VASOACTIVE DRIPS

CRASH CARDCC-VD-01 · ACUTE CARE 03

INFUSIONS usual adult IV · titrate to effect

AGENT	RECEPTOR	DOSE	MIX
VASOPRESSORS
Norepinephrine	α₁ > β₁	0.01–0.5 µg/kg/min	4 mg/250 = 16 µg/mL
Epinephrine	β₁β₂ > α₁	0.01–0.5 µg/kg/min	4 mg/250 = 16 µg/mL
Vasopressin	V₁	0.03–0.04 U/min fixed	20 U/100 = 0.2 U/mL
Phenylephrine	α₁ pure	0.5–6 µg/kg/min	10 mg/250 = 40 µg/mL
INOTROPES
Dopamine	D→β₁→α₁	2–20 µg/kg/min	400 mg/250 = 1600
Dobutamine	β₁ > β₂	2–20 µg/kg/min	250 mg/250 = 1000
Milrinone	PDE3	0.375–0.75 µg/kg/min	20 mg/100 = 200

Amber agent = extravasation / high-alert. Dopamine effect is dose-dependent. Milrinone load & peripheral max rates omitted — facility-specific. Verify concentrations locally.

CHOOSE THE PRESSOR first-line by shock type

SEPTIC	Norepi	+ vaso if refractory
CARDIOGENIC	Norepi ± dobutamine	pressure first, then pump
ANAPHYLAXIS	Epi	drip after IM dosing
NEUROGENIC	Norepi / phenylephrine	watch bradycardia
BRADYCARDIC	Epi / dopamine	pace if refractory

LINE SAFETY

CENTRAL preferred for all vasoactives · dedicated pump · labeled line
PERIPHERAL bridge only · large vein · lowest dose · site check q1h

⚠ EXTRAVASATION

1 stop infusion → 2 aspirate via catheter → 3 phentolamine 5–10 mg SC in 10 mL NS around site → 4 new line · restart

Phentolamine reverses α agents — norepi · epi · phenyl · dopamine.

FIELD REFERENCE · NOT A PROTOCOLVERIFY LOCALLY

FRONT

PUSH-DOSE PRESSORS bridge to the drip

EPI — 10 µg/mL

MIX	1 mL of 0.1 mg/mL + 9 mL NS
YIELDS	10 µg/mL × 10 mL
DOSE	0.5–2 mL (5–20 µg) q2–5 min

PHENYL — 100 µg/mL

MIX	1 mL of 10 mg/mL in 100 mL NS
YIELDS	100 µg/mL — draw 10 mL
DOSE	0.5–2 mL (50–200 µg) q2–5 min

Label every syringe immediately after mixing.

EFFECTS C contractility · R rate · V constriction

AGENT	C	R	V	CAUTION
Norepi	●●	●●	●●	first-line for most shock
Epi	●●	●●	●●	tachyarrhythmia · ↑lactate
Vasopressin	●●	●●	●●	adjunct — fixed, not titrated
Dopamine	●●	●●	●●	arrhythmogenic — avoid if tachy
Dobutamine	●●	●●	↓	may drop BP — pair w/ pressor
Phenylephrine	●●	↓	●●	reflex brady · ok if tachyarrhythmic
Milrinone	●●	●●	↓	long t½ · renal clearance · ↓BP

●● strong · ● mild · ↓ drops it

TITRATION the whole game

TARGET	MAP ≥65 mmHg — or per order · reassess perfusion, not just the number
ADJUST	q2–5 min to response · small steps · one drug at a time
ESCALATE	near max → add second agent, don’t chase one drip forever
MONITOR	art line when able · UOP · mentation · lactate trend
NO RESPONSE	check line · pump · concentration math → then steroids / Ca²⁺ / occult loss
WEAN	taper slowly — never abrupt · vaso last in septic shock

DOSE MATH pump sanity check

µg/min = µg/kg/min × kg
mL/h = µg/min × 60 ÷ conc (µg/mL)

PRESSORS BUY TIME — NOT A FIX

fill the tank, find the cause — reassess volume before every uptitration

VERIFY AGAINST LOCAL PROTOCOL

BACK

REAL CARD ARTWORK · VECTOR TEXT — ZOOM ALL YOU WANT

CC-VD-01 · ACUTE CARE 03

Vasoactive Drips Reference Badge

The seven infusions you actually hang — receptors, dose ranges, standard mixes, choose-the-pressor.

