Drug List

ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.

Medication Adult Dosing Pediatric Dosing

Adenosine
(Adenocard)  6mg IV/IO rapid push  0.1mg/kg IV/IO (max 6mg) push
over 1-3 seconds. If no over 1-3 seconds. If no effect
NCCEP Protocol: effect after 1-2 after 1-2 minutes.
*AC6-Adult Tachycardia Narrow Complex minutes,  Repeat with 0.2mg/kg IV/IO
*AC7-Adult Tachycardia Wide Complex  Repeat with 12mg IV (max 12mg)
*PC5-Pediatric Tachycardia push over 1-2 seconds.  Use stopcock or both ports and
 May repeat 12 mg once a NS flush with each dose
Indications/Contraindications: if necessary
 Specifically, for treatment or diagnosis  Use stopcock or both
of Supraventricular Tachycardia ports and a NS flush
with each dose

Albuterol
Beta-Agonist  2.5-5.0 mg in nebulizer  2.5-5.0 mg in nebulizer
continuously continuously
NCCEP Protocol:  May repeat 3 doses  May repeat 3 doses
*AM1- Allergic Reaction Anaphylaxis
*TB3- Crush Syndrome Trauma
*PM1 Pediatric Allergic Reaction
*AM1 Adult COPD/Asthma Respiratory
Distress
*AR7 Pediatric Asthma Respiratory Distress

Indications/Contraindications
 Beta-Agonist nebulized treatment for
use in respiratory distress with
bronchospasm
Aspirin


Ø
324-650 mg PO for pain
NCCEP Protocol: control
*UP11 Pain Control  81mg chewable (baby)
*AC4 Chest Pain aspirin. Give 4 tablets
to equal usual adult
Indications/Contraindications dose.
 An antiplatelet drug for use in cardiac
chest pain
 Don’t give Aspirin to a child, age less
than or equal to 15 years

1
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List
ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.

Medication Adult Dosing Pediatric Dosing

Amiodarone  150mg in 100mL of D5W IV/IO  Pediatric Wide Complex
infused over 10 minutes (preferred Tacycardia
NCCEP Protocol: method) 5mg/kg over 20-60 minutes
*AC6 Adult Tachycardia Narrow  150mg SLOW IV DILUTED in 10cc MC consult is recommended
Complex flush pushed over 10 minutes
*AC7 Adult Tachycardia Wide Complex  Bolus as needed for repeat  Cardiac Arrest
*AC8 Vfib/Pulseless Vtach symptoms 5mg/kg IV/IO (max dose 300mg)
*PC5 Pediatric Tachycardia May repeat 2X to a Maximum of
*PC6 Pediatric Vfib/Pulseless Vtach  Cardiac Arrest 15mg/kg
*PC7 Pediatric Post Resuscitation 300mg IV/IO initial dose
150mg IV/IO refractory dose
Indications/Contraindications
 Antiarrhythmic agent used to treat
ventricular arrhythmias and atrial
fibrillation.
 Avoid with hypersensitivity to
iodine, cardiogenic shock, high
degree AV blocks
Acetaminophen  Fever and Pain Control  Fever Control
325-1000mg PO 15mg/kg PO
NCCEP Protocol:
*UP10 Fever/Infection Control
*UP11 Pain Control

Indications/Contraindications
 Analgesic and Antipyretic
 Patients with a history of liver
failure should not receive
Atropine  0.5mg IV/IO  0.02mg/kg IV/IO
 May repeat every 3-5 minutes  May repeat 1X
NCCEP Protocol:  Max dose 3mg  Minimum single dose 0.1mg
*AC2 Bradycardia; Pulse Present  Max single dose 0.5mg
*PC2 Pediatric Bradycardia with Poor  Organophosphate-See pearls in
Perfusion TE8 for dosage  Organophosphate-See pearls in
*TE8 WMD Nerve Agent Protocol TE8 for dosage

Indications/Contraindications
 Anticholinergic drug used in
bradycardias

2
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List
ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.

