Special Operations Forces Medical Handbook

8-40

e. Other Agents:
Ketamine - Indications: Painful invasive procedures. Contraindications: Hypertension. Head or eye injury.
Chest or abdominal surgery. Routes: IV, IM. Dose: IV 1 to 2 mg/kg. IM 4 mg/kg. IV infusion of 0.5 to 1
mg/kg per hour approved for adult use only for prolonged procedures. Atropine at 0.1 mg/kg for children to
1 to 2mg for adults should be added to control secretions. Side Effects: Emergence hallucinations (mostly
in adults). Hypertension, respiratory depression if given rapidly IV.
Acetaminophen - Indications: Mild to moderate pain (1-4). Fever reduction, Contraindications: Allergy,
Liver disease. Routes: Oral, rectal. Dose: Adult: 650 to 975 mg every 4 to 6 hours. (Often used in
combination form with codeine or oxycodone) Children: 10 to 15 mg/kg every 4 to 6 hours. Side Effects:
Gastric irritation or bleeding. Liver toxicity in long-term use or in overdose.

f. Reversing Agents:
Naloxone - Indications: Reversal of side effects of opiates. Contraindications: No absolute. Will trigger
opiate withdrawal. Routes: IV,IM,SC. Dose: 0.1 to 2.0 mg q 2-3 min to max of 10 mg. Side effects: Acute
withdrawal may exhibit combativeness.
Flumazenil - Indications: Reversal of benzodiazepam overdose. Contraindications: Benzo dependence or
if used for seizure control as it will trigger intractable seizures, concomitant ingestion of tricyclic
antidepressants (TCAs), presence of increased intracranial pressure such as in head injury. Routes: IV.
Dose: 0.2 mg IV every minute until desired response to a maximum dose of 3 mg. Side effects: See
contraindications.

What Not To Do:
Do not give insufcient pain medication to achieve relief.
Do not give pain medication only after the pain has returned. Anticipate the onset of pain, and give the
medication 30 minutes BEFORE the pain returns to provide effective relief.
Do not fail to consider all classes of pain medications and their few side effects before prescribing. A patient
that gets good pain control from morphine, but starts to vomit repeatedly as a side effect, might have beneted
from a non-opioid medication.

Chapter 34: Lab Procedures

Lab Procedure: Prepare Specimens for Transport

18D Skills and Training Manual

When: To ensure the safe, intact transfer of specimens for later examination.

What You Need: Appropriate shipping containers and packing materials.

What To Do:

1. Prepare specimens to be shipped.


2. Pack specimens in appropriate containers and at the proper temperature.


3. Package specimens in accordance with federal regulations.


4. Provide specimen information to the receiving lab.
   a. Patient identification.
   b. Suspected disease or condition.
   c. Type of specimen.
   d. Body area where specimen was collected.
   e. Sending facility identification.
   f. Type of test requested.
   g. Name of the person requesting the test.


5. Place appropriate warning labels on packages containing infectious material.


6. Ship specimens in accordance with federal regulations.


7. Follow all precautions when shipping infectious material.