$14First run — ships July 25

1

Free US shipping
Rigid PVC · water-resistant
2.25 × 3.5 in · badge-reel slot

SKU	CC-VD-01
Series	ACUTE CARE 03
Size	2.25 × 3.5 in (CR80)
Material	Rigid PVC, water-resistant
Finish	Dark ink on field-kit tan
For	ICU and ED nurses, paramedics, flight crews.

Field reference — not a protocol. Verify against local protocol.

On this card

A dense, field-kit reference for the seven vasoactive infusions you actually hang: norepinephrine, epinephrine, vasopressin, phenylephrine, dopamine, dobutamine, and milrinone. Real receptor notation (α₁ > β₁, V₁, PDE3), usual adult dose ranges, and a typical-mix concentration column per agent — the pharmacology is on the card, not in your head at 0300. Built for ICU and ED nurses, paramedics, flight crews, and anyone who titrates pressors under pressure.

Front

the full infusions table grouped vasopressors/inotropes with receptor, dose range, and standard mix per agent; a CHOOSE THE PRESSOR strip — first-line agent by shock type (septic, cardiogenic, anaphylaxis, neurogenic, bradycardic); central-vs-peripheral line safety rules; and an amber EXTRAVASATION strip — stop, aspirate, phentolamine 5–10 mg SC in 10 mL NS, new line — with which agents phentolamine reverses.

Back

push-dose pressor panels for epinephrine (10 µg/mL) and phenylephrine (100 µg/mL) — mix, yield, and dose per push; an EFFECTS matrix rating contractility, rate, and constriction for all seven agents with a per-agent caution column; a TITRATION table (MAP ≥65 target, q2–5 min adjustment, escalation, monitoring, no-response checklist, wean order); pump-check DOSE MATH formulas; and the boxed rule "pressors buy time — not a fix." Rigid PVC, water-resistant, standard CR80 badge size in the tan field-kit colorway with dark olive-and-amber print. Punched badge-reel slot at the top — rides behind your ID on any reel or lanyard and stays legible after a full shift. Content is clinician-reviewed against standard references. Field reference only, not a protocol; concentrations and protocols vary by facility — always verify locally.

Pairs with

VENT TRANSFER

CRASH CARD

GAS EXCHANGE problem → correction

O2	SpO2 / PaO2 low	↑ FiO2 then ↑ PEEP
CO2	EtCO2 / pCO2 high	↑ RR then ↑ volume
CO2	EtCO2 / pCO2 low	↓ RR

DOPES

Displaced tube
Obstructed / plugged
Pneumothorax
Equipment failure
Stacked breaths

DOTTS

Disconnect vent
O2 100% · bag by hand
Tube: suction + EtCO2
Tweak settings
Sounds equal

HIGH PRESSURE kink · plug · biting · bronchospasm · PTX
LOW PRESSURE disconnect · cuff leak · extubated

TIDAL VOLUME 6 mL/kg PBW · by height & gender

HT	F mL	M mL
5'0"	275	300
5'2"	300	330
5'4"	330	355
5'6"	355	385
5'8"	385	410
5'10"	410	440
6'0"	440	465
6'2"	465	495
6'4"	495	520

ARDSNET (ARMA)

TV 6 mL/kg PBW · range 4–8
Plat ≤30 · if >30: ↓TV 1 mL/kg → min 4
RR ≤35 · titrate to pH
pH 7.30–7.45 · ≥7.15 tolerated
PaO2 55–80 · SpO2 88–95
ΔP ≤15 (Amato, post-hoc)

PBW derives from height + gender, not weight. 8 mL/kg = table × 1.33.