Medication Adult Dosing Pediatric Dosing

Atropine and Pralidoxime Auto-  2-3 nerve agent kits IM  <7 y/o- 1 Nerve kit
Injector depending severity of  8-14 y/o- 2 Nerve kits
symptoms  >15y/o- 3 Nerve kits
NCCEP Protocol:
*TE8 WMD Nerve Agent Protocol

Indications/Contraindications
 Antidote for Nerve Agents or
Organophosphate Overdose

Calcium Chloride  1gm IV/IO  20mg/kg IV/IO over 2-3 minutes

NCCEP Protocol:
*AM3 Dialysis/Renal Failure
*TB3 Crush Syndrome Trauma
*TE7 Overdose/Toxic Ingestion

Indications/Contraindications
 Indicated for severe hyperkalemia
 Sodium Bicarb and Calcium should
not be mixed, ideally given in
separate lines.

Dextrose  D10 125mL-250mL IV/IO  < 1 y/o- D10: 5mL/kg IV/IO

OR Repeat as needed
NCCEP Protocol:  D50 12.5-25gm IV/IO  1-2 years- D25: 2mL/kg IV/IO
*AM2 Diabetic; Adult May repeat until blood glucose Repeat as needed
*PM2 Pediatric Diabetic is greater than or equal to  >2 years- D50: 1mL/kg IV/IO
80mg/dL Maximum 25g per dose
Indications/Contraindications Repeat as needed
 Use in altered mental status or
hypoglycemic states

3
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List
ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.

Medication Adult Dosing Pediatric Dosing

Diazepam  5mg IV/IO  0.1-0.3 mg/kg IV/IO/IM
(Valium) Benzodiazepine  2mg every 3-5 minutes as needed  Repeat dose is 2mg every 3-5
 10mg Rectally minutes as needed
NCCEP Protocol:  Max 10mg  0.5mg/kg Rectally
*UP13 Seizure  Max dose 10mg

Indications/Contraindications
 Seizure control
 Mild sedation
 Muscular rigidity
 Not effective IM, give IV or PR
 Can cause respiratory depression

Diltiazem  0.25mg/kg IV/IO slow IV push

Ø
(Cardizem) over 2-3 minutes
 Max dose 25mg
NCCEP Protocol:  May repeat in 15 minutes if no
AC6 Adult Tachycardia Narrow improvement with 0.35mg/kg
Complex slow IV/IO push over 2-3 minutes

Indications/Contraindications
 Calcium channel blocker used to
treat narrow complex SVT.
 Contraindicated in patients with
heart block, vtach, WPW, and/or
acute MI
Diphenhydramine  25-50mg IV/IM/IO/PO  1mg/kg IV/IM/IO/PO
(Benadryl)  Do not give to infants less than 3
months old.
NCCEP Protocol:
*AM1 Allergic Reaction/Anaphylaxis
*PM1 Pediatric Allergic Reaction
*UP6 Behavioral

Indications/Contraindications
 Antihistamine for control of
allergic reactions
 Treatment of extrapyramidal
reactions

4
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List
ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.

Medication Adult Dosing Pediatric Dosing

Dopamine  2-20mcg/kg/min IV/IO  2-20mcg/kg/min IV/IO

 Titrate to SBP > or equal 90  Titrate to SBP appropriate for age
NCCEP Protocol:
*AC2 Bradycardia; Pulse Present
*AM5 Hypotension/Shock
*PC1 Pediatric Asystole/PEA
*PC2 Pediatric Bradycardia with Poor
Perfusion
*PC7 Pediatric Post Resuscitation
*PM3 Pediatric Hypotension/Shock

Indications/Contraindications
 A vasopressor used in shock or
hypotensive states
Epinephrine 1:1000  0.3-0.5mg IM Allergic Reaction
 <30kg (66lb) 0.15mg IM
NCCEP Protocol:  Nebulized  ≥30kg (66lb) 0.3-0.5 mg IM
*AM1 Allergic Reaction/Anaphylaxis 1mg (1:1000) in 2mL NS
*PC1 Pediatric Asystole/PEA Cardiac Arrest
*PC4 Pediatric Cardiac Arrest  0.1mg/kg ETT
*PC6 Pediatric Vfib/Pulseless Vtach
*PM1 Pediatric Allergic Reaction Respiratory Distress
*AR4 Adult COPD/Asthma  0.01mg/kg IM
Respiratory Distress  Max 0.3mg

