1Normal saline
Normal Saline
Bolus 500 mL IV
Titrate to SBP ≥ 90
2 L Maximum
Peds: 20 mL/kg IV / IO
Titrate age appropriate
SBP ≥ 70 + 2 x Age
Maximum 60 mL/kg
2Oxymetazoline (Afrin)
Oxymetazoline 2 Sprays to Nostril
Followed by Direct Pressure
3Ibuprofen
Ibuprofen 10 mg / kg PO
(if age > 6 months)
Adult Ibuprofen 400 – 600 mg PO
4Acetaminophen
Acetaminophen 15 mg / kg PO
Adult Acetaminophen 325 – 1000 mg PO
5Ketorolac (Toradol)
Ketorolac 15 mg IV / IO
30 mg IM
Peds: 0.5 mg/kg IV / IO / IM
Maximum 30 mg
6Fentanyl
Fentanyl 50 – 100 mcg IV / IO
Repeat every 5 minutes
Maximum 3 mcg/kg
Peds: 1 mcg/kg IV / IO / IM / IN
May repeat 0.5 mg/kg every 5 minutes
Maximum 2 mcg/kg
7Morphine
Morphine 4 mg IV / IO / IM
Repeat 2 mg every 5 minutes as needed
Peds: 0.1 mg/kg IV / IO / IM
May repeat every 5 minutes
Maximum 10 mg
8Ketamine
Ketamine 0.2 mg/kg IV / IO
Mix in 100 mL NS Infuse over 10 minutes
May repeat every 20 minutes
Maximum 30 mg single dose
9Nalbuphine
Nalbuphine 10 mg slow IV/IO/IM
Peds: 0.1 mg/kg slow IV/IO/IM
Maximum 10 mg
10Lorazepam
Lorazepam 1-2 mg IV/IM/IO
Peds: 0.05-0.1 mg/kg IV/IM/IO
Max 2 mg
Repeat every 5 min as needed
11Midazolam
Midazolam 0.5 – 2.5 mg IV / IO
5 mg IM or 2 mg IN
Peds: 0.1 – 0.2 mg/kg
IV / IO / IM / IN
12Diazepam
Diazepam 5 mg IV / IO
10 mg Per Rectum
Peds: 0.1 – 0.3 mg/kg IV / IO / IM
Peds rectal: 0.5 mg/kg
Repeat 2 mg every 3 to 5 minutes as
needed
Maximum 10 mg
13Norepinephrine
Norepinephrine
2-30 mcg/min IV/IO