KS Harishankar–

Emergency drugs & equipment must be available in every dental office

Life-savingSecondary role to

basic life support in overall management

It is a collection of drugs & equipments highly effective in managing life-threatening situations

Should be as simple to use as possibleShould be intended to use for adult or pediatric patients

They are presented in 4 levels or modules based on level of training & experience of the doctor

Drugs in each modulei. Injectablesii.Non-injectables

Endotracheal IntravenousSublingual or intra lingual Intramusculari. Vastus-lateralisii.Mid-deltoidiii.Gluteal region

1) Cleanse the area of needle insertion 2) Grab the muscle & pull it away from the

bone3) Holding the syringe like a dart, quickly

insert the needle into the muscle mass to a depth of approximately 1 inch

4) Aspirate to ensure nonvascular penetration5) Quickly administer the drugs6) Remove the syringe, placing a dry gauze

under pressure at the injection site for a minimum of 1-2 minutes

7) Rubbing the area may increase vascularity & speed the rate of drug absorption

1) Place the tourniquet above the antecubital fossa

2) If possible have the patient open & close the fist to help distend the veins

3) When the patient cannot open & close his/her fist (unconscious) – place arm below the level of patient’s heart to help distend the veins

4) Cleanse & then dry the area in which the venipuncture is to be placed

5) Use an indwelling catheter , scalp-vein needle or syringe with the bevel of the needle facing up held at about 30 – 45 angle to the vein to be entered

6) Advance the needle into the vein until a return of blood is noted

7) Remove the tourniquet & either start the IV infusion or administer the desired drug

8) Secure the needle with a tape to maintain venous access

MODULE ONE- Basic emergency kit (critical drugs &

equipment)

MODULE TWO – non critical drugs & equipment

MODULE THREE – advanced cardiac life support

MODULE FOUR – antidotal drugs

Injectable drugs1. Epinephrine2. Anti-histamineNon-injectable drugs 1. Oxygen2. Vasodialators Emergency equipment1. Oxygen delivery system2. Suction & suction tips3. Tourniquets4. syringes

Secondary Injectable drugs1.Anticonvulsaunt2.Analgesics3.Vasopressor4.Antihypoglycemics5.Corticosteroids6.Antihypertensive7.anticholinergic

Non-injectable drugs 1.Respiratory stimulant2.Antihypoglycemic3.bronchodilatorsEmergency equipment1.Device for cricothyrotomy2.Artificial airways3.Laryngoscope & endotracheal tubes

1. Epinephrine2. Oxygen3. Lidocaine4. Atropine5. Dopamine6. Morphine sulfate7. Verapamil

Narcotic antagonistsBenzodiazepines Antiemergence delerium drugVasodilator

Most important emergency drug Drug of choice in acute allergic reactions DESIRABLE PROPERTIESRapid onset of actionPotent bronchial smooth muscle dilatorHistamine blocking propertiesVasopressor action Cardiac effects(increased cardiac output)

Therapeutic indications

1:1000 concentration in - Anaphylaxis - Acute ashmatic attack 1:10000 concentration - Cardiac arrest

SIDE EFFECTS Tachydysrhythmias - Supraventricular - Ventricular PRECAUTIONS In pregnancy -decreases placental blood

flow -premature labour NO CONTRA INDICATIONS

AVAILABILITY Preloaded syringes - 1:1000 intramuscular and

subcutaneous -1:10000 intravenous1 ml ampulesDOSEAdult dose 0.3 -0.5 ml intramuscular and subcutaneousPediatric dose 0.15mg

In Emergency kits- 1 preloaded syringe(1 ml of 1:1000

epinephrine)

- 3 or 4 ampules(1:1000 epinephrine)

Drug class - Histamine blockersProprietary - Chlor- TrimetonAlternative drug -DiphenhydramineHistamine blockersDrug of choice - delayed allergic response - definitive management of acute allergyMODE OF ACTIONCompetitive antagonists of histaminePrevent histamine’s access to receptor siteBlocking response of effector to histamine

THERAPEUTIC INDICATIONSDelayed onset allergic reactionsAs local anesthetics in allergic patientDefinitive management of acute allergic

reactionsSide Effects - CNS Depression -Decreased Blood Pressure -Thickening of bronchial secretionsContraindications -Acute asthmatic episodes

