoprofen: arthritis
Fentanyl: narcotic analgesic
FERRLECIT: anemia
Fexofenadine: allergies
FIBERCON: constipation
Finasteride: baldness, BPH
FLAGYL: antibiotic
Flecainide: antiarrhythmic
FLEXERIL: muscle relaxant
FLOLAN: pulmonary HTN
FLOMAX: enlarged prostate
FLONASE: allergic rhinitis
FLORINEF: adrenal
suppression
FLOVENT: asthma
FLOXIN: antibiotic
Fluconazole: antifungal
Flucytosine: antifungal
FLUDARA: leukemia
Fludarabine: leukemia
FLUMADINE: influenza A
Flunisolide: asthma
Fluocinolone: dermatoses
Fluocinonide: dermatoses
Fluoxetine: antidepressant,
bulemia
Fluphenazine: schizophrenia
Flurazepam: insomnia
Flurbiprofen: arthritis
Flutamide: prostate CA
Fluvastatin: cholesterol
reducer
Fluvoxamine: antidepressant
FOCALIN: ADHD
Folic Acid: anemia
FORADIL: asthma, COPD
FORTAMET: diabetes
FORTAZ: antibiotic
FOSAMAX: osteoporosis,
Paget’s disease
Foscarnet: cytomeglovirus
FOSCAVIR: cytomeglovirus
Fosinopril: HTN, CHF
Fosphentoin: anticonvulsant
FOSRENOL: phosphate binder
FRAGMIN: anticoagulant
FROVA: migraine headaches
70
Furosemide: CHF, HTN
FUZEON: HIV
G
Gabapentin: seizures,
neuropathic pain
GABITRIL: partial seizures
Galantamine: Alzheimer’s
disease
Ganciclovir: cytomegalovirus
Gemfibrozil: lowers
triglycerides
GENGRAF: organ transplants
Gentamicin: antibiotic
GEODON: schizophrenia
Glatiramir: MS
GLEEVEC: leukemia
Glimepiride: diabetes
Glipizide: diabetes
Glucagon: hypoglycemia
GLUCOPHAGE: diabetes
GLUCOTROL: diabetes
GLUCOVANCE: diabetes
Glyburide: diabetes
Glycopyrrolate: peptic ulcers
GLYNASE: diabetes
GLYSET: diabetes
GOLYTELY: bowel evacuant
Granisetron: antiemetic
GRIFULVIN V: antifungal
Griseofulvin: antifungal
Guaifenesin: expectorant
Guanfacine: HTN
GYNAZOLE-I: antifungal
GYNODIOL: menopause,
breast CA
H
HALCION: insomnia
HALDOL: psychosis
Halobetasol: steroid anti-
inflammatory
Drugs

71
Haloperidol: psychosis
HCT, HCTZ: diuretic
HECTOROL: vitamin D
HEXALEN: ovarian cancer
HUMALOG: diabetes
HUMIBID: expectorant
HUMIRA: arthritis, Crohn’s
HUMULIN N, HUMULIN R:
diabetes
HYCODAN: narcotic antitussive
HYCOMINE COMPOUND:
colds, URI
HYCOTUSS: narcotic
antitussive/expectorant
Hydralazine: HTN, CHF
Hydrochlorothiazide: diuretic
Hydrocodone with APAP:
narcotic analgesic
Hydrocortisone: steroid anti-
inflammatory
HYDROCORTONE: steroid anti-
inflammatory
HYDRODIURIL: diuretic
Hydromorphone: narcotic
analgesic
Hydroxychloroquine: malaria,
lupus
Hydroxyurea: anticancer
agent
Hydroxyzine: sedative/
antihistamine
Hyoscyamine: antispasmodic
HYTRIN: HTN, BPH
HYZAAR: HTN
I JANUMET: diabetes
Ibuprofen: analgesic
Ibutilide: antiarrhythmic
IMDUR: angina
Imipenem/Cilastatin:
antibiotic
Imipramine: antidepressant
IMITREX: migraine H/A
IMODIUM, IMODIUM A-D:
diarrhea
Drugs
IMURAN: immunosuppressant
Indapamide: diuretic
INDERAL, INDERAL LA: HTN,
angina, arrhythmias, H/A
INDOCIN, INDOCIN SR:
arthritis
Indomethacin: arthritis
INFERGEN: hepatitis C
Infliximab: Crohn’s disease
INH: tuberculosis
INSPRA: HTN, CHF
INTAL: asthma
INTELENCE: HIV
INTRON A: Kaposi sarcoma,
Hepatitis B/C, leukemia
INVEGA: schizophrenia
INVIRASE: HIV
IONAMIN: obesity
Ipecac: overdose/poisoning
Ipratropium: bronchodilator
ISENTRESS: HIV
ISMO: angina
Isoniazid: tuberculosis
Isoproterenol: asthma, COPD
ISOPTIN SR: angina, HTN,
PSVT, H/A
ISOPTO CARPINE OPTH:
glaucoma
Isosorbide: angina
Isradipine: HTN
Itraconazole: antifungal
J
JANUVIA: diabetes
JOLIVETTE: contraceptive
JUNEL: contraceptive
K
KADIAN: narcotic analgesic
KALETRA: HIV
KAOPECTATE: diarrhea
Kanamycin: antibiotic
KAPIDEX: GERD
KAYEXALATE: hyperkalemia
K-DUR: potassium
KEFLEX: antibiotic
KEPPRA: anticonvulsant
KERLONE: HTN
KETEK: antibiotic
Ketoconazole: antifungal
Ketoprofen: arthritis
Ketorolac: analgesic
Ketotifen OPTH: allergy
KINERET: arthritis
KLONOPIN: seizures, anxiety
KLOR-CON: potassium
KONSYL: laxative
KRISTALOSE: laxative
KUTRASE: pancreatic enzymes
KWELL: lice, scabies
KYTRIL: antiemetic
L LEXAPRO: antidepressant
Labetalol: HTN
LAC-HYDRIN: emollient
LACRI-LUBE OPTH: lubricant
Lactulose: laxative
LAMICTAL: seizures, bipolar
disorder
LAMISIL: antifungal
Lamivudine: HIV
Lamotrigine: seizures, bipolar
disorder
LANOXIN: CHF, arrhythmias
Lansoprazole: ulcers, GERD
LANTUS: diabetes
LARIAM: malaria
LASIX: diuretic
Leflunomide: arthritis
LESCOL: cholesterol reducer
LESSINA: contraceptive
LEUKERAN: anticancer
Leuprolide: endometriosis,
prostate CA
Levalbuterol: COPD, asthma
72
Levamisole: colon CA
LEVAQUIN: antibiotic
Levatiracetam: seizures
LEVATOL: HTN
LEVBID: antispasmodic
LEVEMIR: diabetes
LEVITRA: erectile dysfunction
LEVLEN 21, 28: contraceptive
Levobunolol OPTH:
glaucoma
Levodopa/Carbidopa:
Parkinson’s disease
Levofloxacin: antibiotic
LEVORA: contraceptive
LEVOTHROID:
hypothyroidism
Levothyroxine:
hypothyroidism
LEVOXYL: hypothyroidism
LEVSIN, LEVSINEX:
antispasmodic
LEXIVA: HIV
LEXXEL: HTN
LIBRIUM: anxiolytic/sedative
LIDEX: anti-inflammatory
LIDODERM: topical anesthetic
Lindane: scabies, lice
Liothyronine: hypothyroidism
Liotrix: hypothyroidism
LIPITOR: reduces cholesterol
LIPRAM UL: pancreatic
enzymes
Lisinopril: HTN, CHF, AMI
Lisinopril/HCTZ: HTN, CHF
Lithium: bipolar disorder
LITHOBID: bipolar disorder
LOCOID: topical steroid
LODRANE 12D Capsules:
allergies, cold
LOESTRIN: contraceptive
LOMOTIL: diarrhea
LONOX: diarrhea
LO/OVRAL: contraceptive
Loperamide: diarrhea
LOPID: lowers serum lipids
Drugs

