Procedure Manual

Medication Administration

Endotracheal Medication Administration


In life-threatening emergencies when drug therapy is vital to patient survival and an IV line cannot be established. Dosage for medications administered via this route must be 2-2.5 times the IVP dose.


  • Medication to be administered:
    • Narcan
    • Atropine
    • Epinephrine (use 10 × IV dose if less than 8 years old)
    • Lidocaine
  • Endotracheal tube with proper placement confirmed by capnography
  • BVM or automatic ventilator


  • Dilute agent in 10 ml normal saline if > 8 years and up to 5 ml if < 8 years old
  • If performing CPR, stop compressions momentarily
  • Detach BVM inject and medication directly into the endotracheal tube
  • Immediately re-attach BVM to tube and ventilate with 5 breaths
  • Resume CPR if patient in cardiac arrest

Intranasal Mucosal Atomization Device

Intranasal Mucosal Atomization Device Procedure

Rectal Administration of Diazepam Gel (Diastat®)


  • Inability to establish peripheral IV access
  • Patient in status seizure activity with Diastat available for home administration


  • Select appropriate dose of medication based on patient’s prescription

Diazepam Gel Rectal Administration Procedure