AVAILABILITY - 1ml and 2ml ampules(10mg|ml) -1ml pre loaded syringes DIPHENHYDRAMINE -10&30ml multidose vials(10mg\ml) -1ml ampules(50mg\ml) -1ml pre-loaded syringes IN EMERGENCY KITS -Three or Four 1ml ampules Chlorpheniramine(10mg/ml) or Diphenhydramine(50mglml)

1)OXYGEN2)VASODILATOR3)BRONCHODILATOR4)ANTIHYPOGLYCEMIC5)ASPIRIN

DRUG CLASS -NONEALTERNATIVE DRUG-NONEPROPRIETARY -NONE

Most useful drug in emergency kitTHERAPEUTIC INDICATIONS Emergency situations where

respiratory

distress is evident SIDE EFFECTS-NONECONTRAINDICATIONS-

HYPERVENTILATION

AVAILABILITY Compressed gas cylinderIN EMERGENCY KIT ONE E CYLINDER

DRUG CLASS-VASODILATORALTERNATIVE DRUG-AMYL NITRITEPROPRIETARY-NITROLINGUALSPRAY -NITROSTAT

TABLETS

THERAPEUTIC INDICATIONS - CHEST PAIN IN In acute myocardial

infarction Angina pectoris - Acute hypertensive episodes

Side Effects -Transient pulsating headache -Facial flushing -Degree of hypotensionCONTRAINDICATIONS -In hypotensive patients

AVAILABILITY -0.3,0.4,0.6mg doses of sublingual

tablets -0.4,0.8mg/dose translingual spray -0.3ml doses of amyl nitrate yellow

vaporoles IN EMERGENCY KIT -One bottle of metered trans lingual

nitroglycerine spray

DRUG CLASS-BRONCHODILATORALTERNATIVE DRUG-

METAPROTERENOLPROPRIETARY-PROVENTIL,VENTONIL

Drug of choice in asthmatic & allergic patients

Mode of action: bronchial smooth muscle relaxation

Therapeutic indication: bronchospasms, acute asthmatic & allergic reactions

Contraindications : pre-existing tachydysrhythmias

AVAILABILITY: - Albuterol inhalers ( Ventolin,

Proventil ) - Metaproterenol inhalers (Alupent) - Epinephrine mistometers

(Medihaler-Epi,

Primatine Mist) - Isoproterenol mistometers

(Medihaler-Iso)

DRUG CLASS-ANTIHYPOGLYCEMICSDRUG OF CHOICE – ORANGE JUICEALTERNATIVE DRUG-SOFT DRINKS

(NONDIET)PROPRIETARY-NONE

Drug of choice in patients with hypoglycemic reactions in Diabetes mellitus & non-diabetic patients with hypoglycemia

Therapeutic indications: management of unconscious hypoglycemic state

Contraindications : patients without active gag reflex, or unable to drink without assistance

Side effects: none

AVAILABILITY: - Glucola - Gluco-stat - Insta-glucose - nondiet cola beverages - fruit juices - granulated sugar - tubes of decorative icing

DRUG CLASS-ANTI-PLATELETALTERNATIVE DRUG-NONEPROPRIETARY-NONE

Drug of choice in suspected myocardial infarctionMode of action: - irreversibly acetylates the platelet cycloxygense - removes all cycloxygenase activity for the lifespan of platelet - stops production of proaggregatory

thromboxane A2 - non platelet effects: diminishes formation of

prostacyclinesTherapeutic indications: suspected myocardial

infarction unstable anginaContraindications & side effects :life-threatening

haemorrhage (bleeding peptic ulcer), history of aspirin allergy

AVAILABILITY: -65, 81, 162 , 325 mg tablets In emergency kit3-4 baby chewable aspirin- 162 mg

Oxygen delivery systemAutomated external defibrillatorSyringesSuction & suction tipsTourniquetsMagill intubation forceps

