Emergency Medicines

Emergency Medicines
Anaphylaxis
 Adrenaline (epinephrine) 500 micrograms in 0.5ml (1 in 1000) IM injection in pre-filled auto-
injector pen (Emerade ®)
Acute Coronary Syndromes

 Adrenaline (epinephrine) 1 mg in 10 ml (1 in 10,000) solution for injection in pre-filled syringe
 Aspirin 300 mg dispersible tablets
 Glyceryl Trinitrate (GTN) 400 micrograms/metered dose sublingual aerosol spray
Status Epilepticus
 Midazolam Buccal 10mg in 2ml Sugar Free oromucosal solution in prefilled syringe
 Diazepam 10mg rectal tubes
Hypoglycaemia
 40% Dextrose in aqueous gel for oral administration (Dextrogel® or GlucoGel®)
 Glucagon 1mg powder and solvent for solution for injection 1mg in 1ml (GlucaGen Hypokit ®)
 Glucose 10% w/v solution for infusion
Camden & Islington NHS Foundation Trust: Emergency medicines: PHA59: April 2017 1
Emergency Medicines
Overdose
 OPIOIDS - Naloxone Hydrochloride 400 micrograms/ml solution for injection
 BENZODIAZEPINE - Flumazenil 0.1 mg/ml solution for injection
Reversible airways obstruction

 Salbutamol 5mg in 2.5ml nebuliser solution
Meningococcal disease
 Benzyl Penicillin Sodium 600mg powder for injection
 Cefotaxime 1 g powder for injection
Dilution Liquids
 Water for Injections BP
 Sodium Chloride Injection BP 0.9% w/v
 Sodium Chloride Intravenous Infusion BP 0.9% w/v
Anaphylaxis
medicines in the emergency bag
Medicine name Adrenaline (epinephrine) 500 microgram in 0.5ml
Solution for IM injection in pre-filled pen
EMERADE®
Available in bag 2 x auto-injector pre-filled pen

Administration May be administered without a prescription for the purpose of
saving life in an emergency
• INTRAMUSCULAR (IM) injection
• Mid-point of the thigh, anterolateral aspect
• Injected as slowly as possible & ensure not directly into a blood vessel
• Further doses can be given at 5 - 15minutes intervals if the patient’s
condition dictates (monitor breathing, blood pressure and pulse)
• Can be injected through clothes
Dosage Adult
500 micrograms then repeat after 5 - 15 minutes as required
Anaphylaxis
Adrenaline 500 microgram in 0.5ml solution for injection

Pre-filled auto-injector pen (Emerade®)
Medicine name Adrenaline (epinephrine)
1 mg in 10 ml (1:10,000 ten thousand)
Solution for injection in pre-filled syringe
Available in bag 3 x Prefilled syringes
Administration • Intravenous adrenaline should only be administered by those experienced
in the use and titration of vasopressors in their normal clinical practice
• Endotracheal use should only be considered as a last resort if no other
route of administration is accessible
• Only clear colourless solution free from particles or precipitates should be
used
• Do not use if the pouch or the blister has been opened or if the tamper
evident seal on the syringe (plastic film at the basis of the end cap) is
broken
Dosage Adult
10 ml of the 1:10,000 (ten thousand) solution (1 mg) by the intravenous or

intraosseous route
Repeat every 3-5 minutes until return of spontaneous circulation
Adrenaline 1 mg/10 ml (1:10,000 ten thousand), solution for injection in pre-filled syringe
Discard the syringe after use, do not re-use
1) Tear open the aluminium pouch by hand only

using the indent(s). Do not use sharp
instruments to open the pouch
2) Withdraw the pre-filled syringe from the
sterile blister
3) Push on the plunger to free the bung. The
sterilisation process may have caused
adhesion of the bung to the body of the
syringe
4) Twist off the end cap to break the seals. Do
not touch the exposed luer connection in
order to avoid contamination
5) Check the syringe seal tip has been
completely removed. If not, replace the cap
and twist again
6) Expel the air by gently pushing the plunger
7) Connect syringe to vascular access device or
to needle. Push the plunger to inject the
required volume
Medicine name Aspirin 300 mg

Dispersible tablets
Available in bag 32 x 300 mg
Administration • By mouth: Disperse readily in water or chewed

