This document outlines the contents and organization of an emergency drug kit. It is divided into four modules: basic/critical drugs and equipment, non-critical drugs and equipment, ACLS drugs, and antidotal drugs. The basic module includes epinephrine, oxygen, bronchodilators, antihistamines, nitroglycerin, oral hypoglycemics, and aspirin. The non-critical module adds analgesics, corticosteroids, beta blockers, dextrose, and airway equipment. The ACLS module focuses on drugs for cardiac arrest like amiodarone and atropine. The antidotal module contains naloxone for opioid overdose and flumazenil for

1. VASHI NARULA
(final year)

2.  Emergency – An unforeseen occurrence
or combination of circumstances that calls
for immediate action or remedy - Mosby’s
 Drug – Any substance or product that is
used or is intended to be used to modify
or explore physiological system or
pathological states for the benefit of the
recipient - W.H.O

3.  Large kit in mobile tool cabinets with
several compartments
 Labels should be applied to each
compartment in which drug is stored,
listing the drug’s generic and proprietary
names, dosage, indication and expiry date
to avoid possible confusion during
emergency.

4.  Expired drugs and empty O2 cylinders are
ineffective
 Drug should be replaced prior to expiry
date.
 An office staff member should be
assigned to check the emergency drug kit
at least once a week

5. THE KISS PRINCIPLE
Complexity in a
time of adversity
breeds chaos
-PALLASCH(1976)

6. MODULE ONE:
Basic emergency kit
(critical drugs and
equipment)
MODULE TWO:
Non-critical drugs and
equipment
MODULE THREE:
ACLS drugs
MODULE FOUR:
Antidotal drugs
INJECTABLE NON-INJECTABLE

7.  ESSENTIAL/ CRITICAL/ PRIMARY
Epinephrine Oxygen Oxygen delivery
system
Histamine blocker Vasodilator Automated
electronic
Bronchodilator defibrillator
Antihypoglycemic Syringes,
suction tips,
Inhibitor of tourniquets
platelet aggregation Magill
INJECTABLE NON-INJECTABLE EQUIPMENTS

8.  Catecholamine
 Most important emergency drug
 Indications
 Anaphylaxis
 Acute (life threatening) allergic reactions
 Actue asthamatic attack
 Cardiac arrest

9. DESIRABLE PROPERTIES
Rapid onset of action
Bronchodilator action
Histamine blocking properties
Vasopressor actions
Cardiac effects
Increase
Heart rate
Systolic blood pressure
Cardiac output
Coronary blood flow
UNDESIRABLE PROPERTIES
Predisposition to dysrhythmias
Short duration of action

10. DOSE AND ADMINISTRATION
I.M. Or S.C. - 1:1000 concentration In dose of
0.3-0.5 mg for 30 kg or greater patients.
0.15mg for patients who weigh less than 30kg is
recommended
 Preloaded auto injectors are preferred- Ana
Guard, Epipen, Epipen Jr, Auvi Q
 Intravenous- 1:10,000- m/m of cardiac arrest
In Pregnancy-decrease placental blood flow and can
induce premature labor

11.  Drug of choice- Diphenhydramine
 Alternative- Chlorpheneramine
 Uses-
 Non-life-threatening allergic reactions
 Delayed allergic response
 Dose And Administration-
emergency kit should contain two 1ml
ampules of
diphenhydramine-50mg/ml
chlorpheniramine-10mg/ml

12.  Side effects
 CNS depression (sedation, drowsiness)
Avoid operating motor vehicle and use of
dangerous machinery
 Decrease blood pressure
 Thickened bronchial secretions therefore
contraindicated in acute asthmatic episodes

13.  Most useful drug
 Compressed gas cylinder
(“E” for emergency)

14.  CONTRAINDICATION-
Management of hyperventilation
Chronic Obstructive Pulmonary Disease

15.  Drug of choice- Nitroglycerin
 Spray or tablets
 Alternative drug- Amyl nitrite
 Uses-
 Immediate management of chest pain (Angina
pectoris or Acute myocardial infarction)
 Route of administration- Sublingual
Bitter in taste and imparts a sting

16.  Side effect
 pulsatile headache
 flushing, weakness
 sweating
 palpitation
 fainting , hypotension
 Precaution
 Rest in supine or sitting position
 Monitor B.P.
 Contraindication in hypotensive state

