Procedure Manual

Medication Administration

Endotracheal Medication Administration

Indications

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.

Equipment:

• 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

Technique:

• 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®)

Indications

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

Technique

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

Diazepam Gel Rectal Administration Procedure