3.001 MEDICAL KIT- CONTENTS AND REFERENCE

(MED CL/SpX-6 - ALL/FIN/T) Page 1 of 27 pages

09 APR 15 3.001_M_26501.doc

OBJECTIVE:

To provide a contents list of each medical pack including medications, potential medication side effects, other contents, locations, 

and supportive information.

Table 1. Convenience Medication Pack (White)

Table 2. Emergency Medical Treatment Pack - Medications (Red)

Table 3. Emergency Medical Treatment Pack - Other Contents (Red)

Table 4. IV Supply Pack (Gray)

Table 5. Medical Diagnostic Pack (Blue)

Table 6. Medical Supply Pack (Green)

Table 7. Minor Treatment Pack (Pink)

Table 8. Oral Medication Pack (Purple)

Table 9. Physician Equipment Pack (Yellow)

Table 10. Topical & Injectable Medication Pack - Medications (Brown)

Table 11. Topical & Injectable Medication Pack - Other Contents (Brown)
3.001 MEDICAL KIT- CONTENTS AND REFERENCE

(MED CL/SpX-6 - ALL/FIN/T) Page 2 of 27 pages

09 APR 15 3.001_M_26501.doc

Table 1. Convenience Medication Pack (White)

Item Strength, 

Volume

Route of 

Use

Qty in 

Pack Unit Possible Side Effects Comments Location

Antibiotic

Bacitracin

500 

units/gm,

0.9 gm

Topical 30

unit 

dose 

pack

No significant side effects Spine

Antidiarrheal

Loperamide (Imodium) 2 mg Oral 40 tablet

Abdominal discomfort, nausea, 

vomiting, constipation, drowsiness, 

dizziness, dry mouth

Use for nonbloody 

diarrhea.

No more than 8 

tablets every 24 

hours.

B2

Antihistamine

Fexofenadine (Allegra) 180 mg Oral 100 tablet

Headache, vomiting, fatigue, 

somnolence, dizziness, fever, pain, 

drowsiness, diarrhea, nausea, upset 

stomach, muscle aches, back pain, 

pain in extremities

Do not use with other 

antihistamines. 

Do not drink 

grapefruit juice 1 

hour before or 2 

hours after taking the 

medication.

B2

Loratadine (Claritin) 10 mg Oral 375 tablet Headache, drowsiness, dizziness, 

fatigue, dry mouth A2

Olopatadine (Pataday) 0.2 %,

2.5 mL Eye 6 bottle Blurred vision, eye pain, stinging, burning, headache

Remove contact

lenses before use. 

After instilling drops, 

wait at least 10 

minutes before 

inserting contact 

lenses.

A3
3.001 MEDICAL KIT- CONTENTS AND REFERENCE

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09 APR 15 3.001_M_26501.doc

Item Strength, 

Volume

Route of 

Use

Qty in 

Pack Unit Possible Side Effects Comments Location

Decongestant

Oxymetazoline (Afrin) 0.05 %,

15 mL Intranasal 10 bottle

Transient burning, stinging, dryness 

of the nasal mucosa, sneezing,

cough

Do not use more 

than 3 consecutive 

days. Rebound 

congestion with 

prolonged use.

A1

Pseudoephedrine

(Sudafed 12 Hour) 120 mg Oral 100 tablet

Dizziness, rapid heart rate, high 

blood pressure, restlessness, 

tremor, headache, loss of appetite, 

may impair ability to concentrate, 

dry mouth, insomnia, 

photosensitivity

B1

Lubricant

Carboxymethylcellulose

(Refresh Plus)

0.5 %,

0.4 mL Eye 40

unit 

dose 

pack

Temporary blurred vision A4

Hypromellose

(Nature’s Tears)

0.4 %,

15 mL Eye 2 bottle Temporary blurred vision Remove contact lenses prior to use. A4

Mineral Oil and White

Petrolatum (Refresh PM)

42.5 %;

57.3 %,

3.5 gm

Eye 2 tube Temporary blurred vision A4

Sodium Chloride

(AYR Saline)

0.9 %,

22 mL Intranasal 3 bottle No significant side effects within prescribed dose A2

Pain Reliever

Acetaminophen (Tylenol) 325 mg Oral 150 tablet No significant side effects within 

prescribed dose

No more than 12 

tablets every 24

hours.