Indications/Contraindications  Nebulized
 Vasopressor used in allergic rx 1mg (1:1000) in 2mL NS
 Respiratory Distress May repeat 1X

Epinephrine 1:10000  1mg IV/IO  0.01mg/kg IV/IO

 Repeat every 3-5 minutes as  Max single dose 1mg
NCCEP Protocol: needed  Repeat every 3-5 minutes as
*AC1 Adult Asystole/PEA needed
*AC8 Vfib/Pulseless Vtach
*PC1 Pediatric Asystole/PEA
*PC6 Pediatric Vfib/Pulseless Vtach

Indications/Contraindications
 Vasopressor used in cardiac
arrest.

5
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List

ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.

Medication Adult Dosing Pediatric Dosing

Fentanyl  Pain Control  1mcg/kg IV/IO/IM/IN

(Sublimaze) 50-75mcg IV/IO  Repeat 0.5mg/kg every 5 minutes
Narcotic Analgesic Repeat 25mcg every 20 minutes  Max dose 2mcg/kg
Max dose 200mcg
NCCEP Protocol:
*AC4 Chest Pain: Cardiac and STEMI  Post Intubation Sedation/Pain
*UP11 Pain Control 50-75mcg IV/IO
*AR7 Post-Intubation/BIAD Mgmt Repeat every 5 minutes
Max 300mcg
Indications/Contraindications
 Narcotic pain relief
 Contraindications to opioids
include severe COPD and
respiratory distress, monitor
closely.
Glucagon  Hypoglycemia  Hypoglycemia
1-2mg IM 0.1mg/kg IM
NCCEP Protocol: Repeat in 15 minutes if needed Max dose 1mg
*AM2 Diabetic; Adult Repeat every 15 minutes as
*PM2 Pediatric Diabetic  Beta Blocker or Calcium Channel needed to keep blood glucose
*TE7 Overdose/Toxic Ingestion Overdose >60mg/dl.
2-4mg IV/IO/IM
Indications/Contraindications May repeat in 15 minutes as  Beta Blocker or Calcium Channel
 Drug acting to release glucose needed Overdose
into blood stream by glycogen 0.1mg/kg IV/IO/IM
breakdown May repeat in 15 minutes as
 Use in patients with no IV access needed
Glucose, Oral  1 tube or packet  ½ to1 tube, if age appropriate
 Repeat based on blood glucose  Repeat based on blood glucose
NCCEP Protocol: results, per protocol results, per protocol
*AM2 Diabetic; Adult
*PM2 Pediatric Diabetic

Indications/Contraindications
 Use in conscious hypoglycemic
states
 Do not administer to patients
that cannot swallow or protect
their airway.

6
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List

ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.
Medication Adult Dosing Pediatric Dosing

Haloperidol  Age ≥ 12

Ø
(Haldol) 2-5mg IM
 Age ≥ 65
NCCEP Protocol: 2.5mg IM
*UP6 Behavioral  May repeat every 5 minutes as
needed
Indications/Contraindications  Max dose 10mg
 Medication to assist with
sedation of agitated patients
 Consider for patients with a
history of psychosis
 Safety and efficacy not
established in patients under 12.
Hydromorphone  0.5mg IV/IO/IM


Ø
(Dilaudid) May repeat once after 15
Narcotic Analgesic minutes

NCCEP Protocol:
*UP11 Pain control

Indications/Contraindications
 Narcotic pain relief
 Avoid use if BP < 110
Ibuprofen  400-600mg PO  10mg/kg PO if age > 6 months
(Motrin)  Max 800mg PO
Non-steroidal Anti-inflammatory drug

NCCEP Protocol:
*UP10 Fever/Infection Control
*UP11 Pain Control
*UP15 Suspected Sepsis

Indications/Contraindications
 Avoid NSAIDS in women who are
pregnant or could be pregnant
 Not to be used in patients with GI
bleeding or renal insufficiency
 Not to be used in patients with
allergies to aspirin or other NSAID
drugs

7
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List
ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document;
the only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.

