A Message from the Central Arizona Regional EMS Medical Directors Consortium
As previously discussed, we will be adding the PediSTAT calculator to the CAREMSG. Go live is scheduled for Monday, July 7th.
Click the button below for instructions on how to use PediSTAT integrations with the CARES Guidelines:
PediSTAT has several pharmacists that reviewed all of our guidelines to ensure correct dosing. As mentioned at the last CAREMDC meeting, the calculator identified some dosing changes that needed to be made to conform with the weight-based dosing algorithm and clear up dosing ambiguity. The guidelines still list an option to use a lower dose for patients over a certain age; however, the calculator will calculate the fixed weight-based dose. The summary of the changes is outlined below:
Push Dose Epi:
- Added route of administration (IV/IO) that was missing throughout the document.
- Corrected the dosing to weight-based 1 mcg/kg to max 20 mcg per dose; previous version resulted in underdosing.
- These changes were applied to the Shock, Crashing Patient, Bradycardia, Bites and Envenomations guidelines along with the Push Dose Epi instructions.
Pain Management:
- Morphine dose updated to 4 mg increments to max total dose of 16 mg.
- Previous version was 2–5 mg increments to max total dose of 15 mg.
Seizure:
- Updated midazolam and lorazepam doses to weight-based dosing.
Hypoglycemia:
- Updated oral glucose to fixed dose instead of range.
- Glucagon was updated to remove conflicting doses for age/weight criteria.
Shock:
- Updated verbiage for IVF bolus for clarity.
Chest Pain:
- Eliminated Morphine for pain control per discussion at CAREMDC.
Agitated Patients:
- Adult lorazepam: removed range dose of 2–4 mg and changed to 2 mg increments.
- Pediatric midazolam: removed range dose for IM and IV/IO options.