73
Lopinavir: HIV
LOPRESSOR: HTN
LOPROX: antifungal
LORABID: antibiotic
Loratadine: allergies
Lorazepam: hypnotic,
anticonvulsant
LORCET 10/650, LORCET HD,
LORCET PLUS: narcotic
analgesic
LORTAB: narcotic analgesic
Losartan: HTN, diabetic
nephropathy
LOTENSIN: HTN, CHF
LOTENSIN HCT: HTN
LOTREL: HTN
LOTRIMIN: antifungal
LOTRISONE: antifungal/
steroid
LOTRONEX: irritable bowel
syndrome
Lovastatin: lowers cholesterol
LOW-OGESTREL 28:
contraceptive
Loxapine: schizophrenia
LOXITANE: schizophrenia
LOZOL: diuretic
LUMIGAN OPTH: glaucoma
LUNESTA: insomnia
LUPRON DEPOT:
endometriosis, prostate CA
LUVOX: anxiety, obsessive
compulsive disorder
LYRICA: seizures, neuropathic
pain
M METHADOSE: narcotic
MAFENIDE: burn wounds
MACROBID: antibiotic
MACRODANTIN: antibiotic
MALARONE: malaria
Malathion: head lice
Mannitol: osmotic diuretic
Maprotiline: antidepressant
Drugs
MARINOL: appetite stimulant
MAVIK: HTN, CHF
MAXAIR: asthma, COPD
MAXALT: antimigraine
MAXIDEX OPTH: conjunctivitis
MAXITROL OPTH: antibiotic
MAXZIDE: diuretic
MEBARAL: epilepsy, anxiety
Mebendazole: intestinal worms
Meclizine: vertigo, nausea
Meclofenamate: analgesic
MEDROL: steroid anti-
inflammatory
Medroxyprogesterone: uterine
bleeding, endometriosis,
contraception
MEFOXIN: antibiotic
Mefloquine: malaria
Megestrol: appetite stimulant/
anticancer
Meloxicam: arthritis
MENTAX: antifungal
Meperidine: narcotic analgesic
MEPHYTON: coagulation
disorders
Meprobamate: tranquilizer
MEPRON: P. carinii pneumonia
MERIDIA: obesity
Mesalamine: ulcerative colitis
Mestinon: myasthenia gravis
METADATE CD, ER: ADHD,
narcolepsy
METAGLIP: diabetes
Metaproterenol: asthma,
COPD
Metformin: diabetes
Methadone: narcotic analgesic
analgesic
Methenamine: UTI, cystitis
METHERGINE: uterine
contractions/bleeding
Methimazole: hyperthyroidism
Methocarbamol: skeletal
muscle relaxant
Methotrexate: psoriasis,
arthritis, anticancer
Methsuximide: absence seizures
Methyldopa: HTN
Methylphenidate: ADHD,
narcolepsy
Methylprednisolone: steroid
anti-inflammatory
Metoclopramide: heartburn,
diabetic gastroparesis
Metolazone: diuretic
Metoprolol: HTN, angina,
arrhythmias
Metronidazole: antibiotic
MEVACOR: lowers cholesterol
Mexiletine: antiarrhythmic
MEXITIL: antiarrhythmic
MIACALCIN: osteoporosis
MICARDIS: HTN
Miconazole: antifungal
MICRO-K: potassium
MICROZIDE: HTN
MIDAMOR: diuretic
Midazolam: sedative/anxiolytic
Midodrine: vasopressor
MIDRIN: migraines
MINIPRESS: HTN
MINITRAN: angina
MINIZIDE: HTN
MINOCIN: antibiotic
Minocycline: antibiotic
Minoxidil: HTN
MIRALAX: laxative
MIRAPEX: Parkinson’s disease,
restless leg syndrome
Mirtazapine: depression
Misoprostol: NSAID induced
ulcers
MOBIC: arthritis
Modafinil: narcolepsy
MODURETIC: HTN
Moexipril: HTN
Mometasone: topical steroid
MONOKET: angina
MONOPRIL: HTN, CHF
MONUROL: antibiotic
Morphine: narcotic analgesic
MOTOFEN: diarrhea
Moxifloxacin: antibiotic
74
MUCINEX: expectorant
Mupirocin: topical antibiotic
MS CONTIN: narcotic
analgesic
MYCELEX 3: antifungal
MYCOBUTIN: antibiotic
Mycophenolate: organ
transplants
MYSOLINE: seizures
N
Nabumetone: arthritis
Nadolol: HTN, angina
Nafcillin: antibiotic
Naftifine: antifungal
NAFTIN: antifungal
Nalbuphine: narcotic analgesic
Naltrexone: opioid/alcohol
deterrent
NAMENDA: Alzheimer’s
disease
Naphazoline OPTH: anti-
inflammatory
NAPHCON-A OPTH: anti-
inflammatory
NAPROSYN: analgesic
NARDIL: depression, bulimia
NASACORT AQ: allergies
NASALCROM: allergies
NASAREL: rhinitis
NASONEX: allergies
NATRECOR: CHF
NAVANE: schizophrenia
NECON: contraceptive
Nefazodone: depression
Nelfinavir: HIV
NEMBUTAL: sedative/
hypnotic, seizures
Neomycin: antibiotic
NEORAL: organ transplant
NEOSPORIN: topical
antibiotics
NEPHROCAPS: Vitamins
NEULASTA: blood cells
stimulator
Drugs

