Emt Medications October 2014

Front 1

Paracetamol - Description

Back 1

Paracetamol is used to reduce pain and body temperature.

Presented in suspension of 120 mg in 5 mL or 6+ is 250 mg in 5 mL or 500 mg tablet.

Front 2

Paracetamol - Indications

Back 2

Pryexia

Minor or moderate pain (1-6 on pain scale for adult and paediatric patients).

Front 3

Paracetamol - Contraindications

Back 3

COK

* Chronic liver disease;

* <1 month old;

* KSAR.

Front 4

Paracetamol - Usual dosages

Back 4

Adult 1g PO.

Paediatric 20 mg/Kg PO.

Front 5

Paracetamol - Side effects

Back 5

Nil.

Front 6

Paracetamol - Additional information

Back 6

Consult with parent/guardian in relation to medication prior to arrival on scene;

If administered in previous 4 hours adjust the dose downward by the amount already given to a maximum of 20 mg/Kg.

Front 7

Entonox - Description

Back 7

Potent analgesic gas contains a mixture of both nitrous oxide and oxygen.

Presented in a blue cylinder with white and blue triangles on shoulders.

Front 8

Entonox - Indications

Back 8

Pain relief.

Front 9

Entonox - Contraindications

Back 9

SCARI DICK

* Shock;

* Chest injury/pneumothorax;

* ALOC;

* Recent scuba dive;

* Inhalation injury;

* Decompression sickness;

* Intestinal obstruction;

* Carbon monoxide poisoning;

* KSAR.

Front 10

Entonox - Usual dosages

Back 10

Both adult and paediatric - Self administered until pain relieved.

Front 11

Entonox - Side effects

Back 11

The 3 L's

* Lowers your inhibition;

* Lowers your level of consciousness;

* Light headedness.

Front 12

Entonox - Additional information

Back 12

SACI

* Sickle Cell - Caution when using for greater than one hour for Sickle Cell Crisis;

* Addictive - It has an addictive property;

* Cold temp - In cold temperatures warm cylinder and invert to ensure good mix of gases;

* Instructions - Don't use if the patient is unable to understand instructions.

Front 13

Naloxone - Description

Back 13

Effective in management and reversal of opiate overdoses.

Presented in ampules of 0.4 mg in 1 mL or pre-loaded syringe.

Front 14

Naloxone - Indications

Back 14

Inadequate respirations and/or ALoC following known or suspected narcotic overdose.

Front 15

Naloxone - Contraindications

Back 15

KSAR.

Front 16

Naloxone - Usual dosages

Back 16

Adult - 0.8 mg IN. Repeat after 3 min to a max of 2 mg (2 doses only).

Paediatric - 0.02 mg/Kg IN. Repeat prn to maintain opioid reversal to max 0.1 mg/Kg or 2 mg.

Front 17

Naloxone - Side effects

Back 17

NAVS

Acute reversal of narcotic effects ranging from:

* Nausea;

* Vomiting;

* Agitation;

* Seizures.

Front 18

Naloxone - Additional information

Back 18

PAWD

* Pregnancy - Use with caution in pregnancy;

* Aggressive - Prepare to deal with aggressive patients;

* Withdrawal - Rapid reversal will precipitate acute withdrawal syndrome;

* Dependent - Administer with caution to patients who have taken large dose of narcotics or are physically dependent.

Front 19

Ibuprofen - Description

Back 19

An anti-inflammatory analgesic (Nurofen).

Presented in Suspension 100 mg in 5 mL; 200 and 400 mg tablet.

Front 20

Ibuprofen - Indications

Back 20

Mild to moderate pain.

Front 21

Ibuprofen - Contraindications

Back 21

KNAPP

* KSAR;

* Not suitable for children < 3 months;

* Aspirin - Patient with history of asthma exacerbated by Aspirin;

* Pregnancy;

* Peptic ulcer disease.

Front 22

Ibuprofen - Usual dosages

Back 22

Adult - 400 mg PO.

Paediatric - 10 mg/Kg PO.

Front 23

Ibuprofen - Side effects

Back 23

Skin rashes.

GI intolerance and bleeding.

Front 24

Ibuprofen - Additional information

Back 24

If ibuprofen is administered within the previous 6 hours adjust the dowse downwards by the amount given by the other sources resulting in a maximum of 10 mg/Kg.

Caution with significant burns or poor perfusion due to risk of kidney failure.

Caution if concurrent NSAIDs (Non-steroidal anti-inflammatory drug) use.

Front 25

Glucagon - Description

Back 25

Glucagon is used to increase the blood glucose level in cases of hypoglycaemia in which an IV can't be immediately placed.

Presented in 1 mg vial powder and solution for reconstitution (1 mL).

Front 26

Glucagon - Indications

Back 26

Hypoglycaemia in patients unable to take oral glucose or unable to gain IV access and with a blood glucose level of <4 mmol/L.

Front 27

Glucagon - Contraindications

Back 27

Phaechromocytoma (feea chroma sytoma) (tumor of the adrenal glands);

KSAR.

Front 28

Glucagon - Usual dosages

Back 28

Paediatric - <= 8 years 0.5 mg IM.

>8 years 1 mg IM.

Front 29

Glucagon - Side effects

Back 29

NHHness

* Nausea and vomiting;

* Headache;

* Rarely may cause hypotension;

* Dizziness.

Front 30

Glucagon - Additional information

Back 30

Alcoholics stay cool and dark

* May be in effective in a patients with low stored glycogen (Gly-co-gen) e.g. prior use in previous 24 hours or alcoholic patients with liver disease;

* Store in a refrigerator;

* Protect from light.

