NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 5308

POLICIES AND PROCEDURES

Subject: Medical Direction

Associated Policies: 01/10/98

1. Class:

1. Diuretic.

2. Indications:

1. Acute pulmonary edema.
2. Severe congestive heart failure.
3. Hypertensive crisis.

3. Therapeutic Effect:

1. Stimulates kidneys to excrete water, salt and potassium which leads to decreased circulating blood volume.
2. Produces vasodilatation.
3. Very potent with rapid onset in 5-10 minutes.

4. Contraindications:

1. Absolute:

1. Dehydration.
2. Pregnancy.

5. Adverse Effects:

1. Cardiac dysrhythmias.
2. Transient hypotension.
3. Nausea and vomiting.
4. Dehydration.

6. Administration and Dosage:

1. Adult: 40 - 80 mg slow IV over 1-2 minutes.
2. Pediatric: 1 mg/ kg slow IV over 1-4 minutes.

7. Special Information:

1. Use cautiously in the presence of suspected AMI.
2. Sulfonamide sensitive persons may develop an allergic reaction.