Medication Adult Dosing Pediatric Dosing

Ipratropium  0.5mg  0.5mg
(Atrovent)  May repeat as needed 3X  May repeat as needed 3X
 Combination nebulizers may be  Combination nebulizers may be
NCCEP Protocol: repeated more than 3X. repeated more than 3X.
*AR4 Adult COPD/Asthma  It is acceptable to continue solely  It is acceptable to continue solely
*AR7 Pediatric Asthma Respiratory with Albuterol after 3 combo with Albuterol after 3 combo
Distress nebulizers as there is no proven nebulizers as there is no proven
*AM1 Allergic Reaction/Anaphylaxis benefit to continual use of benefit to continual use of
ipratropium. ipratropium.
Indications/Contraindications
 Medications used in addition to
Albuterol to assist in patients
with asthma and COPD.

Ketorolac  30mg IV/IO  0.5mg/kg IV/IO/IM

(Toradol) NSAID  60mg IM  Max 30mg
 Max 60mg
NCCEP Protocol:
*UP11 Pain Control

Indications/Contraindications
 Avoid NSAIDS in women who are
pregnant or could be pregnant.
 Not to be used in patients with
history of GI bleeding, renal
insufficiency, or patients who
may need immediate surgery
 Avoid in patients currently taking
anticoagulants such as coumadin.
 NSAID used for pain control

Lactated Ringer’s Solution  Dosing per protocol, similar to  Dosing per protocol, similar to
Normal Saline Normal Saline
NCCEP Protocol:
*TB9 Thermal Burn

Indications/Contraindications
 Crystalloid solution preferred for
fluid resuscitation and preferred
in burn care.

8
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List
ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.
Medication Adult Dosing Pediatric Dosing
Lidocaine  Adult Wide Complex Tachycardia  1mg/kg IV/IO
1mg/kg IV/IO  May repeat if refractory,
NCCEP Protocol:
May repeat 1mg/kg bolus after 0.5mg/kg IV/IO
*AC7 Adult Tachycardia Wide
15 minutes
Complex
*AC8 Vfib/Pulseless Vtach
 Adult Vfib/Pulseless Vtach
*PC5 Pediatric Tachycardia
1-1.5mg/kg IV/IO
*PC6 Pediatric Vfib/Pulseless Vtach
May repeat if refractory,
Indications/Contraindications 0.75mg/kg IV/IO
 Antiarrhythmic used for Max 3mg/kg
control of ventricular
dysrhythmias
Magnesium Sulfate  Respiratory Distress  Respiratory Distress
2g IV/IO over 10-20 minutes 40mg/kg IV/IO over 10-20
NCCEP Protocol:
May repeat 1X minutes (max 2g)
*UP13 Seizure
May repeat 1X
*AR4 Adult COPD/Asthma
 Obstetrical Seizure
Respiratory Distress
2g IV/IO over 2-3 minutes  Torsades de Pointes
*AR7 Pediatric Asthma Respiratory
May repeat 1X 40mg/kg IV/IO over 10 minutes
Distress
*AC8 Vfib/Pulseless Vtach
*AO3 Obstetrical Emergency  Torsades de Pointes  Torsades de Pointes in cardiac
2g IV/IO over 1-2 minutes arrest
*PC5 Pediatric Tachycardia
40mg/kg IV/IO over 2 minutes
*PC6 Pediatric Vfib/Pulseless Vtach
*PC7 Pediatric Post Resuscitation
Indications/Contraindications
 Elemental electrolyte used to
treat eclampsia during the 3rd
trimester of pregnancy
 Smooth muscle relaxer used in
refractory respiratory distress
resistant to beta-agonists
Methylprednisolone  125mg IV/IO/IM  2mg/kg IV
(Solu-medrol)  Max 125mg
NCCEP Protocol:
*AR4 Adult Respiratory Distress
*AR7 Pediatric Respiratory Distress
*AM1 Allergic Rx/Anaphylaxis
*PM1 Pediatric Allergic Reaction
Indications/Contraindications
Steroid used in respiratory distress

9
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List

ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.

