MED REFERENCE · the PCGs
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⚠ UNOFFICIAL · PERSONAL USE
Unofficial personal reference. Tap for info.
NO DRUGS MATCH
🩸 BLOOD PRODUCTS
PCG P27 — Push dose pressors: your bridge when the BP is trying to leave the building. Mix it right, label it, and have the drip running concurrently. These are buying time — not writing prescriptions.
⚡ WHICH AGENT?
▸TRAUMA / Hemorrhagic Shock → Epinephrine push dose
▸NON-TRAUMA / Vasodilatory Shock → Phenylephrine push dose
▸If bradycardia is contributing → Epinephrine preferred (has chronotropic effect)
Epinephrine (Push Dose)
Target concentration: 10 mcg/mL — for TRAUMA / bradycardia
MIXING — USING 1:10,000 (0.1 mg/mL)
1
Draw up 1 mL of Epinephrine 1:10,000 (0.1 mg/mL) into a 10 mL syringe
2
Add 9 mL of 0.9% NS to the same syringe → total 10 mL
3
Final concentration: 0.1 mg / 10 mL = 10 mcg/mL
✓ 10 mL syringe at 10 mcg/mL ready for push dosing
Label syringe clearly before use
DOSING
PatientDoseVolumeInterval
Adult10 mcg1 mLq 3–5 min PRN
Pediatric1 mcg/kg (max 10 mcg)0.1 mL/kg (max 1 mL)q 3–5 min PRN
CLINICAL NOTES
!
Bridge ONLY — initiate vasopressor infusion concurrently
!
Onset: 1–2 min. Duration: 5–10 min
!
Titrate effect by BP response — avoid excessive HTN
!
Do NOT use 1:1,000 concentration for push dose mixing — verify vial concentration
Phenylephrine (Push Dose)
Target concentration: 100 mcg/mL — for NON-TRAUMA vasodilatory shock
MIXING — USING 10 mg/mL VIAL
1
Draw up 1 mL of Phenylephrine 10 mg/mL into a syringe
2
Add 99 mL of 0.9% NS → total 100 mL
3
Final concentration: 10 mg / 100 mL = 100 mcg/mL
✓ 100 mL bag/syringe at 100 mcg/mL ready for push dosing
DOSING
PatientDoseVolumeInterval
Adult100–200 mcg1–2 mLq 2–5 min PRN
Pediatric5–10 mcg/kg0.05–0.1 mL/kgq 3–5 min PRN
CLINICAL NOTES
!
Pure α₁ agonist — increases SVR, NO chronotropy. Reflex bradycardia possible
!
Preferred in non-trauma where tachycardia is undesirable
!
Avoid if cardiac output is already reduced — may worsen
!
Bridge ONLY — initiate norepinephrine infusion concurrently
Vasopressin Infusion Quick Mix
Per PCG M15 — adjunct vasopressor
1
Mix 25 units Vasopressin in 250 mL D5W or NS → 0.1 units/mL
2
Initiate at 0.03 units/min → Rate = 18 mL/hr
3
Obtain consult for dose titration. Typical range 0.01–0.04 units/min
Rate formula: [Dose (units/min) × 60] ÷ 0.1 (units/mL) = mL/hr
0.03 units/min → 18 mL/hr
Select two drugs to check Y-site compatibility. Because slamming incompatible drugs through the same line is how you get a syringe full of mystery precipitate — and a very bad day.
DRUG A
DRUG B
Y-SITE MATRIX — TAP CELL TO SELECT
C
OK
I
NO
?
VAR
Compatibility at standard ICU concentrations. Always confirm with pharmacy.
⚡ DRIP RATE CALCULATOR
Drug
Weight
Dose
--
mL / hr
⚠ Always verify calculations independently. This tool does not replace clinical judgment or institutional protocols.
📐 RATE FORMULAS
Weight-based (mcg/kg/min):
mL/hr = [Dose × Wt (kg) × 60] ÷ Conc (mcg/mL)
Fixed dose (mcg/min):
mL/hr = [Dose (mcg/min) × 60] ÷ Conc (mcg/mL)
Fixed dose (mg/hr):
mL/hr = Dose (mg/hr) ÷ Conc (mg/mL)
Units-based (units/min):
mL/hr = [Dose (units/min) × 60] ÷ Conc (units/mL)
⚡ NOREPI QUICK CONVERSION
For a 70 kg patient — Standard 16 mcg/mL (4mg/250mL)
mcg/min (PCG)mcg/kg/minmL/hr
60.08622.5
80.11430
100.14337.5
120.17145
200.28675
300.429112.5
Based on 70 kg patient, 16 mcg/mL concentration. Recalculate for actual weight/concentration.