75
NEURONTIN: antiepileptic,
neuropathic pain
NEUPOGEN: white blood cells
stimulator
Nevirapine: HIV
NEXIUM: ulcers, GERD
Niacin: reduces cholesterol
NIACOR: lowers cholesterol
NIASPAN: lowers cholesterol
Nicardipine: angina, HTN
NICODERM CQ: smoking
cessation
NICOMIDE: Vitamins, minerals
NICORETTE: smoking
cessation
Nicotinic Acid: reduces
cholesterol
NICOTROL NS, NICOTROL
PATCH: smoking cessation
Nifedipine: angina, HTN
NIFEREX, NIFEREX-150: iron
NILANDRON: prostate CA
Nimodipine: vasospasm in SAH
NIMOTOP: vasospasm in SAH
Nisoldipine: HTN
NITRO-DUR: angina
Nitrofurantoin: antibiotic
Nitroglycerin: angina
NITROLINGUAL SPRAY: angina
NITROMIST: angina
NITROSTAT: angina
NIX: head lice
Nizatidine: ulcers, GERD
NIZORAL: antifungal
NORCO: narcotic analgesic
NORDETTE: contraceptive
NORFLEX: skeletal muscle
relaxant
Norfloxacin: antibiotic
NORGESIC: skeletal muscle
relaxant
NORINYL: contraceptive
NOROXIN: antibiotic
NORPACE, NORPACE CR:
antiarrhythmic
NORPLANT: contraceptive
NORPRAMIN: antidepressant
Drugs
NOR-QD: contraceptive
NORTREL: contraceptive
Nortriptyline: antidepressant
NORVASC: HTN, angina
NORVIR: HIV
NOVANTRONE: prostate
CA, MS
NOVOLIN R: diabetes
NOVOLOG: diabetes
NOVOLOG MIX 70/30:
diabetes
NUBAIN: narcotic analgesic
NUVIGIL: narcolepsy, shift-
work
Nystatin: antifungal
NYSTOP: antifungal
O
Octreotide: diarrhea
associated with carcinoid
tumors
OCUFLOX OPTH: antibiotic
Ofloxacin: antibiotic
Olanzapine: schizophrenia
Olopatadine: antihistamine
Olsalazine: ulcerative colitis
Omeprazole: ulcers,
esophagitis
OMNARIS: allergies
OMNICEF: antibiotic
OMNIHIST LA: antihistamine/
decongestant
Ondansetron: antiemetic
OPANA: narcotic analgesic
Opium tincture: narcotic
analgesic/antidiarrheal
OPTIVAR OPTH: allergies
ORAMORPH SR: narcotic
analgesic
ORENCIA: rheumatoid
arthritis
ORINASE: diabetes
Orphenadrine: skeletal
muscle relaxant
ORTHO EVRA: contraceptive
ORTHO TRI-CYCLEN-21, 28:
contraceptive
ORTHO-CEPT 21, 28:
contraceptive
ORTHO-CYCLEN-21, 28:
contraceptive
ORTHO-EST: menopause,
osteoporosis
ORTHO-NOVUM: contraceptive
OS-CAL: Calcium, Vitamin D
OVCON: contraceptive
OVIDE: head lice
OVRAL: contraceptive
OVRETTE: contraceptive
Oxacillin: antibiotic
Oxandrolone: osteoporosis,
weight loss
Oxaprozin: arthritis
Oxazepam: hypnotic
Oxcarbazepine: anticonvulsant
Oxiconazole: antifungal
OXISTAT: antifungal
OXSORALEN: repigmenting
agent
Oxybutynin: overactive bladder
Oxycodone: narcotic analgesic
Oxycodone/ASP: narcotic
analgesic
Oxycodone w/APAP: narcotic
analgesic
OXYCONTIN: narcotic analgesic
OXYFAST: narcotic analgesic
Oxymetholone: anemia
Oxymorphone: narcotic
analgesic
Oxytocin: induction of labor
OXYTROL: overactive bladder
P Pentazocine/Naloxone:
PACERONE: antiarrhythmic
Paclitaxel: ovarian/breast CA
Palivizumab: antiviral
PAMELOR: antidepressant
PANCREASE, PANCREASE
MT: cystic fibrosis, pancreatitis
76
Pancrelipase: cystic fibrosis,
pancreatitis
PANGESTYME: cystic
fibrosis, pancreatitis
Pantoprazole: ulcers, GERD
PARAPLATIN: ovarian CA
PARCOPA: Parkinson’s
disease
PAREGORIC: diarrhea
Paricalcitrol: vitamin D
PARNATE: antidepressant
Paroxetine: antidepressant,
OCD
PASER: tuberculosis
PATANASE: allergies
PATANOL OPTH: allergies
PAXIL: antidepressant
PEDIAFLOR: fluoride
PEDIAPRED: allergies,
arthritis, MS
PEDIAZOLE: antibiotic
PEDI-DRI: antifungal
PEGANONE: seizures
PEGASYS: hepatitis B/C
PEG-INTRON: hepatitic C
Pemirolast OPTH: allergies
Pemoline: ADHD
Penbutolol: HTN
Penciclovir: herpes
Penicillamine: arthritis,
cystinuria
Penicillin: antibiotic
PENTASA: ulcerative colitis
Pentazocine: narcotic
analgesic
Pentazocine/APAP: narcotic
analgesic
narcotic analgesic
Pentobarbital: sedative,
anticonvulsant
Pentostatin: leukemia
Pentoxifylline: improves
circulation
PEPCID, PEPCID AC: ulcers,
GERD
Drugs

77
PERCOCET: narcotic analgesic
PERCODAN: narcotic
analgesic
PERFOROMIST: asthma, COPD
PERIACTIN: allergies
PERI-COLACE: laxative
Perindopril: HTN
Permethrin: head lice, scabies
Perphenazine: schizophrenia
PERSANTINE: platelet
inhibitor
Phenazopyridine: urinary
tract analgesic
Phenelzine: depression, bulimia
PHENERGAN: sedative/
antiemetic
Phenobarbital: sedative/
anticonvulsant
Phentermine: obesity
Phenyl Salicylate/
Methenamine: urethritis
Phenylephrine: colds
Phenytoin: epilepsy
PHISOHEX: skin cleanser
PHOSLO: phosphate binder
PHRENILIN, PHRENILIN
FORTE: tension HA
Phytonadione: vitamin K
Pilocarpine OPTH: glaucoma
PIMA: asthma, bronchitis
Pindolol: HTN
Pioglitazone: diabetes
Piperacillin: antibiotic
Pirbuterol: asthma, COPD
Piroxicam: arthritis
PLAQUENIL: malaria
PLAVIX: MI, Stroke
PLETAL: improves circulation
PNEUMOTUSSIN: cough
PODOCON-25: genital warts
Podophyllin: genital warts
Polyethylene glycol: laxative
Polymyxin: topical antibiotic
POLYTRIM OPTH: eye infection
PONSTEL: analgesic
PORTIA: contraceptive
Drugs
Posaconazole: antifungal
Potassium Citrate: kidney
stones
Potassium iodide:
expectorant
Pramipexole: Parkinson’s
disease, restless leg
syndrome
Pramoxine: itching
PRANDIMET: diabetes
PRANDIN: diabetes
PRAVACHOL: lowers
cholesterol
Pravastatin: lowers cholesterol
PRAX: itching
Prazosin: HTN
PRECOSE: diabetes
Prednisolone: steroid anti-
inflammatory
Prednisone: steroid anti-
inflammatory
PREFEST: menopause
PRELONE: steroid anti-
inflammatory
PREMARIN: menopause
PREMPHASE: menopause
PREMPRO: menopause
PRENATE: vitamins
PREVACID: ulcers, esophagitis
PREVALITE: lowers
cholesterol
PREVPAC: ulcers
PRIFTIN: tuberculosis
PRILOSEC: ulcers, esophagitis
Primaquine: malaria
PRIMATENE MIST: asthma
PRIMATENE Tablets: asthma
PRIMAXIN: antibiotic
Primidone: epilepsy
PRINIVIL: HTN, CHF
PRINZIDE: HTN
PRISTIQ: depression
PROAMATINE: vasopressor
Probenecid: gout
Procainamide: antiarrhythmic
PROCANBID: antiarrhythmic
Procarbazine: Hodgkin’s
disease
PROCARDIA, PROCARDIA
XL: angina, HTN
Prochlorperazine: antiemetic
PROCRIT: anemia
PROCTOCORT: ulcerative
colitis
PROCTOFOAM-HC: steroid
anti-inflammatory
PROGRAF: organ transplants
Promethazine: sedative/
antiemetic
Propafenone: antiarrhythmic
Propantheline: peptic ulcers
PROPECIA: hair loss
Propoxyphene: narcotic
analgesic
Propranolol: HTN, angina,
arrhythmias, AMI, H/A
Propylthiouracil: hyper-
thyroidism
PROSCAR: enlarged prostate
PROSED/DS: UTIs
PROSOM: insomnia
Protease: digestive enzyme
PROTONIX: ulcers, GERD
PROVENTIL, PROVENTIL HFA:
asthma, COPD
PROVERA: amenorrhea
PROVIGIL: narcolepsy
PROZAC: antidepressant
Pseudoephedrine: colds
PSORCON E: dermatoses
Psyllium: fiber laxative
PULMICORT: asthma
PULMOZYME: cystic fibrosis
Pyrazinamide: tuberculosis
PYRIDIUM: urinary tract
analgesic
Pyridostigmine: myasthenia
gravis
Pyridoxine: Vitamin B6
Pyrimethamine: malaria,
toxoplasmosis
78
Q
QUALAQUIN: malaria
QUESTRAN: reduces
cholesterol
Quetiapine: schizophrenia
Quinapril: HTN, CHF
Quinapril-HCTZ: HTN
QUINARETIC: HTN
Quinidine: arrhythmias,
malaria
Quinine: malaria
Quinupristin/Dalfopristin:
antibiotic
QUIXIN OPTH: conjunctivitis
QVAR: asthma
R
Raloxifene: osteoporosis
Ramipril: HTN, CHF
RANEXA: angina
Ranitidine: ulcers, GERD
RAPAFLO: BPH
RAPAMUNE: organ transplant
RAPTIVA: psoriasis
RAZADYNE: Alzheimer’s
disease
REBETOL: Hepatitis C
REBETRON: Hepatitis C
Rebif: MS
REGLAN: heartburn,
gastroparesis
RELAFEN: arthritis
RELENZA: influenza
RELISTOR: opioid related
constipation
RELPAX: migraine
headaches
REMERON: antidepressant
REMICADE: Crohn’s disease,
arthritis
RENAGEL: phosphate binder
Drugs