B4

Aspirin 325 mg Oral 60 tablet Upset stomach, dizziness, ringing in 

ears, blood in stool Take with food. B4
3.001 MEDICAL KIT- CONTENTS AND REFERENCE

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09 APR 15 3.001_M_26501.doc

Item Strength, 

Volume

Route of 

Use

Qty in 

Pack Unit Possible Side Effects Comments Location

Ibuprofen (Motrin) 400 mg Oral 400 tablet

Dizziness, nervousness, upset 

stomach, nausea, vomiting, rash, 

ringing in the ears

No more than 8 

tablets every 24 

hours.

Take with food.

B3

Sleep

Melatonin 3 mg Oral 60 tablet Headache, nausea, drowsiness, 

dizziness

Do not use with other 

sleep meds. A4

Zaleplon (Sonata) 10 mg Oral 100 bottle

Headache, dizziness, drowsiness, 

short-term memory impairment, or 

lack of coordination, nausea, upset 

stomach, muscle weakness

Do not take with a 

high fat meal.

Do not use with other 

sleep meds.

A4

Zolpidem (Ambien) 10 mg Oral 200 tablet

Drowsiness, dizziness, headache, 

abnormal dreams, insomnia, 

memory impairment, visual and 

attention disturbance

Do not use with other 

sleep meds. A3

Steroid

Hydrocortisone 1 %,

0.9 gm Topical 60

unit 

dose 

packet

No significant side effects B1

Mometasone (Nasonex) 50 mcg,

17 gm Intranasal 3 bottle Headache, cough A1

Stimulant

Caffeine (Vivarin) 200 mg Oral 100 tablet

Diarrhea, dizziness, fast heartbeat, 

low blood sugar, high blood sugar, 

blurred vision, dry mouth, flushed 

skin, increased urination, loss of 

appetite, nausea, stomachache, 

anxious feeling, agitation, cold 

sweats, nervousness, insomnia

A3
3.001 MEDICAL KIT- CONTENTS AND REFERENCE

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09 APR 15 3.001_M_26501.doc

Item Strength, 

Volume

Route of 

Use

Qty in 

Pack Unit Possible Side Effects Comments Location

Modafinil (Provigil) 200 mg Oral 40 tablet

Headache, nervousness, dizziness, 

anxiety, insomnia, chest pain, rapid 

heart rate, diarrhea, upset stomach, 

dry mouth, lack of appetite

A3

Stool Softener

Bisacodyl (Dulcolax) 5 mg Oral 40 tablet Mild abdominal cramps, nausea, 

vomiting, dizziness B2
3.001 MEDICAL KIT- CONTENTS AND REFERENCE

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09 APR 15 3.001_M_26501.doc

Table 2. Emergency Medical Treatment Pack - Medications (Red)

Item Strength, 

Volume Route of Use Qty in Pack Unit PossibleSide Effects Comments Location

ALS Medication Kit B1

Atropine 0.1 mg/mL,

10 mL Intraosseous 2 syringe

Rapid heart rate, dilated pupils, dry skin 

and mouth, cardiac arrhythmias, 

flushing, low blood pressure, headache, 

insomnia, slowed GI motility, nausea, 

dry mouth, urinary hesitancy and 

retention

B1

Epinephrine

1:10,000;

0.1 mg/mL,

10 mL

Intraosseous 2 syringe

Rapid heart rate and palpitations, 

flushing, dizziness, headache, 

nervousness, dry mouth

B1

Lidocaine

2 %;

20 mg/mL,

5 mL

Intraosseous 2 syringe

Low blood pressure, flushing, 

drowsiness, disorientation, muscle 

twitching, dizziness, metallic taste, 

nausea, vomiting

B1

Severe Allergic Reaction

Epinephrine (EpiPen) 1:1000,

0.3 mL Intramuscular 3 syringe

Rapid heart rate and palpitations, 

flushing, dizziness, headache, 

nervousness, dry mouth

B3
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Table 3. Emergency Medical Treatment Pack - Other Contents (Red)

