Idaho Administrative Code › Title IDAPA 24 - Occupational and Professional Licenses, Division of › Rule 24.26.01 - RULES OF THE IDAHO BOARD OF MIDWIFERY › Section 24.26.01.200 - USE OF FORMULARY DRUGS

Current through August 31, 2023
01.
Protocols
. A licensed midwife may use the drugs described in the
			 midwifery formulary according to the following protocol describing the
			 indication for use, dosage, route of administration and duration of treatment:
Drug
Indication
Dose
Route of
							 Administration
Duration of
							 Treatment
Oxygen
Maternal/Fetal Distress Neonatal
							 Resuscitation
10-12 L/min. 10L/min. 10-12L/min.
							 10L/min.
Bag and mask Mask Bag and mask Mask
Until maternal/fetal stabilization is achieved or
							 transfer to hospital is complete Until stabilization is achieved or transfer to
							 a hospital is complete
Oxytocin (Pitocin)
Postpartum hemorrhage only
10 Units/ml
Intramuscularly only
1-2 doses Transport to hospital required if more than
							 two doses are administered
Lidocaine HCl 2%
Local anesthetic for use during postpartum repair of
							 lacerations or episiotomy
Maximum 50 ml
Percutaneous infiltration only
Completion of repair
Penicillin G (Recommended)
Group B Strep Prophylaxis
5 million units initial dose, then 2.5 million units
							 every 4 hours until birth
IV in > 100 ml LR, NS or
							 D5LR
Birth of baby
Methegrine (Methylergonovine)
Postpartum hemorrhage only
0.2mg/ml
Intramuscularly only 1 dose
Transport to hospital required if single dose does
							 not stop hemorrhage
Ampicillin Sodium (Alternative)
Group B Strep Prophylaxis
2 grams initial dose, then 1 gram every 4 hours until
							 birth
IV in >100 ml NS or LR
Birth of baby
Cefazolin Sodium (drug of choice for penicillin
							 allergy with low risk for anaphylaxis)
Group B Strep Prophylaxis
2 grams initial dose, then 1 gram every 8
							 hours
IV in > 100 ml LR, NS or D5LR
Birth of baby
Clindamycin Phosphate (drug of choice for penicillin
							 allergy with high risk for anaphylaxis)
Group B Strep Prophylaxis
900 mg every 8 hours
IV in >100 ml NS (not LR)
Birth of baby
Epinephrine HCl 1:1000
Treatment or post-exposure prevention of severe
							 allergic reactions
0.3 ml
Subcutaneously or intramuscularly
Every 20 minutes or until emergency medical services
							 arrive Administer first dose then immediately request emergency
							 services
Lactated Ringer's (LR) 5% Dextrose in Lactated
							 Ringer's solution (D5LR) 0.9% Sodium Chloride (NS) Sterile
							 Water
To achieve maternal stabilization Reconstitution of
							 antibiotic powder
I - 2 liter bags First liter run in at a wide-open
							 rate, the second liter titrated to client's condition As
							 directed
Intravenously with >18 gauge catheter As
							 directed
Until maternal stabilization is achieved or transfer
							 to a hospital is complete Birth of Baby
Cytotec (Misoprostol)
Postpartum hemorrhage only
800 mcg
Rectally is the preferred method Orally is
							 allowed
1-2 doses Transport to hospital required if more than
							 one dose is administered
Rho(d) Immune Globulin
Prevention of Rho (d) sensitization in Rho (d)
							 negative women
300 mcg
Intramuscularly
Single dose at any gestation for Rho (d) negative,
							 antibody negative women within 72 hours of spontaneous bleeding or abdominal
							 trauma.
Single dose at 26-28 weeks gestation for Rho (d)
							 negative, antibody negative women Single dose for Rho (d) negative, antibody
							 negative women within 72 hours of delivery of Rho (d) positive infant, or
							 infant with unknown blood type
Phytonadione
Prophylaxis for Vitamin K Deficiency
							 Bleeding
1 mg
Intramuscularly
1 dose
0.5% Erythromycin Ophthalmic Ointment
Prophylaxis of Neonatal Ophthalmia
1 cm ribbon in each eye
Topical
1 dose
(3-28-23)