79
REQUIP: Parkinson’s disease,
restless legs syndrome
RESCRIPTOR: HIV
RESTASIS OPTH: increases RYNATAN: common cold
tear production
RESTORIL: hypnotic
RETIN-A: antiacne
RETROVIR: HIV
REVATIO: pulmonary artery
HTN
REYATAZ: HIV
RHINOCORT: allergies
Ribavirin: hepatitis C
RIFADIN: tuberculosis,
meningitis
RIFAMATE: tuberculosis
Rifampin: tuberculosis
Rifapentine: tuberculosis
RIFATER: tuberculosis
Rimantadine: influenza A
RIOMET: diabetes
Risedronate: osteoporosis
RISPERDAL: schizophrenia,
autism
Risperidone: schizophrenia,
autism
RITALIN, RITALIN-LA: ADHD,
narcolepsy
Ritonavir: HIV
Rivastigmine: dementia in
Alzheimer’s & Parkinson’s
ROBAXIN: skeletal muscle r
elaxant
ROBINUL, ROBINUL FORTE:
peptic ulcers
ROBITUSSIN: expectorant
ROCALTROL: vitamin D analog
ROCEPHIN: antibiotic
RONDEC DM: cough
Ropinirole: Parkinson’s disease,
restless leg syndrome
Rosiglitazone: diabetes
ROWASA: colitis, proctitis
ROXANOL: narcotic analgesic
ROXICET: narcotic analgesic
ROXICODONE: narcotic
analgesic
Drugs
ROZEREM: insomnia
ROZEX: rosacea RUM-K:
potassium
RYNATUSS: common cold
RYTHMOL, RYTHMOL SR:
antiarrhythmic
S
SALAGEN: dry mouth
Salicylic acid: removes warts
SALIVART: dry mouth
Salmeterol: asthma, COPD
Salsalate: arthritis
SANDIMMUNE: organ
transplants
SANDOSTATIN: tumors,
diarrhea
Saquinavir: HIV
SARAFEM: premenstrual
dysphoric disorder
SAVELLA: fibromyalgia
Scopolamine: antispasmodic/
motion sickness
SEASONALE: contraceptive
SECTRAL: HTN, angina
Selegiline: Parkinson’s
disease
SEMPREX-D: allergies
Senna Extract: laxative
SENNA-S: laxative
SENOKOT: laxative
SENSIPAR: hyperpara-
thyroidism
SEPTRA, SEPTRA DS:
antibiotic
SEREVENT: asthma, COPD
SEROQUEL: schizophrenia,
bipolar disorder
SEROSTIM: AIDS wasting
Sertraline: antidepressant,
OCD, panic disorder
SERZONE: antidepressant
SILVADENE: burn wounds
SIMCOR: cholesterol reducers
Simethicone: gas
SIMPLY COUGH LIQUID:
cough
Simvastatin: cholesterol
reducer
SINEMET CR: Parkinson’s dis.
SINEQUAN: antidepressant
SINGULAIR: asthma, allergies
SINUVENT: common cold,
allergies
Sirolimus: renal transplant
SKELAXIN: skeletal muscle
relaxant
SLO-NIACIN: lowers
cholesterol
SMX/TMP: antibiotics
Sodium Polysterene Sulfonate:
hyperkalemia
SOMA: muscle spasm
SONATA: insomnia
SORIATANE: psoriasis
Sotalol: arrhythmias
SPECTAZOLE: antifungal
SPECTRACEF: antibiotic
SPIRIVA: asthma, COPD
Spironolactone: diuretic
Spironolactone & HCTZ: HTN
SPORANOX: antifungal
SSKI: expectorant
STADOL NS: narcotic analgesic
STAGESIC: narcotic analgesic
STALEVO: Parkinson’s disease
Stavudine d4T: HIV
STELAZINE: schizophrenia
STRATTERA: ADHD
Streptomycin: antibiotic
SUBOXONE: opiate addiction
SUBUTEX: opiate addiction
Sucralfate: duodenal ulcers
Sufentanil: analgesic/anesthetic
SULAR: HTN
Sulfacetamide OPTH: antibiotic
Sulfamethoxazole: antibiotic
Sulfamylon: burn wounds
Sulfasalazine: ulcerative colitis
Sulfisoxazole: antibiotic
80
Sulindac: arthritis
Sumatriptan: migraine H/A
SUPRAX: antibiotic
SUSTIVA: HIV
SYMBICORT: asthma, COPD
SYMBYAX: bipolar disorder,
depression
SYMMETREL: Parkinson's
disease, influenza A
SYNAREL: endometriosis,
precocious puberty
SYNERCID: antibiotics
SYNTHROID: hypothyroidism
T
TAGAMET: ulcers
TALACEN: narcotic analgesic
TALWIN NX: narcotic analgesic
TAMBOCOR: antiarrhythmic
TAMIFLU: influenza
Tamoxifen: breast CA
TAPAZOLE: hyperthyroidism
TARKA: HTN
TASMAR: Parkinson’s disease
TEGRETOL, TEGRETOL XR:
epilepsy, neuralgia
TEKTURNA: HTN
Telmisartan: HTN
Temazepam: hypnotic
TEMOVATE: topical steroid
TENEX: HTN
TENORETIC: HTN
TENORMIN: arrhythmias,
HTN, angina, MI
TENUATE: obesity
Terazosin: HTN
Terbinafine: antifungal
Terbutaline: COPD, asthma
Terconazole: antifungal
TESSALON: cough
Testosterone: androgenizing
hormone
Tetracycline: antibiotic
TEVETEN: HTN
Drugs