17.  Sublingual tablet - 0.4 mg
(not more than 3 tablets in 15 min)
 Translingual spray- 0.4-0.8 mg

18.  Drug of choice- Salbutamol
 Uses-
 Acute Asthmatic episodes
 Allergic reactions
 Route of administration- Metered Dose
Inhaler, spacer(for pediatric patients)

19.  Produces bronchodilatation within 5 min
and last for 2-4 hours
 one or two inhalations every 4-6 hours is
recommended dosage

20.  Orange juice
 Alternative- Glucose gel
 Uses-
 Hypoglycemic states in a conscious patient
due to
▪ Diabetes mellitus
▪ Fasting
 Oral route of administration

21.  Drug of choice- Aspirin
 Alternative drug- Clopidogrel
 Oral route of administration
 Uses-
 Acute myocardial infarction
 Unstable angina
 Contraindications
 Major life threatening haemorrhage
 Recent bleeding peptic ulcer
 Allergy to aspirin

22.  Standard dose – 160-325mg
 Emergency kit include powdered or
chewable aspirin (325 mg)

23. OXYGEN
DELIVERY
SYSTEM
BAG VALVE
MASK
POSITIVE
PRESSUR
E VALVE
POCKET
MASK

27.  NON-CRITICAL/ SECONDARY
Anticonvulsant Respiratory Oropharyngeal
Analgesic stimulant and nasopharyngeal
Vasopressor Antihypertensive
airways
Antihypoglycemic Laryngeal
mask
Corticosteroid
Laryngoscope Antihypertensive
Endotracheal tubes
INJECTABLE NON-INJECTABLE EQUIPMENTS

28.  Drug of choice- Midazolam
 Alternative drug- Diazepam
 Uses-
 Seizure disorders due to-
▪ Epilepsy
▪ Overdose of local anesthetic
▪ Syncope with airway obstruction
▪ Hypoglycemia
▪ Febrile convulsions
 Dose - 5mg/ml Midazolam in 5-ml vial

29.  Drug of choice- Morphine sulfate
 Alternative drug- N2O-O2
 Uses-
 Acute myocardial infarction
 Heart failure
 Acute pain or anxiety
 CNS and respiratory depressant-
contraindicated in multiple trauma,
compromised respiratory function,
hypovolemic and hypotensive state

30.  Emergency kits may contain morphine
sulfate 10mg/ml (two 2-ml ampules)

31.  Ephedrine
 Indications-
 Syncope
 Drug overdose reactions
 Post seizure states
 Acute adrenal insufficiency
 Allergic reactions
 Dose- 50mg/ml in 1ml ampule
 Contraindication – hypertensive patient
Ventricular tachycardia

32.  Dextrose 50%
 Alternative drug- Glucagon
 Dosage-
 30 ml of 50% Dextrose administered I.V.
 Glucagon im- 1mg of dry powder in 1ml of diluent
(effective only when hepatic glycogen is available;
ineffective in starvation or chronic hypoglycaemic
state)
 Side effects
Tissue necrosis occurs in case of extravascular
infiltration of the solution

33.  Drug of choice- Hydrocortisone sodium
succinate
 Indications
 Definitive m/m of acute allergy
 Adrenal insufficiency
 Asthma
 Recurrent anaphylactic episodes
 Dose - 50 mg/ml (2-ml vials)
 Precautions- hyperglycemia, peptic ulcers,
preexisting infection, delayed wound healing

34.  Non specific anti inflammatory action
 Suppresses sign of inflammation by
reduction of increased capillary permeability,
local exudation, cellular infiltration
 Limitation of recruitment of inflammatory cells
at local site.
 Inhibit phospholipase A responsible for
release of arachidonic acid for PG and LT
synthesis.

35.  Suppress all type of hypersensitisation
and allergic phenomena.
 Reduces bronchial hyperactivity
 Do not remove cause of inflammation
while manifestations are dampened.