Medication Adult Dosing Pediatric Dosing

Metoprolol  5mg given over 5 minutes.

(Lopressor)  May repeat 2X at 5-minute
intervals.
NCCEP Protocol:  Max dose 15mg
*AC6 Adult Tachycardia Narrow

Ø
Complex

Indications/Contraindications
 Beta blocker used to slow
ventricular response in the
presence of Afib with RVR
 Not recommended in AV blocks
or with BP <100 systolic

Midazolam  Seizure, Muscle Spasm, Sedation  Seizure, Muscle Spasm, Sedation

(Versed) 2-2.5mg IV/IO/IN 0.1-0.2mg/kg IV/IO/IM/IN
Benzodiazepine 5mg IM May repeat every 3-5 minutes
May repeat every 3-5 minutes Max dose 10mg
NCCEP Protocol: Max dose 10mg
*UP13 Seizure  Behavioral
*UP6 Behavioral  Behavioral 0.1-0.2mg/kg IV/IO/IM/IN
*AO3 Obstetrical Emergency 2.5mg IV/IO/IN Repeat every 2-3 minutes as
*TB3 Crush Syndrome Trauma 5mg IM needed
*PC5 Pediatric Tachycardia Repeat every 2-3 minutes
*TE1 Bites and Envenomation
*AC2 Bradycardia; Pulse Present  Behavioral age 65 or older
*AC6 Adult Tachycardia Narrow 1-2.5mg IV/IO/IN
Complex 2.5mg IM
*AC7 Adult Tachycardia Wide Repeat every 2-3 minutes
Complex

Indications/Contraindications
 Quick acting benzo used for
seizures and sedation
 IM injection is effective in
terminations of seizures. IM
preferred over IO

10
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List

ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.
Medication Adult Dosing Pediatric Dosing
Morphine Sulfate  Chest Pain  0.1mg/kg IV/IO/IM
Narcotic analgesic 2-4mg IV/IO  May repeat every 5 minutes
Repeat every 5 minutes as  Max 10mg
NCCEP Protocol: needed
*AC4 Chest Pain Max 10mg
*UP11 Pain Control
 Pain Control
Indications/Contraindications 4mg IV/IO/IM
 Narcotic pain relief Repeat 2mg every 5 minutes as
 Avoid if BP <110 needed
Max 10mg

Naloxone  0.4-2mg IV/IO/IM/IN/ETT  0.1mg/kg IV/IO/IM/IN/ETT

(Narcan)  Repeat as needed  Repeat as needed
Narcotic Antagonist

NCCEP Protocol:
*TE7 Overdose/Toxic Ingestion

Indications/Contraindications
 Titrate to adequate ventilation
and oxygenation. NOT given to
restore consciousness.
 It is no longer recommended in
the setting of cardiac arrest.

Normal Saline  See individual protocol for bolus  See individual protocol for bolus
Crystalloid Solutions dosing and/or infusion rate dosing and/or infusion rate
 Usual initial bolus 20ml/kg/IV/IO
NCCEP Protocol:
*Multiple

Indications/Contraindications
 IV fluid for IV access or volume
infusion

11
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List

ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.
Medication Adult Dosing Pediatric Dosing

Nitroglycerin  0.3-0.4mg SL repeat every 5  Dose determined after

minutes as needed or until pain consultation by Medical Control
NCCEP Protocol: free
*AC4 Chest Pain
*AC5 CHF/Pulmonary Edema  Nitroglycerin Paste
*PC3 Pediatric Pulmonary SBP > 100 1 inch
Edema/CHF SBP > 150 1.5 inch
SBP > 200 2 inches
Indications/Contraindications
 Vasodilator used in anginal
syndromes and CHF