TECHNIQUE PERCENTAGE O2 DELIVERED

MOUTH-TO-MOUTH 16

MOUTH-TO-MASK 16

BAG-VALVE MASK 21

BAG VALVE MASK+SUPPLEMENTAL O2

>21 - <100

POSITIVE PRESSURE OXYGEN 100

POSITIVE PRESSUREAdaptable to the E-cylinderDelivers oxygen under positive pressureExamples: Positive pressure or demand valve - Reservoir bagThe devices should be fitted with a clear face

maskEfficient delivery of 100% oxygenPermit the rescuer to inspect the victim’s mouth

for the presence of foreign matter like vomitus, blood, saliva, water

Should be available in child, small adult & large adult sizes

Portable Self-inflating Source of positive pressure oxygen or ambient air or enriched oxygen (>21%, <100%) Attached to oxygen delivery tube Rescuer should be able to maintain an air-

tight seal Should have patent airway with one hand

while using the other hand to activate the device & ventilate the victim

Clear, full-faced maskRescuer applies exhaled air ventilation ( 16%

oxygen) to ventilate the victimExhalation occur through one way valve located

on the side of the maskAlso available with supplemental oxygen port

permitting the attachment of the mask to an oxygen tube & deliver enriched oxygen ventilation

It enables the rescuer to provide mouth to mask ventilation

Advantage: prevention of transmission of disease, low cost

IN PEDIATRIC PATIENTSSimply invert the mask, holding the

narrow nose side of the mask in the cleft of the chin & the wider chin side on the bridge of the child’s nose

IN EMERGENCY KIT One portable oxygen cylinder (E-

cylinder) with positive pressure mask One portable, self-inflating, bag-valve-

mask device One pocket mask for each staff member Sizes: child, small adult, large adult Advanced training for safe &effective

use

Sophisticated,simple,battery operated ,computerised device,reliable &easy to use.

Use-to recognise cardiac dysrrythmias-ventricular fibrillation&pulseless ventricular tachycardia.

In emergency kit:one automated external defibrillator

Plastic , disposable syringes with 18 or 21 gauge needles

2 ml syringes – emergency drug delivery

In emergency kit: 2-4 2 ml disposable syringes

In emergency kit: 2 plastic evacuators or tonsil suction tips

To administer IV drugsFor bloodless phlebotomy in acute

pulmonary oedema In emergency kit: 3 tourniquets & a

sphygmomanometer

To place endotracheal tube during nasal intubation

It is a blunt ended scissor with a right angled bend which permits the forceps to grasp objects deep in the hypopharynx

In emergency kit: one pediatric size Magill intubation forceps

Secondary injectable drugs1.Anticonvulsants2.Analgesics3.Vasopressors4.Antihypoglycemics5.Corticosteroids6.Antihypertensive7.Anticholinergic

DRUG OF CHOICE: MidazolamPROPRIETARY: VersedDRUG CLASS: BenzodiazepineALTERNATIVE DRUG: Diazepam

DRUG OF CHOICE: Morphine sulphate PROPRIETARY: none DRUG CLASS: Opioid agonist ALTERNATIVE DRUG: Meperidine; nitrous oxide & oxygen (N2O-O2) THERAPEUTIC INDICATIONS: Pain & anxiety in ischemic chest

pain SIDE EFFECTS: potent CNS & respiratory depressants CONTRAINDICATIONS: injury & multiple trauma AVAILABILITY: 8,10, 15 mg/ml in 2 ml ampules & 20 ml

vials morphine sulfate, 50, 100 mg/ ml Meperidine in 1 ml ampule & 20,

30 ml vials In emergency kit: 10 mg/ml morphine sulfate (2, 2ml

ampules) 50 mg/ml Meperidine (2, 2ml ampules)

DRUG OF CHOICE: PhenylephrinePROPRIETARY: ManyDRUG CLASS: VasopressorALTERNATIVE DRUG: noneTHERAPEUTIC INDICATIONS: 1.manage hypotension2.Syncopal reactions3.Drug-overdose reactions4.Post-seizure states5.Acute adrenal insufficiency6.allergy

PRECAUTIONS: hyperthyroidism, bradycardia, partial heart block, myocardial disease, severe atherosclerosis

CONTRAINDICATIONS: parenteral administration is contraindiacted in patients with high BP, or ventricular tachycardia

AVAILABILITY: 10 mg/ml in 1 ml ampules IN EMERGENCY KIT: 10 mg/ml 2 – 3, 1 ml

ampules

DRUG OF CHOICE: Dextrose, 50 % solution PROPRIETARY: none DRUG CLASS: Antihypoglycemics ALTERNATIVE DRUG: Glucagon THERAPEUTIC INDICATIONS: treatment of hypoglycemia,

diagnostic aid in unconsciousness or seizures of unknown origin

SIDE EFFECTS: 50% dextrose solution administered IV – tissue necrosis if extravascular infiltration occurs