• Offer people a single loading dose of 300 mg aspirin as soon as possible
unless there is clear evidence that they are allergic to aspirin
• If aspirin is given before arrival at hospital, send a written record that it has
been given with the person
Dosage Adult
300mg stat dose: for antithrombotic effect following myocardial infarction,

transient ischaemic attack, or in patients with unstable angina
Medicine name Glyceryl Trinitrate (GTN)

400 micrograms/metered dose
Sublingual aerosol spray
Available in bag 1 x 200 dose aerosol
Administration • One or two sprays should be administered into the mouth, preferably
onto or under the tongue
• Do not inhale spray
• The medication should not be expectorated or the mouth rinsed for 5 to 10
minutes following administration
• A spray may be repeated every 3-5 minutes as needed
• No more than three metered sprays are recommended within a 15-
minute period. If chest pain persists, prompt medical attention is
recommended
Dosage Adult
Treatment or prophylaxis of angina, spray 1–2 doses under tongue and then
close mouth. Dose may be repeated as required.
Glyceryl Trinitrate (GTN) 400 micrograms/metered dose

Sublingual aerosol spray
1. Remove the plastic cover
2. DO NOT SHAKE
3. Hold the container upright with forefinger on
top of the grooved button
4. Open the mouth and bring the container as
close to it as possible
5. Press the button firmly with the forefinger to
release the spray onto or under the tongue.
DO NOT INHALE THE SPRAY
6. Release button and close mouth. Avoid
swallowing immediately after administering
the spray. The medication should not be
expectorated or the mouth rinsed for 5 to 10
minutes following administration
7. If you require a second administration to
obtain relief, repeat steps 4, 5, and 6.
8. Replace the plastic cover
Status Epilepticus
Medicine name Midazolam Buccal Liquid 10mg in 2ml

Sugar Free
Available in bag 1 x prefilled syringe
Administration • Oromucosal use
• The full amount of solution should be inserted slowly into the space
between the gum and the cheek (buccal cavity)
• Approximately half the dose should be given slowly into one side of
the mouth, then the other half given slowly into the other side
• A second or repeat dose when seizures re-occur after an initial

response should only be given with prior medical advice
Dosage Adult
10mg, then 10mg after 10 minutes if required (unlicensed indication)
Status Epilepticus
Midazolam buccal liquid 10mg in 2ml
1. Hold the plastic tube, break the seal at

one end and pull the cap off. Take the
syringe out of the tube
2. Pull the red cap off the tip of the
syringe and dispose of it safely
3. Using the finger and thumb gently
pinch and pull back the child's cheek.
Put the tip of the syringe into the back
of the space between the inside of the
cheek and the lower gum
4. Slowly press the syringe plunger until
the plunger stops. The full amount of
solution should be inserted slowly into
the space between the gum and the
cheek (buccal cavity)
If necessary (for larger volumes and/or

smaller patients), approximately half the
dose should be given slowly into one side
of the mouth, then the other half given
slowly into the other side.
Status Epilepticus
Medicine name Diazepam 10mg Rectal Tubes

Available in bag 5 tubes
Administration To be administered rectally. Adults should be in the lateral position.
• Tear open the foil pack & remove the cap
• Insert the tube nozzle completely into the rectum
• Hold the tube with the spout downwards. The contents of the tube should
be completely emptied by using firm pressure with the index finger and
thumb
• To avoid suction, maintain pressure on the tube until it is withdrawn from
the rectum. Press the patient's buttocks together for a short time
Dosage Adult
10-20mg (elderly 10mg), repeat once after 10–15 minutes if necessary
• If convulsions are not controlled other anticonvulsive measures should be
instituted
• Elderly and debilitated patients should be given not more than one half the
appropriate adult dose
• Dosage reduction may also be required in patients with liver or kidney
dysfunction
Status Epilepticus
Diazepam 10mg
Rectal Tubes
(1 of 2)
1. Put the person on their side

2. Get the medicine
3. Get the tube
4. Push up with thumb and pull to remove
cap from tube. Seal should remove with
the cap
5. Lubricate rectal tip with lubricating jelly
6. Turn person on side facing you
7. Bend upper leg forward to expose
rectum
8. Separate buttocks to expose rectum
Status Epilepticus
Diazepam 10mg
Rectal Tubes
(2 of 2)
9. Gently insert tube tip into rectum