Ondansetron  4mg IV/IO/IM/PO/ODT  0.15mg/kg IV/IO/IM (max 4mg)

(Zofran)  May repeat in 15 minutes  0.2mg/kg PO/ODT (max 4mg)
Anti-emetic  May repeat in 15 minutes

NCCEP Protocol:
*UP3 Abdominal Pain Vomiting and
Diarrhea

Indications/Contraindications
 Zofran is the recommended anti-
emetic for EMS use since it is
associated with significantly less
side effects and sedation.
Oxygen  1-6 liters/minute via nasal  1-6 liters/minute via nasal
cannula cannula
NCCEP Protocol:  10-15 liters/minute via NRB  10-15 liters/minute via NRB
*Multiple mask mask
 15 liters or > via BVM/ETT/BIAD  15 liters or > via BVM/ETT/BIAD
Indications/Contraindications
 Indicated in any condition with
increased cardiac workload,
respiratory distress, or illness or
injury resulting in altered
ventilation and/or perfusion.
 Goal oxygen saturation 94-98%
 Indicated for pre-oxygenation
whenever possible prior to
endotracheal intubation. Goal
oxygen saturation 100%.

12
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List
ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.

Medication Adult Dosing Pediatric Dosing

Oxymetazoline
sing  2 sprays in affected nostril  2 sprays in affected nostril
(Afrin or Otrivin)
Nasal Decongestant Spray

NCCEP Protocol:
*UP9 Epistaxis

Indications/Contraindications
 Vasoconstrictor used in nasal
intubation and epistaxis
Pralidoxime  600mg IV/IO/IM over 30 minutes  15-25mg/kg IV/IO/IM over 30
(2-PAM)  See local protocols for specific minutes
dosing recommendations  See local protocol for specific
NCCEP Protocol: pediatric dosing
*TE8 WMD-Nerve Agent Protocol recommendations

Indications/Contraindications
 Antidote for nerve agents or
organophosphate overdose
 Administered with Atropine
Promethazine  12.5mg IV/IO/IM
(Phenergan)  May repeat 1X as needed
Anti-emetic  Consider lower starting with
6.25mg dose
NCCEP Protocol:
*UP3 Abdominal Pain Vomiting and
Diarrhea

Ø
Indications/Contraindications
 IV Phenergan should be given IV
only with great caution.
Extravasation of this drug can
result in severe damage.
 Dilute IV with 10ml NS and
administer slowly.
 Use cautiously as it has strong
sedative effects.
 Zofran is the preferred
prehospital anti-emetic.

13
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.
 Drug List
ONLY medications that are included by name and dose in the 2017 NCCEP Protocols are included in this document; the
only purpose of this document is to serve as a reference. For a full list of medications approved for use by EMS
professionals, please refer to the NC Medical Board document titled: Approved Medications for Credentialed EMS
Personnel.
Medication Adult Dosing Pediatric Dosing

Ranitidine  50mg IV  2-4mg/kg IV

Zantac  150mg PO  Max 50mg

NCCEP Protocol:
*AM1 Allergic Reaction/Anaphylaxis
*PM1 Pediatric Allergic Reaction/
Anaphylaxis

Sodium Bicarbonate  50mEq IV/IO  1mEq/Kg IV/IO

 Repeat in 10 minutes as  Repeat in 10 minutes as
NCCEP Protocol: needed needed
*TE7 Overdose/Toxic Ingestion  See individual protocol for  Max 50mEq
*UP6 Behavioral specific dosing algorithm  See individual protocol for
*AM3 Dialysis/Renal Failure specific dosing algorithm
*TB3 Crush Syndrome Trauma

Indications/Contraindications
 A buffer used in acidosis to
increase the pH in cardiac arrest,
hyperkalemia or tricyclic
overdose.
 Sodium Bicarb and Calcium
Chloride should not be mixed.
Ideally give in separate lines.

14
This formulary is provided as a reference only. It does not contain all the contraindications and potential adverse reactions for each listed drug.
It is the responsibility of each EMS professional to become and remain knowledgeable about each drug in this formulary.