81
Thalidomide: HIV, leprosy
THALOMID: HIV, leprosy
THEO-24: asthma, COPD
THEOCRON: asthma, COPD
THEOLAIR: asthma, COPD
Theophylline: asthma, COPD
THERA-GESIC: arthritis
Thiamine: Vitamin B-1
Thioridazine: schizophrenia
Thiothixene: schizophrenia
THORAZINE: schizophrenia
THYROLAR: hypothyroidism
Tiagabine: antiepileptic
TIAZAC: HTN, angina
Ticarcillin: antibiotic
TICLID: stroke prophylaxis
Ticlodipine: stroke prophylaxis
TIGAN: antiemetic
TIKOSYN: atrial fibrillation
TIMENTIN: antibiotic
Timolol: HTN, angina,
arrhythmias
TIMOPTIC: glaucoma
TINACTIN: antifungal
Tizanidine: muscle relaxant
TOBI Solution for Inhalation:
cystic fibrosis
TOBRADEX OPTH: infection/
inflammation
Tobramycin: antibiotic
TOBREX OPTH: antibiotic
TOFRANIL, TOFRANIL PM:
anti-depressant, anxiety
Tolazamide: diabetes
Tolbutamide: diabetes
Tolmetin: arthritis
Tolnaftate: antifungal
Tolterodine: overactive bladder
TOPAMAX: seizures, migraine
TOPROL-XL: HTN, angina, CHF
TORADOL: analgesic
Torsemide: diuretic
TOVIAZ: overactive bladder
TRACLEER: pulmonary HTN
Tramadol: analgesic
TRANDATE: HTN
Trandolapril: HTN, CHF
Drugs
TRANSDERM-SCOP: motion
sickness
TRANXENE: anxiety, seizures
TRAVATAN OPTH: glaucoma
Trazodone: antidepressant,
insomnia
TRECATOR-SC: tuberculosis
TRENTAL: improves
circulation
Tretinoin: antiacne
Triamcinolone: steroid anti-
inflammatory
Triamterene with HCTZ: HTN
Triazolam: insomnia
TRICOR: hyperlipidemia
Trifluoperazine: schizophrenia
TRIGLIDE: high cholesterol
Trihexyphenidyl: Parkinson’s
disease
TRILEPTAL: anticonvulsant
TRI-LEVLEN: contraceptive
Trimethoprim: antibiotic
Trimethoprim/
Sulfamethoxazole:
antibiotics
TRINESSA: contraceptive
TRI-NORINYL 28:
contraceptive
TRIPHASIL: contraceptive
TRIZIVIR: HIV
TRUSOPT OPTH: glaucoma
TRUVADA: HIV
TUSSAFED HC: cough/cold
TUSSI-ORGANIDIN: cough
TUSSIONEX: coughs, allergies
TYGACIL: antibiotic
TYLENOL w/Codeine:
narcotic analgesic
TYLENOL SINUS
CONGESTION: colds, allergies
TYZEKA: Hepatitis B
U
ULORIC: gout
ULTRACET: narcotic analgesic
ULTRAM: analgesic
ULTRASE, ULTRASE MT:
pancreatitis, cystic fibrosis
ULTRAVATE: topical steroid
UNIPHYL: asthma, COPD
UNIRETIC: HTN
UNISOM: insomnia
UNIVASC: HTN
URECHOLINE: urinary retention
URIMAX: UTI
UROXATRAL: prostatic
hypertrophy
UROCIT-K: kidney stones
Ursodiol: gall stones
V arthritis
VICOPROFEN: narcotic
analgesic
VIDEX: HIV
VIGAMOX OPTH: antibiotic
VIMPAT: partial onset Sz
VIOKASE: cystic fibrosis,
pancreatitis
VIRACEPT: HIV
VIRAMUNE: HIV
VIREAD: HIV, Hepatitis B
VISKEN: HTN
VISTARIL: sedation, itching,
anxiety
VIVELLE: menopause
VOLTAREN, VOLTAREN XR:
VYTORIN: lowers cholesterol

Valacyclovir: herpes, shingles W

VALCYTE: cytomegalovirus
VALIUM: hypnotic, anxiety,
seizures Warfarin: anticoagulant
Valproic acid: seizures, WELCHOL: lowers cholesterol
migraine, mania WELLBUTRIN,
Valrubicin: bladder cancer WELLBUTRIN SR:
Valsartan: HTN, CHF antidepressant
VALTREX: herpes, shingles
VANCOCIN: antibiotic X
Vancomycin: antibiotic
VANTIN: antibiotic
VAPRISOL: low sodium XALATAN OPTH: glaucoma
VASERETIC: HTN XANAX, XANAX XR:
VASOTEC: HTN, CHF hypnotic, anxiety
Venlafaxine: depression, XELODA: anticancer
anxiety, panic disorder XENICAL: obesity
VENOFER: iron XIFAXAN: traveler’s diarrhea,
VENTOLIN: asthma, COPD encephalopathy
Verapamil: angina, PSVT, HTN XOPENEX: asthma, COPD
VERELAN, VERELAN PM:
angina, HTN, PSVT, H/A Y
VERMOX: intestinal worms
VESICARE: overactive bladder
VFEND: antifungal YASMIN 28: contraceptive
VIAGRA: male erectile dysfunction YAZ: contraceptive,
VIBRAMYCIN: antibiotic premenstrual dysphoric
VICODIN, VICODIN ES: disorder
narcotic analgesic YODOXIN: intestinal amebiasis
82
Drugs
 Drugs

83
Z
ZADITOR OPTH: conjunctivitis
Zaleplon: insomnia
ZANAFLEX: muscle relaxant
ZARONTIN: absence Sz
ZAROXOLYN: diuretic
ZEBETA: HTN
ZEGERID: ulcers, GERD
ZEMPLAR: vitamin D analog
ZERIT: HIV
ZESTORETIC: HTN
ZESTRIL: HTN, CHF
ZETIA: lowers cholesterol
ZIAC: HTN
ZIAGEN: HIV
Zidovudine: HIV
ZINACEF: antibiotic
Zinc oxide: diaper rash
ZITHROMAX: antibiotic
ZOCOR: cholesterol reducer
ZOFRAN: antiemetic
ZOLADEX: endometriosis,
breast CA
ZOLOFT: depression, OCD,
anxiety
Zolpidem: insomnia
ZOMIG: migraine H/A
ZONEGRAN: partial Sz
Zonisamide: partial Sz
ZOSYN: antibiotic
ZOVIRAX: herpes, shingles
ZYBAN: smoking cessation
ZYFLO: asthma
ZYLOPRIM: gout
ZYMAR OPTH: antibiotic
ZYPREXA, ZYPREXA ZYDIS:
schizophrenia, bipolar disorder
ZYRTEC: allergy, hives,
asthma
ZYRTEC D: allergic rhinitis
ZYVOX: antibiotic
 Spainish