10. Slowly count to 3 while gently
pushing plunger in until it stops
11. Slowly count to 3 before
removing tube from rectum
12. Press the patient’s buttocks
together for a short time.
Camden & Islington NHS Foundation Trust:

14
Emergency medicines: PHA59: April 2017
Hypoglycaemia
Capillary Blood Glucose (CBG) less than 4 mmol/L
• Hypoglycaemia is a common complication of glucose lowering therapies, particularly insulin and
sulphonylureas (e.g. gliclazide)
• Elderly patients or those with renal impairment are at particular risk of hypoglycaemia
Mild Patient is conscious, able to swallow and cooperative

Dextrose gel 40%: Dextrogel® or GlucoGel®
Moderate Patient is conscious, can swallow, but in need of assistance

Glucagon injection: GlucaGen Hypokit®
Severe Patient is unconscious and/or unable to swallow
Glucose 10% w/v infusion
• Always follow up with slowly digested/starchy carbohydrate

• Check glucose level. Once it is 4 mmol/l or above and patient has recovered, give ONE of the
following: 1 slice of bread; half a sandwich; a very small bowl of cereal; a glass of milk with 1 Rich
Tea biscuit; or 1 banana
Note: Doses of insulin and oral hypoglycaemic medicine will need to be reviewed following an
episode of hypoglycaemia. Please contact Diabetes Specialist Nurse or doctor for advice.
Hypoglycaemia - mild
Medicine name Dextrogel® or GlucoGel®

40% Dextrose in an aqueous gel
Available in bag 3 x 25g plastic tubes
Administration For oral use only. Not to be given to unconscious

individuals
• Twist off cap and squeeze required amount inside
the cheek
• Gently massage the outside of the cheek to aid
absorption
• Alternatively, squeeze required amount into the
mouth and swallow
• Wait 10 minutes, recheck CBG and record. If still
below 4 mmol/L or if no physical improvement
repeat step 1
Dosage Adult
1-2 x 25g tube Dextrogel® or Glucogel®

Repeat after 10 -15 minutes if necessary
Hypoglycaemia - moderate
Medicine name Glucagon 1mg (GlucaGen Hypokit®)

Powder and solvent for solution for injection
(1mg in 1ml)
Available in bag 1 x 1mg powder and solvent for solution for injection
• Inject the water for injection (1.1 ml) into the vial containing compacted
powder
• Shake the vial gently until the glucagon is completely dissolved and the
solution is clear. Withdraw the solution back into the syringe
• The reconstituted solution appears clear and colourless and forms an
injection of 1 mg (1 unit) per ml
• Administer by intramuscular injection. The patient will normally respond
within 10 minutes
Dosage Adult
1 mg, if no response within 10 minutes intravenous glucose must be
given
Glucagon is contraindicated in patients with Phaeochoromocytoma and may
be ineffective in chronic hypoglycaemia, starvation, and adrenal insufficiency
Hypoglycaemia - moderate
GlucaGen Hypokit® 1mg powder and solvent for solution for injection
1. Push the orange plastic cap 2. Without withdrawing the 3. Ensure that the plunger is 4. The solution is used for
off the vial. Pull the needle cover syringe and needle gently shake completely depressed. injection. Ensure there is no air
off the syringe and insert the the vial until GlucaGen is Withdraw all of the solution remaining in the syringe before
needle through the rubber disc completely dissolved and the back into the syringe. Be careful giving the injection. When the
of the vial. Inject all the liquid solution is clear that the plunger is not pulled patient responds administer oral
from the syringe into the vial. out of the syringe carbohydrate to prevent a
further “hypo”
Hypoglycaemia - severe
Medicine name Glucose

10% w/v Solution for Infusion
Available in bag 1 x 500ml
Administration • Glucose 10% w/v solution for intravenous infusion is a hypertonic solution
• The osmolarity of a final admixed infusion solution must be taken into
account when peripheral administration is considered
• A gradual increase of flow rate should be considered when starting
administration of glucose-containing products
• Caution irritant & may cause extravasation
Dosage Adult
Give 150-160mls 10% w/v Glucose intravenously (if patient has IV access)
over 10-15 minutes
Overdose - OPIOID
Medicine name Naloxone Hydrochloride

400 micrograms per 1ml solution for injection
Available in bag 10 x 400 micrograms in 1ml ampules

• Naloxone hydrochloride may be administered by intramuscular (IM) or
subcutaneous (SC) injection
• Caution: Lower doses may be required for management of opioid-induced
respiratory depression and sedation in those receiving palliative care or
chronic opioid use, in particular for pain management.
• Naloxone has a short duration of action; repeated doses may be necessary
to reverse effects of opioids with longer duration of action
Dosage Adult
Initially 400 micrograms, repeat every 2-3 minutes.

