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.