1. Antivenom & Snakebite-Specific Medications

Primary therapeutic agents

- Antivenom - Minimum: 2 high doses OR 4 low doses per Antivenom needed.
- Epinephrine 2mg (1:1000 (IM anaphylaxis), 1:10,000 (IV))
- Atropine (Multidose vials 8mg/20mL, or 4x 1mg/mL vials)
- Neostigmine

Anaphylaxis medications:

- Epinephrine (1:1000 (IM anaphylaxis), 1:10,000 (IV))
- Corticosteroids (e.g., methylprednisolone or dexamethasone)
- H1 antihistamines (e.g., diphenhydramine)
- H2 antihistamines (e.g., famotidine)

Special ophthalmic medications (Spitting Cobra exposures)

- Tetracaine ophthalmic
- Phenylephrine 10% ophthalmic
- Antibiotic eye drops (e.g. oxfloxacin or moxifloxacin gtts)
- Lubricating eye drops

2. Adjunct Medications

- Ketamine
- Fentanyl
- Acetaminophen (PO/IV)
- Antibiotics (IV and ophthalmic as needed)
- Benzodiazepines (for seizures)
- Etomidate (If not using Ketamine)
- Paralytics (If considering RSI + Trained )
- Tetanus vaccine
- Antibiotics (IV and ophthalmic as needed)

3. Blood Products

- Whole Blood

4. Intravenous Fluids & Administration

- Normal Saline (preferred; flushes for rapid mix/push + bag for mixing & antivenom infusion, if given by infusion)
- Lactated Ringer’s (alternative)
- Bag sizes: 250mL Preferred
  - Alternate: 100mL, or SIVP only if supplies are low.
  - 500 and 1000 mL, adds unneeded time and fluid, especially for pediatrics.
  - 10 cc syringes (or saline flushes) + fill needles

5. IV / IO Access Equipment

- Peripheral IV catheters - Various sizes (22–18g)
- IV start kits
- IO access kits
- Coban for IVs on diaphoretic patients
- Central line kits
- Tegaderm
- Medical tape
- Syringes – (1, 3, 5, 10, and 20 mL)
- Needles
- Tape

6. Airway & Ventilation Equipment

- Cricothyroidotomy kit
- Endotracheal tubes
- Supraglottic airway (iGel)
- Bag Valve Mask (BVM)
- PEEP valve
- Ventilator
- Oxygen supply (O2 tanks, Oxygen concentrator, and Masks/NRB)
- Laryngoscope (VL preferred)
- Powered suction unit
- Backup manual suction device
- Assorted suction catheters
- NG and OG tubes (various sizes)

7. Monitoring & Diagnostic Equipment

- Sharpies 2-3
- Pulse oximeter
- Non-invasive blood pressure monitor
- ECG monitor
- Temperature monitor
- Respiratory rate monitoring
- Capnography
- Peak flow meter
- Spirometer
- Glucometer

8. Laboratory Capability

- iSTAT system (CBC, CMP, Hemoglobin / Hematocrit, PT / PTT / INR, Fibrinogen, Creatine Kinase (CK)
- Test strips / lancets
- Vacutainer tubes (red-top)
- Clean, dry, 100% glass tubes for WBCT
- Blood draw needles

9. Ophthalmic Diagnostic Equipment

- Fluorescein stain kit
- Slit lamp (if available)
- Ophthalmoscope

10. Wound Care & Limb Management

- Bandages
- Sterile dressings
- Splints

For additional information including National Stock Number (NSN), please contact dha.ncr.med-log.list.lpr-cps@health.mil

DISCLAIMER: This is not an exhaustive list. These are items identified to be important for the care of combat casualties.