Further doses may be required if respiratory function deteriorates
Overdose – BENZODIAZEPINE
Medicine name Flumazenil 0.1 mg / 1ml solution for injection
5ml ampoules containing 500 micrograms
Available in bag 5 x 5ml ampoules (500 micrograms)
Administration • Flumazenil must be administered by medical staff only
• Intravenous (IV) administration
• Avoid rapid injection in high risk patients
• Short-acting (repeat doses may be necessary - benzodiazepine effects
may persist for at least 24 hours)
• Caution: prolonged benzodiazepine therapy for epilepsy (risk of
convulsions)
• Caution: head injury (rapid reversal of benzodiazepine sedation may
cause convulsions)
Dosage Adult (Unlicensed indication)
200 micrograms over 15 seconds, then 100 micrograms at 60-second

intervals if required.
Usual dose range, 300–600 micrograms; max. total dose 1 mg
Reversible airways obstruction
Medicine name Salbutamol

5mg in 2.5ml nebuliser solution
Available in bag 20 x 5mg in 2.5ml ampoules
Administration
• To be administered by a suitable nebuliser, via a face mask or T piece or
via an endotracheal tube
• To be breathed in through the mouth
Dosage Adult
The usual starting dose is 2.5mg as a single dose. This may be increased to
5mg.
• Salbutamol Nebuliser Solution is designed to be used undiluted. However,
if a prolonged delivery time is indicated (more than 10 minutes) then
dilution with Sodium Chloride Solution (0.9% w/v) for nebulisation may be
required
• For oxygen driven delivery patients should be given 5mg for 5 minutes with
6 litres of oxygen
Reversible Airways Obstruction
Salbutamol 5mg in 2.5ml nebuliser solution
1. Open the plastic ampoule,

take a strip of ampoules
from the foil pack
2. Remove one ampoule,
replacing the rest back in
the foil pack, and replace
the foil pack back in the
carton
3. Hold the ampoule upright
and open it by twisting off
the top
4. Squeeze the liquid into the
solution holder of the
machine or the chamber
of the nebuliser mask
Meningococcal Disease
Medicines in the Emergency Drug Cupboard
(not in emergency bag)
• Single dose should be given, if time, whilst waiting for urgent transfer to hospital
• If possible obtain a blood sample (white blood cell count and lactate) for culture analysis
Medicine name Benzyl penicillin sodium Penicillin allergic

600mg Cefotaxime 1g
powder for injection powder for injection
Administration • Intramuscular (IM) • Intramuscular (IM)
• Dissolve in 1.6 to 2.0 ml of • Reconstitute with 4ml of Water for
Water for Injections BP Injections BP
• Reconstituted solutions are for • Shake well until dissolved
immediate administration • Reconstituted solutions are for
immediate administration
Dosage Adult Adult
• 1200 mg STAT before transfer • 1 g STAT before transfer to

to hospital unless history of hospital
anaphylaxis (Not just allergy).
Dilution Liquids
in the emergency bag
Medicine name Water for Injections BP

Each 1ml of solution contains 1ml of Water for Injections B.P.
Available in bag 10 X 10ml ampoules
Administration • To be used for dilution or reconstitution of certain medicinal products

for parenteral administration
• Not be administered alone, may cause haemolysis
Dosage Refer to the instructions for each individual medicinal product for details
of volume of diluent and route of administration
Dilution Liquids
Medicine name Sodium Chloride Injection BP 0.9% w/v