85
Spanish Translations
(In Spanish “h” is silent; “ll” is pronounced like “y”; “j” like “h” \
[ham]; “qu” like “k”, so the “u” is silent here; and “ñ” like “nya”.
An accented vowel [á, ó, etc.] simply indicates the syllable that
must be stressed when pronouncing the word.)
History & Examination
I am a paramedic Soy paramédico (bombero;
(firefighter; nurse; doctor) enfermera, enfermero; médico).
I speak a little Spanish. Hablo un poco de español.
Is there someone here that ¿Hay alguien aquí que habla
speaks English? inglés?
What is your name? ¿Cómo te llamas?
I don’t understand. No entiendo.
Can you speak more slowly ¿Por favor, puede hablar más
please? despacio?
Wake up sir/madam. Despiértate, señor/señora.
Sit up. Siéntate por favor.
Listen. Escúchame.
How are you? ¿Cómo estás?
Do you have neck or back ¿Te duele el cuello o la
pain? espalda?
Were you unconscious? ¿Estuviste inconsciente?
Move your fingers and toes. Mueva los dedos de las manos
y los pies.
What day is today? ¿Qué día es hoy?
Where is this? ¿Dónde está?
Where are you? ¿Dónde estás?
What is your telephone ¿Cuál es tu número de teléfono?
number? …address? …domicilio?
When were you born? ¿Cuando naciste?
Sit here please. Siéntate aquí, por favor.
Lie down please. Acuéstate, por favor.
Do you have pain? ¿Tienes dolor?
...trouble breathing? dificultad para respirar?
...weakness? débilidad?
Where? ¿Dónde?
Show me where it hurts with Muéstrame con tu mano dónde
your hand. te duele.
Does the pain increase when
you breathe?
Breathe deeply through your
mouth.
Breathe slowly.
What medicines do you take?
Have you been drinking?
Have you taken any drugs?
Do you have chest pain?
Heart problems?
Diabetes?
Asthma?
Allergies?
Have you had this pain before?
How long ago?
Are you sick to your stomach?
Are you pregnant?
Do you need to vomit?
You will be OK.
It’s not serious.
It is serious.
Treatment
Please don’t move
What’s the matter?
Do you want to go to the
hospital?
To which hospital?
You must go to the hospital.
We’re going to take you to the
hospital.
We are going to give you
oxygen.
We are going to apply a C-collar.
We are going to give you an IV.
86
¿Te aumenta el dolor cuando
respiras?
Respira profundo por la boca.
Respira despacio.
¿Qué medicinas tómas?
¿Has estado tomado alcohol?
¿Has tomado alguna droga?
¿Tienes dolor de pecho?
¿problemas de corazon?
¿diabétes?
¿asma?
¿alergias?
¿En otra ocasión has tenido
este dolor?
¿Hace cúanto tiempo?
¿Tienes nausea o asco?
¿Estás embarazada?
¿Necesitas vomitar?
Todo estará bien.
No es serio.
Es serio.
Por favor, no te muevas.
¿Qué pasa?
¿Quieres ir al hospital?
¿A cuál hospital?
Tienes que ir al hospital.
Te vamos a llevar al hospital.
Te vamos a dar oxígeno.
Te vamos a poner un collarín.
Te vamos a poner un suero.
Spainish
 Spainish

87
Miscellaneous
abdomen el abdomen lungs los pulmónes
ankle el tobillo meds medicinas
arm el brazo mouth la boca
back la espalda neck el cuello
bone el hueso No No
cancer cáncer penis el pene
chest el pecho stretcher la camilla
drugs drogas stroke ataque cerebral
ear el oîdo Thank you Gracias

Excuse me. Perdóname throat la garganta

eye el ojo to help ayudar

foot el pie vagina la vagina
fracture una fractura wrist la muñeca
Goodbye Adiós Yes Si
hand la mano
head la cabeza
heart el corazón
Hello Hola
hip la cadera
hypertension presión alta
leg la pierna
 Spell Checker
A
abdomen anemic ashen
abrasion anesthesia asphyxia
abruptio placenta anesthetic aspirate
abscess aneurysm aspiration
abuse angulation assault
acetone anorexia assessment
acidosis antecubital asthma
accumulate antibiotic asthmatic
addiction anticoagulant asystole
adolescent antidepressant atelectasis
afebrile antidote atrial
agonal antipyretic aura
alcohol antispasmodic auscultate
alcoholic anxiety auscultation
alcoholism anxious avulsion
alkali aphasia axilla
alkalosis aphasic axillary
aligned antacid
alignment antecubital B
allergy apnea
alleviate apneic babies
alopecia appearance Babinski
Alzheimer appendicitis bacteremia
amenorrhea appendectomy bacterial
aminophylline appendix balance
ammonia apprehensive bandage
amnesia aqueous barbiturate
amniotic arachnoid barium
amphetamines arrhythmia barotrauma
amputation arteriosclerosis baseline
analgesic arthritis basal
anaphylactic artifact basilar
anaphylaxis artificial basic
anemia ascites belch

88
Spelling
 Spelling

89
belching bursitis circulation
benign buttock cirrhosis
Betadine clavicle
biceps
C coagulate
bicuspid coccyx
calcium
bifocal colitis
cancer
bifurcate collapse
cannula
bifurcation Colles
capillaries
bigeminal colostomy
capillary
bigeminy comatose
carbon
bilateral comminuted
carbon monoxide
bile biopsy communicable
cardiogenic
blackout concussion
cardiopulmonary
bladder congenital
cardiovascular
blindness congestion
cardioversion
bolus congestive
carotid
botulism conjunctiva
carpal
bowel conjunctivitis
carpopedal
brachial conscious
cartilage
bradycardia consciousness
casualty
bradypnea constipation
cataract
brain constrict
catheter
breast constricted
caudal
breath contagious
cellulitis
breathe contaminate
cerebellum
breech contraction
cerebral
bronchi contraindication
cerebral palsy
bronchial contusion
cerebrospinal
bronchiectasis convalescent
cerebrovascular
bronchiolitis convulsion
cerebrum
bronchitis copious
cervical
bronchospasm cornea
cervix
bronchus corneal
cesarean
bruise coronary
characteristic
bruit cranium
chemotherapy
buccal cranial
cheyne-stokes
bulimia crepitus
cholecystitis
bunion cricoid
cholesterol
cricothyroid diaphragmatic E
cricothyrotomy diarrhea
croup diastolic ecchymosis
cutaneous difficulty eclampsia
cyanosis digestion ectopic foci
cyanotic digitalis ectopy
cystic fibrosis dilate edematous
cystitis dilation electrolytes
diminished emaciated
D diplopia emboli
discoloration embolism
deceleration discomfort
decerebrate embolus
disease
decompensate emesis
disentanglement
decompression emetic
dislocated
decorticate emphysema
dislocation
decubitus emphysemic
dispersed
defecate disruption encephalitis
defibrillate dissecting endocarditis
defibrillation dissociation endotracheal
deficiency dissolve enteritis
deficit distal enzyme
definitive distended epidermis
deformity distention epidural
dehydrated diuretic epiglottis
dehydration diverticulitis epiglottitis
delirious dizziness epilepsy
delirium tremens dorsalis pedis epileptic
dementia duodenum epinephrine
dependent duration epiphyseal plate
depression dysarthria epistaxis
dermatitis dysconjugate equilibrium
development dysfunction equivalent
dextrose dysmenorrhea esophageal
diabetes dysphagia esophageal
diabetic dyspnea esophagus
diagnosis dyspneic etiology
diaphoresis dysrhythmia eustachian
diaphragm dysuria eviscerate