Item Qty in Pack Location

Basic Airway Management

AMBU Bag 1 A1

Nasal Airway Kit - A3

Nasal Airway 6 mm 1 A3

Nasal Airway 7 mm 1 A3

Oral Airway 2 A4

Biohazard Trash Bags - A2

Biohazard Trash Bag 5 A2

Level 1 Hazardous Material Decal 5 A2

Level 2 Hazardous Material Decal 5 A2

General Use

Scissors - Trauma 1 Spine

Sharps Container 1 Spine

Stethoscope 1 A1

Stethoscope Holder 1 A1

Surgical Lubricant 4 B2

Intraosseous Device Start Kit - B4

Gauze 4"x4" 10 B4

Intraosseous Injection Device 2 B4

Iodine Swabstick 2 B4

IV Cap 2 B4

Medical Tape 1 B4

Syringe 10 mL 1 B4
3.001 MEDICAL KIT- CONTENTS AND REFERENCE

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Table 4. IV Supply Pack (Gray)

Item Qty in Pack Location

Bandages

Clear Bandage 4 A2

Gauze 4"x4" 4 A2

Medical Tape 1 B1

IV Insertion & Fluid Administration

IV Administration Set 3 A3/A4

IV Cap 5 B2

IV Catheters - A1

IV Catheter 14G 2 A1

IV Catheter 18G 4 A1

IV Catheter 20G 4 A1

IV Catheter 22G 4 A1

Sharps Container - IV Catheter 1 A1

IV Fluid - 500 mL 8 B3/B4

IV Fluid 1L 0 B3/B4

IV Pressure Infusor 1 A2

Tourniquet 1 B2

Skin Preparation Items

BZK Wipe 4 B1
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Table 5. Medical Diagnostic Pack (Blue)

Item Qty in Pack Location

Physical Exam Hardware

Blood Oximeter 1 B1

Blood Pressure Cuff - Large 1 B2

Blood Pressure Cuff - Small 1 B2

Blood Pressure Monitor 1 B4

Eye Chart 1 with Locator Card

Eye Simulator 1 A4

Eye Simulator Cornea 1 A4

Otoscope Bulb 1 Spine

Otoscope Head 1 A2

Otoscope Speculum 80 A1/A3

Otoscope USB Cable 1 A2

Panoptic Bulb 2 Spine

Panoptic Handle 1 A2

Panoptic Head 1 A1

Stethoscope 1 B1

Stethoscope Earpieces 1 pair B3

Stethoscope Holder 1 B1

Thermometer 1 B3

Tonometer 1 A4

Tonometer Battery 2 Spine/A4

Tonometer Tip Cover 150 A3/A4

Therapeutic Items

Ear Curette 2 Spine

Hot/Cold Pack 1 B3
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Table 6. Medical Supply Pack (Green)

Item Qty in Pack Location

Bandages

Bandaid 1"x3" 10 Spine

Gauze 4"x4" 36 A3

Medical Tape 2 B2

Biohazard Trash Bags - B1

Biohazard Trash Bag 10 B1

Level 1 Hazardous Material Decal 10 B1

Level 2 Hazardous Material Decal 10 B1

General Use

Cotton Swab 6 Spine

Ear Wick 6 B2

Gloves

Nitrile Gloves Large 10 pair B4

Nitrile Gloves Medium 10 pair B2

Nitrile Gloves Small 10 pair B2

Injection Items

Carpuject Injector 2 A1

Needle 23G 20 A3

Needle 25G 4 Spine

Needle Plastic 10 A2

Syringe 3 mL 20 A4

Syringe 5 mL 6 A2

Syringe 10 mL 5 A1

Skin Preparation Items

BZK Wipe 56 B3

Iodine Swabstick 12 B3
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Table 7. Minor Treatment Pack (Pink)