Each ml contains 0.9% Sodium Chloride in Water for Injections
Available in bag 5 X 10ml ampoules
Administration To be used for dilution or reconstitution of certain medicinal products

for parenteral administration
Dosage Refer to the instructions for each individual medicinal product for
details of volume of diluent and route of administration
Dilution Liquids
Medicine name Sodium Chloride Intravenous Infusion BP 0.9% w/v
Available in bag 1 x 500ml
Administration • For intravenous use: Sodium chloride 0.9% intravenous infusion

contains Na+ and Cl- each 150 mmol/litre
• The solution is for administration by intravenous infusion through a
sterile and non-pyrogenic administration set using aseptic
technique
• Do not administer unless solution is clear, free from visible particles
and the seal intact
Dosage • Treatment of isotonic extracellular dehydration and sodium

depletion: 500 ml to 3 litres / 24 hours
• Recommended dosage when used as a vehicle or diluent ranges
from 50 to 250 ml per dose of medicinal product to be administered
• Treatment for Sepsis: With a bolus of 500ml over less then 15
minutes
References
ANAPHYLAXIS:
1. C&I Foundation Trust Anaphylaxis Guidelines May 2014
2. Resuscitation Council (UK) Emergency treatment of anaphylactic reactions: Guidelines for healthcare providers. www.resus.org.uk
January 2008 (annotated with links to NICE guidance in July 2012)
3. NICE clinical guidance (CG 134): Anaphylaxis: assessment to confirm an anaphylactic episode and the decision to refer after emergency
treatment for a suspected anaphylactic episode. Available at: https://www.nice.org.uk/guidance/CG134 (Accessed: 10/05/2016)
4. EMC (2016) Emerade, 500 micrograms, solution for injection in pre-filled pen, Available at:
https://www.medicines.org.uk/emc/medicine/28631 (Accessed: December 2016).
5. BNF - Medicines Complete (2016) ADRENALINE/EPINEPHRINE, Available at
http://dx.doi.org/10.18578/BNF.844811582 (Accessed: December 2016)
CARDIAC ARREST
1. BNF On line, Medical emergencies in the community, Available at: https://www.medicinescomplete.com/mc/bnf/current/PHP78126-
medical-emergencies-in-the-community.htm?q=soluble%20aspirin&t=search&ss=text&tot=8&p=6#_hit (Accessed: 02/11/2016).
2. Handbook of Drug Administration via Enteral Feeding Tubes , Dispersible aspirin, Available at
:https://www.medicinescomplete.com/mc/tubes/current/c38.htm?q=aspirin&t=search&ss=text&tot=2&p=1#_hit (Accessed: 2/11/2016)
3. Thomas & Guy Foundation Trust - Using your GTN spray to treat your chest pain, Leaflet number: 2484/VER3 Date published:
February 2016 © 2016 Guy’s and St Thomas’ NHS Foundation Trust. Available at:
http://www.guysandstthomas.nhs.uk/resources/patient-information/cardiovascular/using-your-GTN-spray-to-treat-your-chest-pain-
discomfort.pdf. (Accessed: 2/11/2016).
4. Drugs Data Base – NITROLINGUAL - nitro-glycerine spray, metered Physicians Total Care, Inc. Available at www.drugsDB.eu.
(Accessed on 2/11/206).
References
CARDIAC ARREST
1. BNF (Medicines Complete) (2016) Aspirin, Available at: http://dx.doi.org/10.18578/BNF.456850132 (Accessed: May 2016).
2. EMC (2015) Boots Aspirin 300mg Dispersible Tablets, Available at: http://www.medicines.org.uk/emc/medicine/30290 (Accessed: May
2016).
3. EMC (2016) Adrenaline 1 mg/10 ml (1:10,000), solution for injection in pre-filled syringe, Available at:
http://www.medicines.org.uk/emc/medicine/31592 (Accessed: May 2016).
STATUS EPILEPTICUS
1. Holsti M, Dudley N, Schunk J, Adelgais K, Greenberg R, Olsen C, Healy A, Firth S, & Filloux F (2010). Intranasal midazolam vs rectal
diazepam for the home treatment of acute seizures in paediatric patients with epilepsy. Archives of paediatrics & adolescent medicine,
164 (8), 747-53 PMID: 20679166
2. Wong L, McQueen KD. Midazolam routes of administration. DICP Ann Pharmacother 1991; 25: 476–7. PubMed
3. EMC (2016) BUCCOLAM 2.5mg, 5mg, 7.5mg and 10 mg oromucosal solution,Available at:
https://www.medicines.org.uk/emc/medicine/25538 (Accessed: October 2016).
4. BNF - Medicines Complete (2016) DIAZEPAM, Available at http://dx.doi.org/10.18578/BNF.273684709 (Accessed: August 2016)
5. EMC (2015) Diazemuls, Available at: http://www.medicines.org.uk/emc/medicine/520 (Accessed: August 2016).
EMC (2015) Diazepam RecTubes 10mg, Available at http://www.medicines.org.uk/emc/medicine/12170 (Accessed: August 2016).
6. Orange County EMS (2016) Rectal Administration of Diazepam Gel , Available at
http://www.orangecountyfl.net/emsref/EMSrefMainMenu/ProcedureManual/MedicationAdministration.aspx (Accessed: September
2016).
References
HYPOGLICAEMIA
1. Baldwin E.J, Feher, M.D Sweets, fluids and food in the treatment of mild hypoglycaemia. Practical diabetes international 2006 , Vol 23,
N 5, p 218-220
2. Diabetes UK (2016) HYPOS AND HYPERS, Available at: http://www.diabetes.org.uk/ (Accessed: November 2016).
3. BNF (Medicines Complete) (2016) GLUCAGON, Available at: http://dx.doi.org/10.18578/BNF.127583135 (Accessed: October 2016).
4. Dr M.Barnard, E. Baker - Whittington Trust Hospital (2013) Hypoglycaemia Management for Adult Inpatients with Diabetes, Available
at: http://www.whittington.nhs.uk/diabete s a (Accessed: September 2016).
5. EMC - SPC (2015) GlucaGen Hypokit 1 mg, Available at: http://www.medicines.org.uk/emc/medicine/4258 (Accessed: September
2016).
6. Medicines Complete (2016) Treatment of hypoglycaemia, Available at: http://dx.doi.org/10.18578/BNF.706830076 (Accessed:
November 2016).
7. NeoCeuticals Dextrogel - Fast Acting Dextrose Gel, Available at: http://www.dextro-gel.co.uk/ (Accessed: September 2016).
8. Novo Nordisk Pharmaceuticals Ltd. (2015) GlucaGen™ KIT 1 mg, Available at: http://doctor-deena.blogspot.co.uk/2015/12/how-to-use-
glucagon-for-treatment-of.html (Accessed: May 2016).
NALOXONE & FLUMAZENIL