CONTRAINDICATIONS: IV or IM glucagon in starvation or chronic hypoglycemia

AVAILABILITY: 50 % dextrose in 30 ml glass Glucagon in 1mg of dry powder with 1 ml of diluents IN EMERGENCY KIT: 50% dextrose 1-2 vials (IV) or

1mg/ml glucagon (IV or IM)

DRUG OF CHOICE: Hydrocortisone sodium succinate

PROPRIETARY: Solu-CortefDRUG CLASS: Adrenal

glucocorticosteroidALTERNATIVE DRUG: none

THERAPEUTIC INDICATIONS: definitive management of acute allergy, in acute adrenal insufficiency

PRECAUTIONS: peptic ulcer, pre-existing infection, hyperglycemia

AVAILABILITY: Hydrocortisone sodium succinate 50 mg/ml, (2ml vials)

IN EMERGENCY KIT: 1, 2ml vial

DRUG OF CHOICE: Esmolol PROPRIETARY: Brevibloc DRUG CLASS: β-Adrenergic blocker ALTERNATIVE DRUG: Propanolol THERAPEUTIC INDICATIONS: acute hypertensive

episodes, as antidysrhythmic agent in PSVT, intra-operative & post-operative tachycardia

CONTRAINDICATIONS: sinus bradycardia, heart block greater than 1st degree, cardiogenic shock, overt heart failure

AVAILABILITY: 2.5 g in 10 ml ampule which is diluted to a 10 mg/ml concentration prior to infusion

IN EMERGENCY KIT: 2 ampules (100 mg/ml) with diluents

DRUG OF CHOICE: Atropine PROPRIETARY: none DRUG CLASS: Anticholinergic ALTERNATIVE DRUG: none THERAPEUTIC INDICATIONS:bradycardia,

hemodynamically significant bradydysrhythmias SIDE EFFECTS: hot, dry skin, headache, blurred near-

sightedness , dry mouth throat, disorientation & hallucinations

CONTRAINDICATIONS: glaucoma, prostatic hypertrophy AVAILABILITY:0.5 mg/ml in 1 ml vials 7 1 mg/ml in 10

ml pre-loaded syringes IN EMERGENCY KIT: 2 or 3 ampules of 0.5 mg/ml (IM) or

2, 1o ml syringes (IV)

1. Respiratory stimulant2. Antihypertensives

DRUG OF CHOICE: Aromatic ammonia

PROPRIETARY: noneDRUG CLASS: Respiratory stimulantALTERNATIVE DRUG: none

THERAPEUTIC INDICATIONS:to treat respiratory depression not induced by opioid analgesics ,vasodepressor syncope

SIDE EFFECTS:irritating effects on mucous membrane of upper respiratory tract precipitates bronchospasm

CONTRAINDICATIONS: chronic obstructive pulmonary disease or asthma

Availability :silver grey vaporoles containing 0 .3ml of ammonia

IN EMERGENCY KIT: one or two boxes of vaporoles

DRUG OF CHOICE: NifedipinePROPRIETARY: ProcardiaDRUG CLASS: Calcium channel blockerALTERNATIVE DRUG: NitroglycerinTHERAPEUTIC INDICATIONS:hypertension,acute

anginal painSIDE EFFECTS:excessive hypotension CONTRAINDICATIONS: in patients receiving β-

blockers, patients undergoing anasthesia with high doses of fentanyl

AVAILABILITY:10mg or20 mg capsules IN EMERGENCY KIT: one bottle of 10mg capsules

1. Scalpel or cricothyrotomy needle2. Artificial airway3. Laryngoscope & endotracheal tubes4. Laryngeal mask airway

Indicated when all other noninvasive procedure fail to secure a patent airway

In emergency kit: 1 scalpel with a disposable blade

1 cricothyrotomy device

Plastic or rubber oropharyngeal or nasopharyngeal airways used

Used to assist in maintenance of patent airway in unconscious patient

Act by lifting the base of the tongue off the posterior pharyngeal wall

In patients who are not deeply unconscious – gagging, regurgitation, vomiting

Available in variety of sizes: child, small adult & large adult

In emergency kit: 1 set of each adult & pediatric nasopharyngeal airways

These are advanced airway devicesEndotracheal intubation uses a laryngoscope

to visualize the trachea & an endotracheal tube

Advantages: isolation of the airway preventing aspiration

Facilitation of ventilation & oxygenationFor the easy administration of emergency

drugs In emergency kits: 1 laryngoscope & a set of

spare batteries & assorted adult & pediatric size endotracheal tubes

Laryngeal mask airway maintains airway during anaesthesia

The airway is a tube & a small mask with an inflatable circumferential cuff intended for placement in victim’s posterior pharynx which seals the base of the tongue & laryngeal opening