36.  Drug of choice - Esmolol
 Alternative drug- Labetalol
 Indication
 Acute Hypertensive episodes
 Action
 Ultrashort acting β1 blocker
(action last 15-20 min after terminating I.V.
Infusion)
 Decreases heart rate, force of contraction

37.  Contraindications
 sinus bradycardia
 heart block
 cardiogenic shock
 heart failure
 Dose
 100 mg/ml of esmolol which is diluted to 10
mg/ml with a diluent prior to administration

38.  Drug of choice – Atropine
 Indications- symptomatic bradycardia
Likely in extremely fearful patients
 Dose - 0.5 mg/ml in 1 ml vials

39.  Side effects
 Xerostomia
 Dry, flushed and hot skin- inhibition of sweating
- stimulation of temperature regulating centre in
hypothalamus
 Excitement, Hallucinations, disorientation
 Cardiovascular collapse
 Respiratory depression
 Contraindications
 Narrow angle glaucoma - rise in intraocular
tension
 Prostatic hypertrophy - urinary retention

40.  Drug of choice- Aromatic ammonia
 Indications
 Vasodepressor syncope
 Respiratory depression
 Dose- Silver gray vaporoles containing 0.3
ml of aromatic ammonia
 Precaution
 Chronic obstructive pulmonary disease or
asthma- irritating effect may precipitate
bronchospasm.

42.  Drug of choice– Hydralazine
 Alternative Drug – Nitroglycerin
 Indications- Hypertensive urgencies
 Dose - Hydralazine is available in 10, 25, 50
and 100 mg tablets.
 Contraindication
 patients with mitral valve rheumatic heart
disease
 caution is indicated in the presence of
cardiovascular disease, cerebrovascular

43. NASOPHARYNGEAL
AIRWAYS
OROPHARYNGE
AL AIRWAYS

45. LARYNGOSCOPE
ENDOTRACHEA
L TUBE

47.  ADVANCED CARDIOVASCULAR LIFE
SUPPORT
Epinephrine Oxygen
Amiodarone
Atropine
Verapamil
INJECTABLE NON-INJECTABLE

48.  Drug of choice – Epinephrine
 Action
 Maintain coronary artery blood flow
 preserves blood flow to the brain, helping to
minimize neurologic damage.
 Dose – 1 : 10,000 concentration in preloaded
10ml syringes

49.  Drug of choice – Amiodarone
 Alternative drug : Lidocaine
 Indication
 Ventricular Dysrhythmias
 First line m/m of Ventricular fibrillation and
pulseless Ventricular tachycardia that is
unresponsive to CPR, defibrillation and
vasopressor therapy (epinephrine)
 Dose – 50mg/ml solution in 3ml vial

50.  Contraindications
 Atrioventricular block
 Bradycardia
 Cardiogenic shock
 Iodine hypersensitivity
 Sick sinus syndrome

51.  Drug of choice - Atropine
 Alternative drug- Isoproterenol
 Indication – Hemodynamically
unstable bradydysrhythmia
 Dose- 0.5mg (3-5mins)
 Contraindication-
 Patient with known Atropine allergy
 used with caution in patient with known cardiac disease
or recent myocardial infarction

52.  Drug of choice- Verapamil
 Indications
 PVST
 Variant, unstable and chronic stable angina
 Hypertension
 Availability – 2.5mg/ml in 2ml and 4ml
ampules

53.  ANTIDOTAL DRUGS
Opioid Antagonist
Benzodiazepine antagonist
Antiemergence delirium drug
Vasodilator
INJECTABLE

54.  Drug of choice- Naloxane
 Alternative drug- Nalbuphine
 Indications- Opioid induced respiratory
depression
 Availability –
 Adults-0.4mg/ml in 1ml ampules and 10ml vials.
 Childern- 0.02mg/ml in 2-ml ampules
Injected I.V. It acts in 2-3 min
 Side effect- abrupt and complete reversal of
opioid agonist effect may precipitate acute
withdrawal symptoms.

55.  Drug of choice – Flumazenil
 Availability-
 0.1mg/ml in 5ml and 10ml
multidose vials
 Side effects
 onset of seizures in patients using
benzodiazepines to control seizures and
in person who have become dependent
on BZD

56.  Drug of choice– Physostigmine
 Indication
 Antiemergence delirium drug
Several drugs such as brnzodiazapenes
diazepam and midazolam that are commonly
employed parenterally to induce sedation can
produce emergence delirium ( anticholinergic
syndrome)
 The patient
 appears to lose contact to reality
 Increased muscular movement
 Makes unintelligible sounds

57.  Availability –
1mg/ml in 2 ml ampules
 Side effects-
 Increased salivation
 possible emesis
 involuntary urination and defecation

58.  Drug of choice - Phentolamine mesylate
 Alternative drug- Procaine
 Indication
 M/m of vasospasm and compromised circulation
following intraarterial injection of a drug.
 M/m of pain and vascular compromise following
extravascular administration of irritating drugs.
 Availability- 5mg/ml vial
 Contraindication- known hypersensitivity to
phentolamine.