1. BNF (Medicines Complete) (2017) FLUMAZENIL, Available at: http://dx.doi.org/10.18578/BNF.201031366 (Accessed: April 2017).
2. EMC (2012) Flumazenil 0.1 mg/ml solution for injection, Available at: http://www.medicines.org.uk/emc/medicine/26619 (Accessed: May
2016).
3. Flumazenil – Martindale (Medicines Complete (2016), available on line at:
https://www.medicinescomplete.com/mc/martindale/current/13215-d.htm?q=flumazenil&t=search&ss=text&tot=72&p=1#_hit
(Accessed October 2016)
4. International Medication Systems, Limited (2015) Naloxone hydrochloride injection , Available at :
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=236349ef-2cb5-47ca-a3a5-99534c3a4996 (Accessed: May 2016).
5. NICE Clinical guideline [CG16] (2004) Self-harm in over 8s: short-term management and prevention of recurrence, Available at:
https://www.nice.org.uk/guidance/cg16/chapter/1-Guidance (Accessed: May 2016).
References
REVERSIBLE AIRWAYS OBSTRUCTION
1. EMC (2016), Ventolin Nebules 2.5mg, 5mg Available at: http://www.medicines.org.uk/emc/medicine/102 (Accessed: December 2016).
2. BNF (Medicines Complete) (2016) , SALBUTAMOL Available at: http://dx.doi.org/10.18578/BNF.867541028 (Accessed: December
2016).
MENINGOCOCCAL DISEASE
1. EMC (2016),Cefotaxime Powder for solution for injection or infusion Available at:
https://www.medicines.org.uk/emc/medicine/7339 (Accessed: December 2016).
2. BNF (Medicines Complete) (2016) CEFOTAXIME, Available at: http://dx.doi.org/10.18578/BNF.400806124 (Accessed: December 2016).
3. EMC (2016), Benzyl penicillin sodium 600mg Powder for Injection Available at: https://www.medicines.org.uk/emc/medicine/2962
(Accessed: December 2016).
4. BNF (Medicines Complete) (2016) BENZYLPENICILLIN SODIUM(Penicillin G) , Available at: http://dx.doi.org/10.18578/BNF.975478351
(Accessed: December 2016).
5. C&I Foundation Trust Antimicrobial Guidelines available on Trust Intranet.
DILUTION LIQUIDS
1. EMC (2015) Sterile water for injection, Available at: http://www.medicines.org.uk/emc/medicine/28705 (Accessed: August 2016).
2. EMC (2016) Sodium Chloride Intravenous Infusion BP 0.9% w/v , Available at:
https://www.medicines.org.uk/emc/medicine/30221 (Accessed: August 2016).
3. BNF (Medicines Complete) (2016) , SODIUM CHLORIDE Available at: http://dx.doi.org/10.18578/BNF.345805218 (Accessed:
December 2016).
4. National Institute for Health and Care Excellence (July 2016) Sepsis: recognition, assessment and early management (NG51) available
at: nice.org.uk/guidance/ng51
LEGAL REQUIREMENTS
1. Human Medicines Regulations 2012 – SCHEDULE 19 Medicinal products for parenteral administration in an emergency . Available at
http://www.legislation.gov.uk/uksi/2012/1916/schedule/19/made (Accessed: December 2016)
2. Resuscitation Council UK (2016) , Mental health - Inpatient care - equipment and drug lists, Available at https://www.resus.org.uk/
(Accessed December 2016)