90
Spelling
 Spelling

91
evisceration flexed groin
exacerbated flexible gurney
examination fontanelle
excessive foramen magnum H
exhale forearm
forehead hallucinate
exhaust hallucination
exhaustion fossa
fracture hallucinogen
expiration hazard
frostbite
exposure hazardous
exsanguinate G Heimlich
exsanguinating hematemesis
external gag reflex hematoma
extremity gait hematuria
extricate gallbladder hemiparalysis
extrication gallstone hemiplegia
extrude gangrene hemophilia
eyeball gastric hemopneumothorax
gastritis hemoptysis
F gastroenteritis hemorrhage
gastrointestinal hemorrhagic
facial hemorrhoid
failure gauge
gauze hemothorax
faint
generalized hepatitis
fallopian
genital hepatomegaly
Fahrenheit
febrile genitalia hereditary
fecal genitals hernia
femoral geriatric heroin
femur gestation herpes
fetal hiccough
gestational
fetus hormones
girdle
fever humerus
glaucoma
feverish hyperextension
glottis hyperglycemia
fibrillate glucose
fibrillation hyperkalemia
gonorrhea hyperpnea
fibula
gout hyperpyrexia
flaccid
flail grand mal hyperreflexia
flare grandeur hyperresonance
flaring gravida hypertension
hyperventilation infiltrate joules
hyphema infiltration jugular
hypnotic inflammation junctional
hypoglycemia infusion juvenile
hyporesonance ingestion
hypotension inguinal K
hypothermia inhalation
hypoxia initiate keratitis
hypoxic injection ketoacidosis
hypovolemia inoculation kidneys
hysterectomy insensible kidney stones
hysteria insufficiency knuckle
insufficient Kussmaul’s
I insulin kyphosis
integumentary
idiosyncrasy intercostal L
idioventricular intermittent
ileum intestinal laceration
iliac crest intestine laryngeal
ilium intoxicated laryngectomy
immobilize intracranial laryngoscope
immobilization intracranial laryngospasm
immunization pressure laryngitis
impairment intramuscular laryngospasm
impending intravenous larynx
inadequate intubate lateral
incident intubation lavage
incision ipecac lethargic
incontinence irreversible lethargy
incontinent irritability
increment leukemia
ischemia leukocytes
induced
ischemic ligament
indwelling
inebriated ischial linear
inebriation ischium lividity
infarct J localize
infarction lumbar
infection jaundice lymph
infectious jejunum
inferior

92
Spelling
 Spelling

93
M myocardial occlusive
myocardium ocular
malaise odontoid
N oliguria
malignant
malleolus opaque
naloxone
malnourished ophthalmic
narcosis
mandible opiate
narcotic
maneuver opposite
nares
manifestation orbit
narrowing
marijuana orbital
nasogastric
maxilla organophosphate
nasopharyngeal
measles oriented
nausea
medial orifices
nauseated
meninges oropharyngeal
nauseous
meningitis oropharynx
nebulizer
menstruation orthopedic
necrosis
mesenteric orthopnea
necrotic
mesentery orthostatic
neonatal
metabolism oscilloscope
neonate
metacarpal osteoporosis
neurogenic
midclavicular otitis
neurological
minimal ovarian
nitroglycerin
minimum ovaries
nocturia
mitral oxygenate
nocturnal
Mobitz oxygenated
noxious
modality nystagmus
moderate P
morbidity O
morphine pacemaker
mucosal obese palate
mucus obesity pallor
mucous oblique palpate
membrane obstruct palpation
multifocal obturator palpitation
multigravida occipital palsy
myalgia occiput pancreas
myasthenia gravis occlude pancreatitis
mydriasis occlusion paradoxical
paralysis phenobarbital profuse
paranoia phlebitis prognosis
paranoid phlegm prolapse
paraplegia phobia prone
paraplegic physiologic prophylactic
parasympathetic pinna prostate
parenteral placenta prostatitis
paresthesia previa prosthesis
parietal platelets proximal
paroxysmal pleural pruritus
partial seizure pneumonia psychiatric
patella pneumothorax psychogenic
patent poison psychologic
pathologic poisoning psychosis
patience polydipsia psychosomatic
pectoris polyphagia puberty
pedal edema polyuria pubis
pediatric pontine pulmonary
pelvic popliteal pulsating
penetrate posterior pulsation
penicillin postictal pulseless
peptic postpartum pulsus alternans
percussion posture pulsus
perfuse potassium puncture
perfusion potential pupillary
pericardial precordial
perineal preeclampsia
Q
perineum pregnancy
peripheral quadrant
pregnant
peritoneum quadriplegia
premature
peritonitis quality
prenatal
personnel quivering
prescribe
perspiration presenting R
pertinent previous
petit mal priapism raccoon eyes
pharmacology primigravida radial
pharyngeal primipara radial pulse
pharynx prodromal radiates

94
Spelling
 Spelling

95
radius rhythm septum
rales rhythmic sequelae
rational rigor sever
reaction rigor mortis severe
rebound rotate severity
rectal rotating shallow
rectum route shiver
recumbent routine shortness
recurrence rubella shoulder
reduce rupture sibling
redness sinus
reflex
S skeletal
refractory skull
sacroiliac
regurgitate sleepiness
sacrum
regurgitation sleepy
sagittal
rehydrate snoring
salicylate
relapse spasm
saliva
relief spastic
scapula
relieve sphincter
scar
remission spinous
sciatic
renal spleen
sclera
renal colic splenomegaly
sebaceous
resistance spontaneous
secondary
respiration sprain
secrete
respiratory sputum
secretion
respond stability
sedate
response stable
sedation
restless status asthmaticus
seize
resuscitate status epilepticus
seizure
resuscitation stenosis
Sellick’s maneuver
retention sterile
semi-Fowler’s
retina sternum
senile
retraction stethoscope
sensation
retrograde stimulate
sensitive
retroperitoneal stimuli
sensory
retrosternal stimulus
separation
rheumatic stomach
sepsis
rhonchi straight
septic
strain systolic tolerance
stretch tolerate
stretcher tongue
stridor
T tonic
stroke tonsil
tachycardia
subclavian tonsillectomy
tachypnea
subcutaneous tonsillitis
tamponade
subdural tooth
tarsals
sublingual tourniquet
technique
substernal toxemia
teeth
successive toxic
telemetry
sudden trachea
temperature
sufficient tracheostomy
temporal
suffocate traction
temporomandibular
suicidal tranquilizer
tenderness
suicide transfusion
tendon
superficial transient
tension
supine transverse
tetanus
suppository trauma
toxoid
supraventricular tremors
tetany
swallow Trendelenburg
therapeutic
sweat triage
thoracic
swelling triangular
thorax
swollen tricyclic
thready
symmetric trigeminy
throat
symmetrical trousers
thrombi
symmetry tuberculosis
thrombosis
sympathetic tympanic
thrombus
symphysis pubis
symptom
thumb U
thyroid
symptomatic
tibia ulcer
syncopal
tibial ulceration
syncope
tuberosity ulna
syndrome
tincture umbilical
syphilis
tingling umbilicus
syringe
tinnitus unconscious
syrup
tissue unifocal
systemic
titrate unsynchronized
96
Spelling
 Spelling

97
uremia venturi mask Y
ureters vertebra
urethra vertebrae yawn
urethral vertigo yeast
urinary vessels
urinate viable Z
urine victim
urticaria viral zygoma
uterine virus zygomatic arch
uterus viscera
uvula visceral
vision
V vitamins
volume
vaccine
vomit
vagal
vomiting
vagina
vomitus
vaginal
vulva
vallecula
Valsalva W
varices
vas deferens waist
vascular weak
vasodilate weakness
vasodilation weight
vasodilator wheal
vasopressor wheeze
vasovagal wheezing
vehicle widening
vein withdrawal
venereal worsen
venipuncture worsening
venous wrist
ventilate
ventilation
X
ventilator
xiphoid
ventilatory
ventricle
ventricular
 Abbreviations
1° primary, first degree
2° secondary, second degree
3° tertiary, third degree
<; < less than; less than or equal to
>; > greater than; greater than or equal to
α alpha
a before
@ at
a.c. before meals
abd abdomen
ABG arterial blood gas
abn abnormal
ADHD Attention Deficit Hyperactivity Disorder
Adm. administration
AF atrial fibrillation
AIDS acquired immunodeficiency syndrome
AKA also known as
AMA against medical advice
AMI acute myocardial infarction
ANS autonomic nervous system
ant. anterior
A-P, AP anterior-posterior
APAP acetaminophen
APE acute pulmonary edema
ARC AIDS-related complex
asa acetyl salicylic acid (aspirin)
ASAP as soon as possible
ASHD arteriosclerotic heart disease
ausc auscultation
A-V arteriovenous, atrioventricular
ax axillary
β beta
BBB bundle branch block
b.i.d. twice a day
bilat bilateral
BM bowel movement
BP blood pressure
98
Abbrevs
 Abbrev