Item Qty in Pack Location

Bandages

Bandaid 2"x3" 5 A1

Bandaid Dot 10 A1

Bandaid Knuckle 5 A1

Burn Bandage 10 A4

Clear Bandage 5 B4

Nasal Packing 10 A4

Nonstick Bandage 20 A4

Rolled Gauze 2 A1

Dental Tools Kit - B1

Dental Amalgam File (F) 1 B1

Dental Carver File (G) 1 B1

Dental Crown Remover (D) 1 B1

Dental Elevator (I) 1 B1

Dental Elevator (J) 1 B1

Dental Explorer Probe (E) 1 B1

Dental Forceps (A) 1 B1

Dental Forceps (B) 1 B1

Dental Forceps (C) 1 B1

Dental Mirror (H) 1 B1

Trash Bag 1 B1

General Use

Mirror 1 Spine

Scissors - Bandage 1 Spine

Sharps Container 2 Spine

Syringe 60 mL 1 B2

Gloves

Sterile Gloves - A3

Sterile Gloves Large 2 pairs A3

Sterile Gloves Medium 2 pairs A3
3.001 MEDICAL KIT- CONTENTS AND REFERENCE

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Item Qty in Pack Location

Sterile Gloves Small 2 pairs A3

Musculoskeletal

ACE Bandage 2" 1 A3

ACE Bandage 3" 1 A3

ACE Bandage 4" 1 A3

Finger Splint 1 A3

Leg/Arm Splint 1 A3

Surgical Tools Kit - B1

Hemostat (CC) 1 B1

Needle Driver (AA) 1 B1

Scalpel #11 2 B1

Smooth Forceps (DD) 1 B1

Suture Scissors (BB) 1 B1

Toothed Forceps (EE) 1 B1

Trash bag 1 B1

Sutures

Absorbable Suture 3-0 2 A2

Nylon Suture 2-0 2 A2

Nylon Suture 5-0 2 A2

Urinary

Urine Catheters - B3

Urine Catheter Coude 2 B3

Urine Catheter Foley 2 B3

Urine Catheter Straight 2 B3

Urine Catheter Short 10 B3

Urine Collection Bag 2 B3

Wound Repair

Skin Stapler 2 A2

Skin Staple Remover 1 A2

Wound Packing 3 B4
3.001 MEDICAL KIT- CONTENTS AND REFERENCE

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Table 8. Oral Medication Pack (Purple)

Item Strength, 

Volume

Route of 

Use

Qty in 

Pack Unit PossibleSide Effects Comments Location

Altitude Sickness

Acetazolamide (Diamox) 250 mg Oral 100 tablet

Flushing, tingling sensation in 

extremities, loss of appetite, 

increased urine output, drowsiness, 

dizziness, confusion, 

photosensitivity, hearing 

disturbances, kidney stones

A4

Antibiotic

Amoxicillin (Amoxil) 500 mg Oral 100 capsule nausea, vomiting, diarrhea, rash B1

Azithromycin (Zithromax) 250 mg Oral 18 tablet Diarrhea, nausea, abdominal pain, 

vomiting B1

Clindamycin (Cleocin) 300 mg Oral 100 capsule Abdominal pain, nausea, vomiting, 

diarrhea, rash B1

Doxycycline (Vibramycin) 100 mg Oral 50 capsule

Diarrhea, severe headache, blurred 

vision, skin rash, redness of the skin 

(sunburn), itching, loss of appetite, 

upset stomach, stomach pain, 

extreme tiredness or weakness, 

confusion, decreased urination

Spine

Levofloxacin (Levaquin) 500 mg Oral 50 tablet

Headache, insomnia, dizziness, 

nausea, constipation, diarrhea, 

vomiting, abdominal pain, rash, 

photosensitivity

B2

Metronidazole (Flagyl) 500 mg Oral 100 tablet

Headache, dizziness, nausea, 

vomiting, diarrhea, loss of appetite, 

metallic taste, rash

Take with food. B2

Sulfamethoxazole and

Trimethoprim (Bactrim DS)

800 mg,

160 mg Oral 40 tablet

Headache, dizziness, insomnia, 

stomach upset, diarrhea, nausea, 

vomiting, photosensitivity, rash

B1
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Item Strength, 

Volume

Route of 

Use

Qty in 

Pack Unit PossibleSide Effects Comments Location

Antifungal

Fluconazole (Diflucan) 150 mg Oral 5 tablet

Headache, dizziness, nausea, 

abdominal pain, vomiting, diarrhea, 

rash

B2

Antihistamine

Diphenhydramine (Benadryl) 25 mg Oral 60 capsule

Drowsiness, sedation, inability to 

concentrate, dry mouth, blurred 

vision, rash, headache, rapid heart 

rate, dizziness, fatigue, 

photosensitivity, urinary retention, 

ringing in the ears, nasal stuffiness

May cause 

sedation and impair 

performance.

Do not use with 

sleep meds. 

A1

Fexofenadine (Allegra) 180 mg Oral 400 tablet

Headache, vomiting, fatigue, 

somnolence, dizziness, fever, pain, 

drowsiness, diarrhea, nausea, upset 

stomach, muscle aches, back pain, 

pain in extremities

Do not use with 

other 

antihistamines. 