Emergency Medicines - PHA 59 - April 2017

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Acute Coronary Syndromes

Reversible airways obstruction

Available in bag 2 x auto-injector pre-filled pen

500 micrograms then repeat after 5 - 15 minutes as required

Adrenaline 500 microgram in 0.5ml solution for injection

10 ml of the 1:10,000 (ten thousand) solution (1 mg) by the intravenous or

1) Tear open the aluminium pouch by hand only

Medicine name Aspirin 300 mg

Administration • By mouth: Disperse readily in water or chewed

300mg stat dose: for antithrombotic effect following myocardial infarction,

Medicine name Glyceryl Trinitrate (GTN)

Glyceryl Trinitrate (GTN) 400 micrograms/metered dose

Medicine name Midazolam Buccal Liquid 10mg in 2ml

• A second or repeat dose when seizures re-occur after an initial

10mg, then 10mg after 10 minutes if required (unlicensed indication)

Midazolam buccal liquid 10mg in 2ml

1. Hold the plastic tube, break the seal at

If necessary (for larger volumes and/or

Medicine name Diazepam 10mg Rectal Tubes

1. Put the person on their side

9. Gently insert tube tip into rectum

Camden & Islington NHS Foundation Trust:

Mild Patient is conscious, able to swallow and cooperative

Moderate Patient is conscious, can swallow, but in need of assistance

• Always follow up with slowly digested/starchy carbohydrate

Medicine name Dextrogel® or GlucoGel®

Administration For oral use only. Not to be given to unconscious

1-2 x 25g tube Dextrogel® or Glucogel®

Medicine name Glucagon 1mg (GlucaGen Hypokit®)

Medicine name Glucose

Available in bag 1 x 500ml

Medicine name Naloxone Hydrochloride

Administration May be administered without a prescription for the purpose of

Initially 400 micrograms, repeat every 2-3 minutes.

200 micrograms over 15 seconds, then 100 micrograms at 60-second

Usual dose range, 300–600 micrograms; max. total dose 1 mg

Medicine name Salbutamol

Salbutamol 5mg in 2.5ml nebuliser solution

1. Open the plastic ampoule,

Medicine name Benzyl penicillin sodium Penicillin allergic

Dosage Adult Adult

• 1200 mg STAT before transfer • 1 g STAT before transfer to

Medicine name Water for Injections BP

Available in bag 10 X 10ml ampoules

Administration • To be used for dilution or reconstitution of certain medicinal products

Medicine name Sodium Chloride Injection BP 0.9% w/v

Available in bag 5 X 10ml ampoules

Administration To be used for dilution or reconstitution of certain medicinal products

Available in bag 1 x 500ml

Administration • For intravenous use: Sodium chloride 0.9% intravenous infusion

Dosage • Treatment of isotonic extracellular dehydration and sodium

NALOXONE & FLUMAZENIL

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