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EMERGENCY & CPR RELATED University of Iowa Hospitals and Clinics Department of Nursing Childrens and Womens Services

SUBJECT: PURPOSE: POLICY: PROCEDURE: Emergency Drug List 1. 2. 3. 4. 5. Sign on to the computer terminal. Select Master - PF10 at bottom of screen. Select Display Nursing Pharmacy Master. Select Print Emergency Drug List from the master list. The unit census will come on the screen. Select desired patient if on the unit. If patient is not on the unit, select any patient but use body weight of patient being admitted. (See PRECAUTIONS, CONSIDERATIONS, AND OBSERVATIONS.) Select Emergency Drug List: Neonate for Special Care Nurseries. Select Emergency Drug List: Pediatric for patients on general care areas and PICU. A screen asking for body weight will come on. Type in the patient's body weight in kilograms, then press ENTER key. A screen will come on with the patient's weight displayed. Select C (continue) if patients weight is correct. If patient's weight is not correct, select R (return) to type in correct body weight. When patient's weight is correctly entered, the emergency drug list will be printed and the screen will return to the master menu screen. For patients with renal failure or fluid overload, use patients dry weight. Emergency and Infusion Drug List To provide the nurse with an accurately calculated list of emergency drugs and drugs to be given by IV drip.

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PROCEDURE: Infusion Drug List 1. 2. 3. 4. 5. Sign on to the computer terminal if not already signed on. Select Master - PF10 at bottom of screen. Select Display Nursing Pharmacy Master. Select Display Infusion Drug List from the master list. The unit census will come on the screen. Select desired patient if on the unit. If patient is not on the unit, select any patient but use body weight of patient being admitted (see PRECAUTIONS, CONSIDERATIONS, AND OBSERVATIONS).

-26. Select Infusion Drug List: Pediatric for patients weighing less than 40 Kg. Select Infusion Drug List for patients weighing 40 Kg or more. (Infusion Drug List: Pediatric may be used for patients over 40 Kg, if desired.) a. When Infusion Drug List is selected, a screen with the drugs, body weight, and drug concentration will be displayed. 1) 2) 3) 4) 5) 6) 7) b. Type in patient's body weight in kilograms. Type in desired drug concentration in mg/ml. Select drug desired or type in drug name if not on the list provided. Press ENTER key. The patient's weight will be displayed on the screen. Select C (continue) if patient's body weight is correct. If weight is not correct, select R (return) to type in correct body weight. Select N (new list) if you want to change the concentration of the drug or choose a different drug. Select P (print) if you want to print out a copy of the infusion drug list. When P is selected, the screen will return to the drug list.

When Infusion Drug List: Pediatric is selected, a screen with the drugs, body weight, dose, and infusion rate is displayed. 1) 2) 3) 4) 5) 6) Type in patient's body weight in kilograms. Type in drug dosage in mcg/Kg/min. Type in infusion rate in ml/hr. Select drug desired or type in drug name not on the list provided. Press ENTER key. A screen will be displayed with the patient's weight. Select C (continue) if patient's body weight is correct. If weight is not correct, select R (return) to type in correct body weight. When patient's weight is correctly entered, a screen will display patient's weight, drip rate, and dose (in mcg/Kg/min). Select N (new list) if you want to change the concentration of a drug or choose a different drug. Select P (print) if you want to print out a copy of the infusion drug list. When P is selected, the screen will return to the drug list.

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Select Master to return to the master menu screen.

PRECAUTIONS, CONSIDERATIONS, AND OBSERVATIONS: 1. 2. 3. 4. Help screen may be obtained by selecting "Help" on many of the screens to provide assistance in completing the Emergency Drug List and the Infusion Drug List. An asterisk (*) appearing to the left of the drip rate on the infusion drug lists indicates that it exceeds 4 ml/Kg/hr. An asterisk (*) appears to the left of each dose on the infusion drug lists when the dose is greater than the maximum recommended for the selected drug. If using a patient name other than the unadmitted patient, cross out the patient name on the printout so as not to confuse the unadmitted patient with a patient on the unit.

-35. If the computer is unavailable, calculating drip concentrations is easy by using the Rule of Sixes. 6 x child's weight in Kg = mg dose of medication added to 100cc IV fluids Each 1cc/hr of this concentration = 1 mcg/Kg/min Example for 7 kg child: 6 x 7 Kg = 42 mg dopamine/100cc D5W 6cc/hr = 6 mcg/Kg/min The exception to this rule is epinephrine and norepinephrine. With these potent drugs, dosing is smaller. Change the formula as follows: 0.06 x child's weight in Kg = mg of dose added to 100cc Each 1cc/hr = 0.01 mcg/Kg/min REFERENCE: Kelly, K. J., Neu, J., et al. (January 1984). Efficacy of a Programmed Calculator for ConstantInfusion Medication Calculations. Pediatrics, 73:1, pp. 68-70. Written: 9/86

Approved: Pediatric Nursing Procedure Committee, 9/86 Reviewed: 7/87; 6/88; 6/89; 6/92; 1/94; 5/98; 1/04 Revised: 8/90; 3/96; 1/01