⚠ STILL HYPOXIC — ESCALATE IN ORDER

1 sedate deeper → 2 paralyze → 3 ↑PEEP (Plat ≤30, ΔP ≤15) → 4 prone if able → 5 accept SpO2 88 / pH ≥7.15 → 6 ECMO call (P/F <80)

High PEEP derecruits in seconds — clamp the tube before ANY circuit break.

FIELD REFERENCE · NOT A PROTOCOLVERIFY LOCALLY

Vent TransferCC-VT-01

LAB VALUES

CRASH CARDCC-LV-01 · ACUTE CARE 01

BASIC METABOLIC PANEL adult reference

	Na	135–145
▲	K	3.5–5.0
	Cl / CO₂	98–106 / 23–29
	BUN / Cr	7–20 / 0.6–1.2
▲	Glucose	70–100 (fasting)
	Calcium	8.5–10.5
	Mg / Phos	1.7–2.2 / 2.5–4.5

EXTENDED CHEMISTRY

	Anion gap	8–12
	Osmolality	275–295 mOsm/kg
	Ammonia lab-specific	15–45 µg/dL
	Lipase lab-specific	10–140 U/L

ABG arterial · PaCO₂ / PaO₂ mm Hg

	pH	7.35–7.45
	PaCO₂	35–45
	PaO₂	80–100
	HCO₃⁻	22–26 mEq/L
	SaO₂	95–100 %
▲	Lactate	0.5–2.0 · >4 critical mmol/L

▲ amber = high-alert analyte — recap on back

FIELD REFERENCE · NOT A PROTOCOLVERIFY LOCALLY

Lab ValuesCC-LV-01

ETT SIZING

CRASH CARDCC-ETT-01 · ACUTE CARE 02

PEDIATRIC ETT uncuffed-led · cuffed = −0.5 · depth at lip

AGE	lb	kg	UNCUFF	CUFF	DEPTH cm
Preterm	2–5	1–2.5	2.5–3.0	—	6–8
Newborn	7–11	3–5	3.0–3.5	—	9–10
6 mo	15	7	3.5–4.0	3.0–3.5	10.5–12
1 yr	22	10	4.0–4.5	3.5–4.0	12–13.5
2 yr	26	12	4.5	4.0	13.5
4 yr	35	16	5.0	4.5	15
6 yr	44	20	5.5	5.0	16.5
8 yr	55	25	6.0	5.5	18
10 yr	70	32	6.5	6.0	19.5
12 yr	88	40	7.0	6.5	21
14 yr	110	50	7.0–7.5	6.5–7.0	21

FORMULAS · 1–10 YR

Uncuffed (age÷4)+4
Cuffed (age÷4)+3.5
Depth 3 × tube ID cm
Neonate kg + 6 cm at lip

BLADE

Preterm Miller 0
NB–2 yr Miller 1
2–8 yr Miller / Mac 2
8 yr+ Mac 3 · Mac 4 lg

SUCTION CATH 2 × ETT ID in Fr · 4.0 tube → 8 Fr

GASTRIC / OG 2 × ETT ID in Fr · decompress after BVM

STYLET straight-to-cuff ~35° · tip never past Murphy eye

⚠ FAILED AIRWAY — MOVE, DON'T REPEAT

1 reposition + bougie → 2 size down 0.5 → 3 SGA / LMA → 4 2-person BVM + OPA/NPA → 5 surgical airway — mark cricothyroid early if predicted difficult

Max 2 attempts per operator — SpO2 recovery between every attempt.

FIELD REFERENCE · NOT A PROTOCOLVERIFY LOCALLY

ETT SizingCC-ETT-01