RASS — Richmond Agitation-Sedation Scale
Goal: RASS –1 to 0 (light sedation) in most ICU/transport patients
⌄
+4
Combative
Overtly combative, violent, immediate danger to staff
+3
Very Agitated
Pulls or removes tubes/lines, aggressive
+2
Agitated
Frequent non-purposeful movement, fights ventilator
+1
Restless
Anxious, apprehensive, not aggressive
0
Alert & Calm
Spontaneously alert and calm ✓ TARGET
–1
Drowsy
Not fully alert, sustained awakening (eye contact) to voice >10 sec ✓ TARGET
–2
Light Sedation
Brief awakening to voice, eye contact <10 sec
–3
Moderate Sedation
Movement or eye opening to voice, no eye contact
–4
Deep Sedation
No response to voice, movement or eye opening to physical stimulation
–5
Unarousable
No response to voice or physical stimulation
GCS — Glasgow Coma Scale
Total 3–15 · Intubate consideration ≤8 · Severe TBI ≤8
⌄
EYES (E)
4
Spontaneous
3
To voice
2
To pain
1
None
VERBAL (V)
5
Oriented
4
Confused
3
Words
2
Sounds
1
None
MOTOR (M)
6
Obeys
5
Localizes
4
Withdraws
3
Flexion
2
Extension
1
None
E + V + M =
3–15
≤8 = Severe (consider airway) · 9–12 = Moderate · 13–15 = Mild
CPOT — Critical Care Pain Obs. Tool
For non-verbal / intubated patients · Score 0–8 · ≥3 = significant pain
⌄
FACIAL EXPRESSION (0–2)
0
Relaxed, neutral
1
Tense
Brow lowering, orbit tightening, levator contraction
2
Grimacing
All above + eyelid tightly closed
BODY MOVEMENTS (0–2)
0
Absence of movements, normal position
1
Protection
Slow, cautious movements, touching pain site
2
Restlessness / Agitation
Pulling tubes, attempting to sit up, thrashing
MUSCLE TENSION (0–2)
0
Relaxed
No resistance to passive movements
1
Tense & rigid
Resistance to passive movements
2
Very tense or rigid
Strong resistance, unable to complete movement
COMPLIANCE (intubated) / VOCALIZATION (extubated) (0–2)
0
Tolerating vent / Talking in normal tone
1
Coughing but tolerating / Sighing, moaning
2
Fighting vent / Crying out, sobbing
TOTAL SCORE
0–8
≥3 = Treat pain · Goal: <3
Shock Index Calculator
HR ÷ SBP · ≥0.9 = higher mortality / transfusion need (PCG T9)
⌄
÷
--
Enter HR and SBP above
<0.6
Normal
0.6–0.9
Mildly elevated — monitor
0.9–1.2
↑ Mortality risk — prepare blood products
>1.2
High mortality — activate MTP, aggressive resuscitation
Pediatric Weight Estimator
Broselow-based · Enter age (years) or length (cm)
⌄
BY AGE (1–10 years)
COMMON PEDS DRUG DOSES (based on estimated weight)
Weight estimate: (Age × 2) + 8 for 1–10 yrs · Verify with Broselow tape
NIH Stroke Scale — Quick Reference
Mild <5 · Moderate 5–9 · Severe ≥10 · LVO if high score
⌄
#ItemScore
1aLOC0–3
1bLOC Questions (month, age)0–2
1cLOC Commands (eyes, grip)0–2
2Best Gaze0–2
3Visual Fields0–3
4Facial Palsy0–3
5a/bMotor Arm (L/R)0–4 each
6a/bMotor Leg (L/R)0–4 each
7Limb Ataxia0–2
8Sensory0–2
9Best Language0–3
10Dysarthria0–2
11Extinction/Inattention0–2
MAX SCORE = 42
BP Goals: Non-thrombolytic <220/110 · Thrombolytic candidate <180/105
Do not lower SBP >15% from baseline (M16/M17)