Do not drink 

grapefruit juice 1 

hour before or 2 

hours after taking 

the medication.

A2

Antiseizure

Phenytoin (Dilantin ER) 300 mg Oral 30 capsule

Tingling sensation in extremities, 

drowsiness, dizziness, blurred 

vision, slurred speech

Swallow whole; do 

not crush or chew. B4

Antiviral

Valacyclovir (Valtrex) 1 gm Oral 60 tablet Headache, nausea, vomiting, 

fatigue, dizziness, rash B2
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Item Strength, 

Volume

Route of 

Use

Qty in 

Pack Unit PossibleSide Effects Comments Location

Behavioral Health

Aripiprazole (Abilify) 5 mg Oral 60 tablet

Headache, agitation, insomnia, 

anxiety, tremor, restlessness, 

sedation, dizziness, nausea, 

constipation, vomiting, abdominal 

discomfort, dry mouth, blurred 

vision, nasal congestion

B3

Lorazepam (Ativan) 1 mg Oral 60 tablet

Drowsiness, slowed breathing, low 

blood pressure, sedation, dizziness, 

headache, memory impairment, 

nausea, changes in appetite, visual 

disturbances, headache

A1

Sertraline (Zoloft) 50 mg Oral 60 tablet

Headache, drowsiness, dizziness, 

insomnia, nervousness, anxiety, 

nausea, dry mouth, loss of appetite, 

constipation, tremor, weakness, 

visual difficulty, sweating, rash, 

tinnitus

B3

Venlafaxine (Effexor XR) 75 mg Oral 60 tablet

Headache, drowsiness, dizziness, 

insomnia, nervousness, anxiety, 

nausea, dry mouth, loss of appetite, 

constipation, weakness, sweating

Swallow whole; do 

not crush or chew. B3

Cardiac

Lisinopril (Zestril) 10 mg Oral 100 tablet

Headache, low blood pressure, 

dizziness, fatigue, diarrhea, nausea, 

vomiting, abdominal pain, cough, 

blurred vision, decrease in urine 

output or urine-concentrating ability, 

sweating, weakness

B4
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Item Strength, 

Volume

Route of 

Use

Qty in 

Pack Unit PossibleSide Effects Comments Location

Metoprolol XL (Toprol XL) 50 mg Oral 60 tablet

Slow heart rate, dizziness, 

weakness, insomnia, diarrhea, 

blurred vision, shortness of breath, 

fatigue, confusion, memory loss 

(short-term), sleep disturbances, 

rash, itching, photosensitivity

Swallow whole; do 

not crush or chew. B4

Nitroglycerin (Nitrostat) 0.4 mg Oral 25 tablet Flushing, headache, dizziness, 

nausea, vomiting, dry mouth B4

Decongestant

Pseudoephedrine 

(Sudafed) 30 mg Oral 100 tablet

Dizziness, rapid heart rate, high 

blood pressure, restlessness, 

tremor, headache, loss of appetite, 

may impair ability to concentrate, 

dry mouth, insomnia, 

photosensitivity

A1

Hormone

Medroxyprogesterone 

(Provera) 10 mg Oral 100 tablet Dizziness, headache, nervousness, bloating, acne, breast pain Spine

Norgestrel and Ethinyl 

Estradiol (Ogestrel)

0.5 mg,

0.05 mg Oral 2

unit dose pack

(21 tablets 

each)

Elevated blood pressure, headache, 

dizziness, nervousness, nausea, 

abdominal cramps, blood clots, 

appetite changes, bloating, breast 

pain

Spine

Pain Reliever

Hydrocodone and 

Acetaminophen

(Vicodin HP)

10 mg,

300 mg Oral 30 tablet

Slower heart rate, dizziness, 

drowsiness, mental impairment, 

sedation, nausea, vomiting, 

constipation, urinary retention

May cause 

sedation and impair 

performance.

Do not use with 

sleep meds.

A2
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Item Strength, 

Volume

Route of 

Use

Qty in 

Pack Unit PossibleSide Effects Comments Location

Space Motion Sickness/Anti-Nausea

Meclizine (Antivert) 25 mg Oral 20 tablet

Drowsiness, headache, fatigue, 

nervousness, dizziness, dry mouth, 

blurred vision

May cause 

sedation and impair 

performance. 

Do not use with 

sleep meds. 

