ADULT Dosing Guide - Effective July 2026 - Medication Administration Dosing

Q: What does the guide specify for adult medications?

It provides drug concentrations, indications, initial dosing, repeat dosing (including limits or “do not repeat”), and route-specific instructions for emergency use.

Q: How does the guide handle medication safety and contraindications?

Each medication section includes caution notes such as contraindications, interaction guidance, monitoring requirements, and administration precautions (for example, spacer use for MDI or avoiding extravasation).

Q: When should repeat dosing stop or be avoided?

The guide states repetition rules per drug, including explicit instructions like “DO NOT REPEAT” and maximum total dosing or repetition intervals where applicable.

Sep 23, 2026

Uploaded by pixelkiddo

San Mateo County Emergency Medical Services provides an adult medication dosing guide effective July 2026, listing concentrations, indications, initial dosing, and repeat dosing instructions for multiple emergency drugs. The content specifies administration routes (IV/IO/IM/PO/nebulized/MDI), dosing limits, and when repetition is prohibited. It also includes key caution statements addressing contraindications, monitoring requirements, drug interactions, and safety steps such as spacer use, extravasation avoidance, and rechecking glucose after dextrose.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages28

Reading Time1 h 11 min

AccessFree to download

San Mateo County Emergency Medical Services Adult Dosing Guide

Acetaminophen

Adenosine

Albuterol

Aspirin

Atropine

Calcium Chloride

Dextrose 10%

Diphenhydramine

Epinephrine PUSH DOSE

Epinephrine DRIP

| | | --- | |

San Mateo County Emergency Medical Services
Acetaminophen
| |
Concentration = 1,000 mg/100 ml
INDICATION INITIAL DOSING REPEAT DOSING Pain Control 1,000 mg over 15 minutes IV
Using macro drip tubing, 1 drop/secover 15 minutes DO NOT REPEAT Fever ≥ 100.5o F or 38o C 1,000 mg over 15 minutes IV
Using macro drip tubing, 1 drop/secover 15 minutes DO NOT REPEAT
CAUTION:
• Do not administer if patient has taken more than 2,000 mg acetaminophen in the past 24 hours.
• Do not administer to patients with severe liver impairment/disease. | |

ADULT Dosing Guide
Page 1 of 1
Effective July 2026

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San Mateo County Emergency Medical Services
Adenosine
| | |
Concentration = 3 mg/ml
INDICATION INITIAL DOSING REPEAT DOSING Narrow complex 6 mg rapid IVP Repeat x 1 12 mg rapid IVP tachycardia Follow with 20 ml NS rapid IVP Follow with 20 ml NS rapid IVP
CAUTION:
• May cause transient heart block or asystole.
• Use ½ dose for patients taking carbamazepine or dipyridamole.
• Do not administer if patient is experiencing acute asthma exacerbation. | | |

8 Rights
of Medication Administration

ADULT Dosing Guide
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Effective July 2026
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San Mateo County Emergency Medical Services
Albuterol
| |
Concentration = 2.5 mg/3 ml
INDICATION INITIAL DOSING REPEAT DOSING Bronchospasm 5 mg nebulized Repeat as needed 6 puffs MDI with spacer Repeat as needed Crush injury/ Hyperkalemia 10 mg nebulized continuously or
6 puffs MDI with spacer Repeat as needed
CAUTION:
• Use continuous cardiac monitoring with patients taking MAOI antidepressants (phenelzine and tranylcypromine) .
• When using MDI, always use a spacer. | |

ADULT Dosing Guide
Page 1 of 1
Effective July 2026

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San Mateo County Emergency Medical Services
Aspirin
| | | | |
Concentration = 81 mg tablets
INDICATION INITIAL DOSING REPEAT DOSING Chest pain – suspected cardiac or STEMI 324 mg PO DO NOT REPEAT
CAUTION:
• Contraindicated in patients with aspirin or salicylate allergy.
• Blood thinner use is NOT a contraindication. | | | | | | 8 Rights
of Medication Administration |
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ADULT Dosing Guide
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Effective July 2026 | | | | | | | | | | | | --- | |

San Mateo County Emergency Medical Services
Atropine
| |
Concentration = 0.1 mg/ ml
INDICATION INITIAL DOSING REPEAT DOSING Symptomatic bradycardia 1 mg IV/IO Repeat every 3-5 minutes to a maximum of 3 mg. Organophosphate overdose 1-2 mg IV/IO/IM Repeat every 3-5 until relief of symptoms is achieved.
CAUTION:
• Can dilate pupils, aggravate glaucoma, cause urinary retention, confusion, and dysrhythmias (V-Tach/V-Fib) .
• Increases myocardial O2 consumption.
• Doses < 0.5 mg can cause paradoxical bradycardia. | |

ADULT Dosing Guide
Page 1 of 1
Effective July 2026

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San Mateo County Emergency Medical Services

Calcium Chloride
| |
Concentration = 1 g/10 ml
INDICATION INITIAL DOSING REPEAT DOSING Calcium channel blocker OD 1 g IV/IO over 60 seconds DO NOT REPEAT Crush injury 1 g IV/IO over 60 seconds DO NOT REPEAT Hyperkalemia 1 g IV/IO over 60 seconds DO NOT REPEAT
CAUTION:
• Use cautiously or not at all in patients on digitalis.
• Avoid extravasation.
• Rapid administration can cause dysrhythmias or cardiac arrest. | |

ADULT Dosing Guide
Page 1 of 1
Effective July 2026

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San Mateo County Emergency Medical Services
Dextrose 10%
| |
Concentration = 0.1 g/ ml
INDICATION INITIAL DOSING REPEAT DOSING Hypoglycemia 100 ml IV/IO 150 ml if glucose remains ≤ 70 m

FAQs

What does the guide specify for adult medications?

It provides drug concentrations, indications, initial dosing, repeat dosing (including limits or “do not repeat”), and route-specific instructions for emergency use.

How does the guide handle medication safety and contraindications?

Each medication section includes caution notes such as contraindications, interaction guidance, monitoring requirements, and administration precautions (for example, spacer use for MDI or avoiding extravasation).

When should repeat dosing stop or be avoided?

The guide states repetition rules per drug, including explicit instructions like “DO NOT REPEAT” and maximum total dosing or repetition intervals where applicable.

Sep 23, 2026

Uploaded by pixelkiddo