Very high success rate; low complication rate

Essential ACLS drugs include:EpinephrineOxygenLidocaineAtropineDopamineMorphine sulfateVerpamil

CATEGORY GENERICNAME

PROPRIETARY NAME

ALTERNATIVE QUANTITY AVAILABILTY

Cardiac arrest Epinephrine Adrenaline - 3×10 ml

syringe

1:10,000 concentrati

onOxygen Oxygen - - 1E

cylinder

Antidysrhythmic

Lidocaine Xylocaine Procainamide 1× 5ml ampule

100 mg

Symptomatic bradycardia

Atropine Atropine Isoproternol 2×10ml syringe

1 mg/10 ml

Symptomatic

hypotension

Dopamine Intropin Dobutamine

2×5 ml ampule

s

80 mg/ml

Analgesic Morphine Morphine Meperidine

2×2 ml ampule

s

10 mg /ml

PSVT Verapamil Isoptin - 1×4 ml ampule

s

2.5 mg/ml

Drug class: catecholamine Alternative drug: noneProprietary name: Ana-guard, Epi-

pen, Twinject,

DRUG CLASS: Endogenous catecholamine ALTERNATIVE DRUG : none PROPRIETARY: Adrenaline ACTIONS: Maintains coronary artery blood flow while CPR in progress- life saving in cardiac arrest THERAPEUTIC INDICATIONS: Cardiac arrest including ventricular

fibrillation, pulseless ventricular

tachycardia, asystole, pulseless

electrical activity SIDE EFFECTS: exacerbate ventricular ectopy in patients receiving Digitalis AVAILABILITY: 1:10,000 conc in pre-loaded 10 ml syringes In emergency kit: 2 - 3 pre-loaded syringes

Essential in cardiac resuscitation & emergency cardiac care

Prevents hypoxiaSide effect: toxicity on long term

administrationAVAILABILITY: 1 E-cylinder

DRUG CLASS: local anesthetic, anti-dysrhythmic

ALTERNATIVE DRUG: ProcainamidePROPRIETARY: XylocaineTHERAPEUTIC INDICATIONS: i. Primary anti-dysrhythmic drugii.In premature ventricular contraction ( coupled, multi-focal

iii.Ventricular tachycardiaiv.Ventricular fibrillation

SIDE EFFECTS: myocardial, circulatory & CNS depression

• Overdose:Drowsiness, paraesthesia, muscle twitching • Severe overdose: Tonic clonic seizuresCONTRAINDICATION: Depressed hepatic functionAVAILABILITY: - as IV injection in 5 ml pre-filled syringes(50/100mg)

- 5 ml ampules of 100 mg IN EMERGENCY KIT: 1 -100 mg pre-loaded syringe 1 - 5 ml ampule

DRUG CLASS: ParasympatholyticALTERNATIVE DRUG: IsoprotrenolPROPRIETARY: AtropineTHERAPEUTIC INDICATION: i. haemodynamically significant

bradydysrhythmiasii.Asystole refractory to epinephrine

ISOPROTRENOLSynthetic sympathomimetic amine Increases cardiac output Increases myocardial oxygen consumption

DRUG CLASS: Sympathomimetic amine ALTERNATIVE DRUG: Dobutamine PROPRIETARY: Intropin THERAPEUTIC INDICATION: haemodynamically significant hypotension in absence of

hypovolemia MODE OF ACTION: Large doses stimulates both α & β adrenergic receptors• Small doses dialates mesentric, renal & cerebral

arteries• Also stimulates the release of nor-epinephrine

SIDE EFFECTS i. Exacerbate supraventricular or ventricular dysrhythmias

ii.Exacerbates myocardial ischemiaCONTRAINDICATIONS:In patients receiving monoamine oxidase inhibitors

(Isocarboxazid, pargyline, tranyl-cypromine, phenelzine)

AVAILABILITY: 200, 400 & 800 mg in 5 ml ampules IN EMERGENCY KIT: 1-2 400 mg ampules

