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Red Flag: Respiratory rate below 8–10
Action: Stop the infusion immediately, administer naloxone, monitor closely for re-sedation.

Red Flag: Platelets below 100,000
Action: Stop heparin immediately, notify provider, avoid antiplatelets.

Red Flag: INR above 3.5–4 or any active bleeding
Action: Hold the dose, give vitamin K (planned) or FFP (active bleed).

Red Flag: Yellow/green halos, heart rate below 60, significant nausea
Action: Hold digoxin, draw serum level before considering antidote.

Red Flag: Severe burning, rhythm changes, undiluted infusion
Action: Stop the infusion instantly.

Red Flag: Intense flushing and rash during infusion
Action: Slow the infusion, pre-treat with diphenhydramine for future doses.

Red Flag: Purple, swollen, painful IV site
Action: Stop the infusion, use slow rate and inline filter for prevention.

Red Flag: Rapid swelling of lips, tongue, or face
Action: Stop the drug immediately, never restart ACE inhibitors.

Red Flag: New tinnitus or hearing loss
Action: Stop the medication, check peak and trough levels.

Red Flag: Coarse tremor, confusion, severe nausea
Action: Hold the dose, check level, increase fluids.

Red Flag: High fever, agitation, rigidity, hyperreflexia
Action: Stop the medication immediately, initiate cooling and supportive care.

Red Flag: Child with viral illness taking NSAIDs/aspirin
Action: Stop immediately, switch to acetaminophen.

Red Flag: Upcoming contrast study or muscle pain/drowsiness
Action: Hold 48 hours before and after contrast.

Red Flags: Respiratory rate below 12, absent DTRs, low urine output
Action: Stop magnesium, give calcium.

Red Flag: Heart rate below 50–60 with symptoms
Action: Hold dose, notify provider; glucagon for severe overdose.

Red Flag: Scheduled surgery within 3–5 days
Action: Hold medication pre-op (5 days for clopidogrel, 3–5 for ticagrelor).

Red Flag: Persistent dry cough, new shortness of breath, abnormal chest image
Action: Stop amiodarone, start steroids.

Red Flag: Burning, swelling, pain at IV site
Action:

Stop the infusion

Do NOT remove the IV

Aspirate the drug

Remove needle

Apply cold (or heat for vinca alkaloids)

Give antidote

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