Transport Medications Role 1
For Role 1 Transport, the focus will be on delivering medications for 4 purposes.
Hemostasis (highest priority)
Oral options include Ondansetron (Zofran).
The standard adult dose is 8 mg every 6-8 hours.
Available in pill and preferrred ODT (Oral Dissolving Tablet)
Parenteral options include Promethazine (Phenergan).
DO NOT ADMINISTER IV; IM USE ONLY
The standard dose is 12.5 to 25 mg IM every 6-8 hours.
Oral options include Paracetamol/Acetaminophen and NSAIDs.
MOAS is administering a combination dose pack of Paracetamol + NSAID to any patient who can take medication by mouth. The choice of NSAID varies with availability
Analgesic Oral Single Dose Packs have been prepared.
Paracetamol 1000 mg + Meloxicam 15 mg
Parenteral analgesics available include Ketorolac, an NSAID, and possibly an opioid analgesic based upon availability.
Ketorolac 15-30 mg IV; 30-60 mg IM
Nalbuphine (synthetic mixed agonist-antagonist opioid)
The usual recommended adult dose is 10-20 mg for a 70 kg individual, administered subcutaneously, intramuscularly, or intravenously; this dose may be repeated every 3 to 6 hours as necessary. Individual dose not to exceed 20 mg. Start low and go slow to minimize adverse effects
Given to ALL patients with open or penetrating trauma or in whom emergency surgery is anticipated (surgical antibiotic prophylaxis).
Oral single-dose options (emergency surgery is NOT anticipated) include the following.
Cephalexin 2000 mg + Doxycycline 200 mg PO
Moxifloxacin 400 mg + Doxycyline 200 mg PO
Parenteral single-dose (Emergency Surgery IS anticipated) options include the following.
Ceftriaxone 2000 mg IV
Ceftriaxone 2 gm IV + Metronidazole 500 mg IV
Cefazolin 2 gm IV + Metronidazole 500 mg IV
Tranexamic Acid given within 3 hours of hemorrhagic trauma has been shown to decrease mortality by 30%.
It is the highest priority to administer Tranexamic Acid AS SOON AS POSSIBLE.
May be administered IM/IV/PO.
IM dose is 10 ml and as a consequence is considered the last option
MOAS protocol is to administer an oral dose of 1950 mg (650 mg x 3) as soon as possible to ALL patients with hemorrhagic trauma.
These are pre-packed for ease of administration.
Bioequivalent dose IM/IV 1000 mg = Oral 1950 mg