A2

Ondansetron (Zofran ODT) 8 mg Oral 30 tablet

Headache, fatigue, drowsiness, 

dizziness, anxiety, constipation, 

diarrhea, urinary retention, itching

A2

Promethazine (Phenergan) 25 mg Oral 100 tablet

Sedation, inability to concentrate, 

drowsiness, dizziness, blurred or 

double vision, nausea, dry mouth, 

urinary retention, constipation, rash, 

agitation, photosensitivity, 

uncontrolled muscle spasms

May cause 

sedation and impair 

performance. 

Do not use with 

sleep meds.

A2

Steroid

Methylprednisolone

(Medrol) 4 mg Oral 4

dose pack 

(21 tablets 

each)

Headache, dizziness, insomnia, 

restlessness, depression, anxiety, 

sweating, mood changes, hair 

growth, flushing, acne

A4

Prednisone (Deltasone) 20 mg Oral 40 tablet Headache, fluid retention, vertigo, 

high blood pressure, mood changes Take with food. A4

Stimulant

Modafinil (Provigil) 200 mg Oral 30 tablet

Headache, nervousness, dizziness, 

anxiety, insomnia, chest pain, rapid 

heart rate, diarrhea, upset stomach, 

dry mouth, lack of appetite

A1

Stomach

Bismuth Subsalicylate

(Pepto Bismol) 262 mg Oral 80 chewable May darken tongue and stool. A3
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Item Strength, 

Volume

Route of 

Use

Qty in 

Pack Unit PossibleSide Effects Comments Location

Omeprazole (Prilosec) 20 mg Oral 90 capsule

Headache, dizziness, rash, 

flatulence, diarrhea, abdominal 

pain, nausea, vomiting, 

constipation, joint pain

A4

Ranitidine (Zantac) 150 mg Oral 60 tablet Dizziness, headache, insomnia, 

abdominal discomfort, blurred vision A3

Urinary

Tamsulosin (Flomax) 0.4 mg Oral 10 capsule

Headache, dizziness, drowsiness, 

diarrhea, nausea, weakness, back 

pain, blurred vision, inflammation of 

the nasal membranes, runny nose, 

cough

A4
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Table 9. Physician Equipment Pack (Yellow)

Item Qty in Pack Location

Advanced Airway Management Hardware

Endoctracheal Tubes - A2

Bougie ET Tube Introducer 1 A2

Endotracheal Stylet 1 A2

Endotracheal Tube 7.0 1 A2

Endotracheal Tube 8.0 1 A2

ILMA Hardware - B1

ILMA Endotracheal Tube 7.0 1 B1

ILMA Endotracheal Tube 7.5 1 B1

ILMA Large 1 B1

ILMA Small 1 B1

ILMA Stabilizer Rod 1 B1

Laryngoscope 1 Spine

Suction Device - B4

Suction Cartridge 1 B4

Suction Collection Bag 1 B4

Suction Syringe 1 B4

Suction Tip - Mouth 1 B4

Suction Tubing - Endotracheal Tube 1 B4

Suction Tubing - Gastric Tube 1 B4

Variable Oxygen System - A1

VOS Intubated Patient Hardware 1 A1

VOS Non-Intubated Patient Hardware 1 A1

VOS Spare Parts 1 A1

Ear Hardware

Otoscope Head Manual 1 B2

General Use

Surgical Lubricant 4 Spine

Syringe 35 mL 1 B1
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Table 10. Topical & Injectable Medication Pack - Medications (Brown)

Item Strength, 

Volume Route of Use Qty in Pack Unit PossibleSide Effects Comments Location

Anesthetic

Dental

Benzocaine Swabstick 20 %,

0.15 mL Topical 24 swab No significant side effects B3

Eye

Tetracaine 0.5 %,

15 mL Eye 1 bottle

Burning, stinging, redness of 

the eye, light sensitivity, 

tearing

Remove contact

lenses prior to 

administration and 

wait 15 minutes 

before reinserting.