99
BS breath sounds
BSA body surface area
BVM bag-valve-mask
c with
C centigrade
CA cancer
CABG coronary artery bypass graft
CAD coronary artery disease
CAO conscious, alert, oriented
CAT computerized axial tomography
CBC complete blood count
CC chief complaint
cc cubic centimeter
CCU coronary care unit
CHF congestive heart failure
Cl chloride
cm centimeter
CNS central nervous system
c/o complaining of
CO2 carbon dioxide
COHb carboxyhemoglobin
COPD chronic obstructive pulmonary disease
CSF cerebrospinal fluid
CVA cerebrovascular accident (stroke)
cx chest
D 5W Dextrose 5% in Water
D/C discontinue
dl deciliter (100 ml)
DKA diabetic ketoacidosis
DM diabetes mellitus
DNR do not resuscitate
DOA dead on arrival
DOE dyspnea on exertion
DSD dry sterile dressing
DTR deep tendon reflex
DT’s delirium tremens
Dx diagnosis
EBL estimated blood loss
EEG electroencephalogram
EENT eyes, ears, nose, and throat
ED emergency department
ECG electrocardiogram
EMS emergency medical service
ENT ears, nose & throat
EPS extrapyramidal sympt. (dystonias)
ET endotracheal
ETOH ethyl alcohol
F Fahrenheit
FH family history
FHR fetal heart rate
FUO fever of undetermined origin
fv fever
fx fracture
g, Gm gram
GCS Glasco Coma Score
GI gastrointestinal
gr grain
GSW gun shot wound
gtt drops
GU genitourinary
GYN gynecology
H+ hydrogen ion
hr. hour
Hb, Hgb hemoglobin
HBP high blood pressure
H&P history and physical examination
H/A headache
HCO3 bicarbonate ion
Hct hematocrit
HEENT head, eyes, ears, nose, and throat
Hg mercury
HIV human immunodeficiency virus
H 2O water
HPI history of present illness
HR heart rate
HTN hypertension
hx history
ICP intracranial pressure
100
Abbrevs
 Abbrev

101
ICS intercostal space
IDDM insulin-dependent diabetes mellitus
IL intralingual
IM intramuscular
I&O intake and output
IO intraosseous
IPPB intermittent positive pressure breathing
IUD intrauterine device
IV intravenous
IVP intravenous push; intravenous pyelogram
JVD jugular venous distension
K+ potassium ion
kg kilogram (1000 grams; 2.2 pounds)
KVO keep vein open (30 – 60 µgtt/min)
L left
L liter
lb pound
LLQ left lower quadrant
LMP last menstrual period
LOC level of consciousness
LP lumbar puncture
LPM liters per minute
LS lung sounds
LUQ left upper quadrant
LZ Landing Zone
mcg microgram (1/(µg)1,000,000 of 1 gram)
mEq milliequivalent
Mg++ magnesium ion
mg milligram (1/1,000 of 1 gram)
MI myocardial infarction
m meter
ml, mL milliliter (1/1,000 of 1 liter; 1 cc)
mm millimeter
MOI mechanism of injury
MVA motor vehicle accident
Na+ sodium ion
NA not applicable
NaCl sodium chloride
NAD no acute distress, no apparent distress
NaHCO3 sodium bicarbonate
NB newborn
NG nasogastric
NIDDM non-insulin dependent diabetes mellitus
NKA no known allergy
NPO nothing by mouth
NRB non-rebreather (mask)
NS normal saline (0.9%)
NSAID non-steroidal anti-inflammatory drug
NSR normal sinus rhythm
NTG nitroglycerin
N&V nausea and vomiting
O2 oxygen
OB obstetrics
OD overdose
OLMC On-Line Medical Control
oz ounce
p after
PAC premature atrial contraction
PASG pneumatic antishock garment
PAT paroxysmal atrial tachycardia
PCO2 carbon dioxide pressure
p.c. after meals
PE physical exam
PEA pulseless electrical activity
PEARL pupils equal and react to light
PEEP positive end-expiratory pressure
pH hydrogen ion concentration (inverse)
PID pelvic inflammatory disease
PLA Plasmalyte-A
PMH past medical history
PND paroxysmal nocturnal dyspnea
P.O., p.o. by mouth, orally
PO2 oxygen pressure
PP postpartum
pr per rectum; rectally
PRN as needed
PSM pulse, sensory & motor functions
PSVT paroxysmal supraventricular tachycardia
102
Abbrevs
 Abbrev

103
Pt. patient
PVC premature ventricular contraction
q every
* (write out “every day”)
qh every hour
q id four times a day
R right
RBC red blood cell
RL Ringer’s Lactate
RLQ right lower quadrant
R/O rule out
ROM range of motion
RR respiratory rate
RUL right upper lobe
RUQ right upper quadrant
Rx prescription, therapy, treatment
s without
S-A sinoatrial
SaO2 arterial oxygen saturation
SC, SQ subcutaneous
SpO2 saturation via pulse oximetry
SLUDGE salivation, lacrimation, urination, defecation,
gastrointestinal distress, emesis
SL sublingual
SOB short of breath
S/S signs & symptoms
S/Sx signs & symptoms
stat immediately
STD sexually transmitted disease
Sx symptoms
Sz seizure
T temperature
TB tuberculosis
TCA tricyclic antidepressant
TIA transient ischemic attack
tid three times a day
TKO to keep open (30–60 µgtt/min)
TPR temperature, pulse, and respiration
TX therapy
U unit
UA urinalysis
URI upper respiratory infection
UTI urinary tract infection
UV umbilical vein
V-Fib, VF ventricular fibrillation
VS vital signs
V-Tach tachventricular tachycardia
VT ventricular tachycardia
w/ with
w/o without
WBC white blood cell
WNL within normal limits
WPW Wolff-Parkinson-White (syndrome)
wt weight
y/o years old
y.o. years old
X times
i decreased
male
female
h increased
µ micro (1/1,000,000)
µg microgram
D change (delta)
Ø no, none, null

104
Abbrevs
 Charting

105
Charting Guidelines – S.O.A.P.E.
S–Subjective. Record what the patient tells you, relevant to
the current problem, and pertinent negatives. This section
should contain a description of the history of the present
illness. Patient's medications can be listed here.

O–Objective. Record your observations, the patient's signs,

and other information about the scene, mechanism of injury,
etc. which pertains to the patient's current medical problem.

A–Assessment. This is your clinical impression (often the

patient's chief complaint). Examples: “chest pain,” or
“difficulty breathing.”

P–Plan. Record your pre-hospital care. Include all care,

especially spinal immobilization, oxygen, and other essential
basics. Patient refusal for specific treatments should be
documented here and above in the Subjective or Objective
areas of your chart.

E–Evaluation. Document the response to your treatment.

NOTE: Write a chart for all patient contacts and document

all patient refusals.
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