DRUG CLASS: Opioid agonist ALTERNATIVE DRUG: Meperidine PROPRIETARY: Morphine THERAPEUTIC INDICATIONS:Pain & anxiety in ischemic

chest pain SIDE EFFECTS: potent CNS & respiratory

depressants CONTRAINDICATIONS: injury & multiple trauma AVAILABILITY: 10 mg/ml morphine sulfate, 50 mg/ ml Meperidine

DRUG CLASS: Calcium channel blockersALTERNATIVE DRUG: nonePROPRIETARY: IsoptinTHERAPEUTIC INDICATIONS:Paroxysmal supraventricular tachycardia

SIDE EFFECTS: transient decrease in arterial pressure, severe hypotension, ventricular fibrillation

CONTRAINDICATIONS: ventricular tachycardiaAVAILABILITY: 2.5 mg/ml in 2 ml & 4 ml ampules IN EMERGENCY KIT: 1-2 4 ml ampules

OPIOID ANTAGONISTSBENZODIAZEPENESANTIEMERGENCE DELIRIUM DRUGVASODILATOR

CATEGORY GENERICNAME

PROPRIETARY NAME

ALTERNATIVE

QUANTITY AVAILABILTY

Narcotic antagonist

NALOXONE NARCAN NALBUPHINE 2×1 ml ampule

s

0.4 mg/ml

Benzodiazepine antagonist

FLUMAZENIL MAZICON - 1×10 ml vial

0.1 mg/ml

Antiemergence delirium

PHYSOSTIGMINE ANTILIRIUM - 2×2 ml ampule

s

1 mg/ml

vasodilator PROCAINE NOVOCAIN - 2×2ml ampule

s

10mg/ml

DRUG CLASS: Thebaine derivativeALTERNATIVE DRUG: NalbuphinePROPRIETARY: NarcanTHERAPEUTIC INDICATIONS:Opioid induced depression including respiratory

depressionSIDE EFFECTS: respiratory depression recurs when administered parenterallyCONTRAINDICATIONS: use with extreme care in

physical dependanceAVAILABILITY: 0.4 mg/ml in 1 ml ampules & 10 ml vialsPEDIATRIC ADMINISTRATION: 0.02 ml in 2 ml ampules IN EMERGENCY KIT: 2 - 1 ml ampules

DRUG CLASS: Benzodiazepine antagonist ALTERNATIVE DRUG: None PROPRIETARY: Romazicon MODE OF ACTION: o Rapid reversal of sedationo Increased alertnesso Decreased amnesic effect in geriatric population THERAPEUTIC INDICATIONS:o Reverse the clinical actions of parenterally

administered Benzodiazepenes SIDE EFFECTS & CONTRAINDICATIONS:o Rebound anxiety AVAILABILITY: 0.1 mg/ml in 5 ml ampules & 10 ml

vials IN EMERGENCY KIT: 1 - 10 ml vial

DRUG CLASS: Cholinesterase inhibitor ALTERNATIVE DRUG: None PROPRIETARY: Antilirium THERAPEUTIC INDICATIONS:Reverse emergence delirium Emergence delirium:i. loss of contact with reality due to drugs like

Scopolamine,benzodiazepenes, diazepam, midazolam.ii. Patient makes unintelligible sounds, increased muscular

movement MODE OF ACTION: reversible cholinesterase inhibitor, can

cross BBB

SIDE EFFECTS i. Increased salivationii.Possible emesisiii.Involuntary urination & defecationiv.Bradycardia & hypersalivation CONTRAINDICATIONS:i. Asthmaii.Diabetesiii.Cardiovascular diseasesiv.Mechanical obstruction of gastrointestinal

genito-urinary tract AVAILABILITY: 1 mg/ml in 2 ml ampules IN EMERGENCY KIT: 2-3 ampules

DRUG CLASS: Local anesthetic ALTERNATIVE DRUG: None THERAPEUTIC INDICATIONS:i. Vasospasm & compromised circulation following

intra-arterial administration of a drugii. Management of pain & vascular compromise

following extravascular administration of irritating drugs

SIDE EFFECTS & CONTRAINDICATIONS:History of local

anesthetic allergy

AVAILABILITY: 1% (10 mg/ml) solution in 2 & 6 ml ampules

IN EMERGENCY KIT: 2 - 2ml ampules

Should not be complicated Only those drugs and equipment which

doctor is familiar should be included Should be stored in plastic box with

several compartments Labels should be applied in each

compartment containing generic and proprietary names and dosage and expiry dates