A2

Local

Lidocaine and Epinephrine 

(Xylocaine and Epinephrine)

2 % with 

1:100,000 epi,

20 mL

Subcutaneous 2

multi 

dose 

vial

Burning, stinging, blanching, 

tissue death B4

Lidocaine (Xylocaine) 1 %,

10 mL Subcutaneous 3

multi 

dose 

vial

Burning, stinging, blanching, 

tissue death B2

Urinary

Lidocaine Jelly 2 %,

30 mL Topical 3 tube Irritation, itching, rash B4

Antibiotic

Bacitracin 500 units/gm,

28 gm Topical 4 tube No significant side effects A1

Ceftriaxone (Rocephin) 1 gm Intramuscular 3

single 

dose 

vial

Thickening of tissue at 

injection site, rash, diarrhea B1

Ciprofloxacin and

Dexamethasone (Ciprodex)

0.3 %;

0.1 %, 

7.5 mL

Ear 2 bottle Ear discomfort, ear pain, ear 

itching Spine
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Item Strength, 

Volume Route of Use Qty in Pack Unit PossibleSide Effects Comments Location

Ertapenem (Invanz) 1 gm Intramuscular 6

single 

dose 

vial

Headache, altered mental 

status, insomnia, nausea, 

vomiting, diarrhea, abdominal 

pain, constipation, cough

B1

Erythromycin 0.5 %,

3.5 gm Eye 1 tube Hypersensitivity, minor eye irritation, redness A1

Moxifloxacin (Vigamox) 0.5 %,

3 mL Eye 4 bottle

Dry eye, eye pain, itching eye, 

tearing, visual acuity 

decreased

Contact lenses 

should not be worn 

during therapy.

A1

Mupriocin (Bactroban) 2 %,

22 gm Topical 2 tube Skin irritation, itching A1

Tobramycin and 

Dexamethasone (Tobradex)

0.3 %;

0.1 %,

10 mL

Eye 1 bottle

Eye redness, increased 

intraocular pressure, tearing, 

lid itching, lid swelling

Contact lenses 

should not be worn 

during therapy.

A1

Antifungal

Clotrimazole (Lotrimin) 1 %,

30 gm Topical 2 tube Skin irritation, itching A2

Antihistamine

Cromolyn (Nasalcrom) 5.2 mg,

26 mL Intranasal 4 bottle

Increase in sneezing, burning, 

stinging or irritation inside the 

nose, headache, unpleasant 

taste, hoarseness, cough, 

post-nasal drip

A3
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Item Strength, 

Volume Route of Use Qty in Pack Unit PossibleSide Effects Comments Location

Diphenhydramine (Benadryl) 50 mg/mL,

1 mL Intramuscular 6

single 

dose 

vial

Drowsiness, sedation, inability 

to concentrate, dry mouth, 

blurred vision, rash, 

headache, rapid heart rate, 

dizziness, fatigue, 

photosensitivity, urinary 

retention, ringing in the ears, 

nasal stuffiness

May cause 

sedation and 

impair 

performance. 

Do not take with 

sleep meds. 

B4

Behavioral Health

Aripiprazole (Abilify) 7.5 mg/mL,

1.3 mL Intramuscular 2

single 

dose 

vial

Headache, agitation, 

insomnia, anxiety, tremor, 

restlessness, sedation, 

dizziness, nausea, 

constipation, vomiting, 

abdominal discomfort, dry 

mouth, blurred vision, nasal 

congestion

B4

Diazepam (Valium) 5 mg/mL,

2 mL Intramuscular 4 syringe

Drowsiness, fatigue, 

headache, memory loss, 

confusion, slurred speech, 

slower breathing rate, nausea, 

slow heart rate, blurred vision, 

constipation, dry mouth, 

urinary retention

B1

Breathing

Albuterol (Proventil HFA) 90 mcg,

6.7 gm Inhaler 3 inhaler

Tremors, palpitations, fast 

heart rate, dizziness, 

nervousness

A3
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Item Strength, 

Volume Route of Use Qty in Pack Unit PossibleSide Effects Comments Location

Fluticasone (Flovent HFA) 220 mcg,

12 gm Inhaler 2 inhaler

Fatigue, headache, throat 

irritation, oral yeast infection, 

cough, hoarseness, abdominal 

discomfort, nausea, vomiting, 

muscle pain, rash, itching

A4

Salmeterol (Serevent) 50 mcg Inhaler 1

Multi 

dose 

inhaler

Headache, muscle pain, high 

blood pressure, dizziness, 

sleep disturbance, anxiety, 

rash, throat irritation, nausea, 

dry mouth

A3

Dental

Eugenol 1 mL Topical 2

oral 

syringe Gum and skin irritation

Warning: 

DO NOT swallow. 

Medication is very 

damaging to the 

esophagus and 

stomach.

Precaution:

Do not pour the 

entire syringe into 

mouth at once. Use 

small amounts in 

increments.

B3

Earwax Removal

Carbamide Peroxide (Debrox) 6.5 %,

15 mL Ear 2 bottle Irritation, redness in the ear A4
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Item Strength, 

Volume Route of Use Qty in Pack Unit PossibleSide Effects Comments Location

Eye

Cyclopentolate (Cyclogyl) 2 %,

15 mL Eye 1 bottle

Transient irritation, blurred 

vision, sensitivity to light, 

increased intraocular pressure

Remove contact

lenses prior to 

administration and 

wait 15 minutes 

before reinserting.

A2

Fluorescein Strip 1 mg Eye 20 strip No significant side effects

Remove contact 

lenses before 

using.

Spine

Tropicamide (Mydriacyl) 1 %,

15 mL Eye 2 bottle

Blurred vision, burning, 

temporary stinging, increased 

intraocular pressure; dry 

mouth, headache, light 

sensitivity

Remove contact 

lenses before 

using.

A2

Intubation

Glycopyrrolate (Robinul) 0.2 mg/mL,

2 mL Intramuscular 5

single 

dose 

vial

Flushing, dizziness, 

drowsiness, headache, fast 

heartbeat, nausea, vomiting, 

constipation, loss of taste, dry 

mouth, blurred vision, urinary 

retention, photosensitivity

For use by 

Physician CMO 

Only

B2

Ketamine (Ketalar) 50 mg/mL,

10 mL Intramuscular 4

multi 

dose 

vial

Cardiac arrhythmia, visual 

hallucinations, vivid dreams, 

confusion, increased 

intraocular pressure, 

increased intracranial 

pressure, nausea, vomiting, 

increased salivation

For use by 

Physician CMO 

Only

B2
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Item Strength, 

Volume Route of Use Qty in Pack Unit PossibleSide Effects Comments Location

Pain Reliever

Hydromorphone (Dilaudid) 2 mg/mL,

1 mL Intramuscular 18 syringe

Drowsiness, dizziness, 

fatigue, headache, sedation, 

nausea, slow heart rate, 

blurred vision, nausea, 

vomiting, constipation, dry 

mouth, tinnitus, urinary 

retention, abnormal dreams, 

agitation, mood

May cause 

sedation and 

impair 

performance. 

Do not use with 

sleep meds. 

B2

Ketorolac (Toradol) 30 mg/mL,

2 mL Intramuscular 3

single 

dose 

vial

Headache, nausea, upset 

stomach, diarrhea, dizziness, 

drowsiness, elevated blood 

pressure, swelling

B4

Space Motion Sickness/Anti-Nausea

Promethazine (Phenergan) 25 mg/mL,

1 mL Intramuscular 24

single 

dose 

vial

Sedation, inability to 

concentrate, drowsiness, 

dizziness, blurred or double 

vision, nausea, dry mouth, 

urinary retention, constipation, 

rash, agitation, 

photosensitivity, uncontrolled 

muscle spasms

May cause 

sedation and 

impair 

performance.

B4

Steroid 

Dexamethasone (Decadron) 10 mg/mL,

1 mL Intramuscular 20

single 

dose 

vial

High blood pressure, slow 

heart rate, headache, vertigo, 

insomnia, mood swings, 

increased intraocular pressure

B2

Fluocinonide (Lidex) 0.05 %,

30 gm Topical 3 tube Skin irritation, itching A2
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Item Strength, 

Volume Route of Use Qty in Pack Unit PossibleSide Effects Comments Location

Wound Repair

Chemical Cautery

Silver Nitrate and Potassium

Nitrate (Silver Nitrate Applicators)

75 %;

25 %

Topical 10 each Burning and skin irritation, 

staining of the skin A2

Skin Adhesive

Cyanoacrylate (Dermabond) 0.5 mL Topical 2 swab Skin irritation, itching A2
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Table 11. Topical & Injectable Medication Pack - Other Contents (Brown)

Item Qty in Pack Location

Dental

Dental Adhesive 1 B3

Dental Adhesive Tip 4 B3

Temporary Tooth Filling 1 B1

Urine Testing Hardware

EPT 2 Spine

Urine Chemstrip 10 B3

Urine Color Chart 1 B3