Front 31

Aspirin - Description

Back 31

Anti-inflammatory agent and an inhibitor of platelet function.

Presented in a 300 mg dispersible tablet.

Front 32

Aspirin - Indications

Back 32

Cardiac chest pain or suspected myocardial infraction (MI).

Front 33

Aspirin - Contraindications

Back 33

ABBA

* Age <16;

* Bleeding disorder (e.g. haemophilia);

* (Bleeding) Active symptomatic gastrointestinal (GI) ulcer;

* Any KSAR.

Front 34

Aspirin - Usual dosages

Back 34

Adult - 300 mg tablet PO.

Paediatric - contraindicated.

Front 35

Aspirin - Side effects

Back 35

BEG

* Bronchospasm;

* Epigastric pain and discomfort;

* Gastrointestinal haemorrhage.

Front 36

Aspirin - Additional information

Back 36

Aspirin 300mg is indicated for cardiac chest pain regardless if the Pt has taken anticoagulants or is already on Aspirin;

If the Pt has swallowed an Aspirin (enteric coated) preparation without chewing it, the Pt should be regarded as not taken any and therefore administered 300 mg PO.

Front 37

Glucose Gel - Description

Back 37

Synthetic glucose paste.

Presented in a tube or sachet.

Front 38

Glucose Gel - Indications

Back 38

Hypoglycaemia, blood glucose <4 mmol/L.

Front 39

Glucose Gel - Contraindications

Back 39

KSAR.

Front 40

Glucose Gel - Usual dosages

Back 40

Paediatric - <= 8 years 5 to 10 g buccal. Repeat prn.

> 8 years 10 to 20 g buccal. Repeat prn.

Front 41

Glucose Gel - Side effects

Back 41

May cause vomiting in patients under 5 if administered too quickly.

Front 42

Glucose Gel - Additional information

Back 42

Glucose gel will maintain glucose levels once raised but should be used secondary to dextrose to reverse hypoglycaemia;

Proceed with caution when dealing with patients with compromised airways and patients with an ALOC.

Front 43

Oxygen - Description

Back 43

Colourless, tasteless, odourless gas necessary for life.

Presented in D, E, F (1,360 L) cylinders which are black with white shoulders and CD (460 L) cylinders which are white.

Front 44

Oxygen - Indications

Back 44

Absent or inadequate ventilations following an acute medical or traumatic event.

SpO2:

* <96% Paed;

* <94% Adults;

* <92% COPD.

Front 45

Oxygen - Contraindications

Back 45

Bleomycin lung injury.

Front 46

Oxygen - Usual dosages

Back 46

Cardiac and respiratory arrest 100%. Life threats identified during primary survey or acute medical and trauma 100% until reliable SpO2 is obtained then titrate to:

* 96% - 98%;

* 94% - 98%;

* 92%.

Front 47

Oxygen - Side effects

Back 47

Prolonged use with chronic CPOD patients may lead to reduction in ventilation stimulus.

Front 48

Oxygen - Additional information

Back 48

A written record must be made of what O2 therapy is given to each Pt;

Documentation should state whether the Pt is breathing air or a specified dose of supplemental O2;

Consider humidifier of O2 for paediatric patient will last more than 30 mins;

Caution with paraquat poisoning, then admin O2 if SpO2 is < 92%.

Front 49

Epinephrine 1:1,000 (auto injector) - Description

Back 49

Naturally occurring catecholamine (caty cola mean).

Presented in a pre-filled auto injector of 1 mg in 1 mL.

Front 50

Epinephrine 1:1,000 (auto injector) - Indications

Back 50

Severe anaphylaxis.

Front 51

Epinephrine 1:1,000 (auto injector) - Contraindications

Back 51

Nil.

Front 52

Epinephrine 1:1,000 (auto injector) - Usual dosages

Back 52

Paediatric - 6 months - <10 years 0.15 mg IM (auto injector). Repeat every 5 mins prn.

>= 10 years 0.3 mg IM (auto injector). Repeat every 5 mins prn.

Front 53

Epinephrine 1:1,000 (auto injector) - Side effects

Back 53

PHAT (Fat)

* Palpitations;

* Hypertension;

* Angina-like symptoms;

* Tachyarrthymias.

Front 54

Epinephrine 1:1,000 (auto injector) - Additional information

Back 54

N.B. double check the concentration on pack before use.

Front 55

GTN (Glyceryl TriNitrite) - Description

Back 55

Vascular dilator in a aerosol form that delivers precisely 0.4 mg of GTN per spray.

Presented in an aerosol spray metered dose of 0.4 mg.

Front 56

GTN (Glyceryl TriNitrite) - Indications

Back 56

Angina or suspected MI.

Front 57

GTN (Glyceryl TriNitrite) - Contraindications

Back 57

Grandad

* Systolic BP <90 mmHg;

* Viagra or similar used within previous 24 hours;

* KSAR.

Front 58

GTN (Glyceryl TriNitrite) - Usual dosages

Back 58

Adult - 0.4 mg SL. Repeat 3 to 5 mins prn to a max of 1.2 mg (3 doses);

Paediatric is contraindicated.

Front 59

GTN (Glyceryl TriNitrite) - Side effects

Back 59

HFHD (High Frequency / High Definition)

* Headache;

* Flushing;

* Transient Hypotension;

* Dizziness.

Front 60

GTN (Glyceryl TriNitrite) - Additional information

Back 60

If the pump is new or not used for a week or more then the first spray should be released into the air.

Front 61

Salbutamol - Description

Back 61

Bronchodilator designed to open your airway.

Presented in a nebulae of 2.5 mg in 2.5 mL or a nebulae of 5 mg in 2.5 mL or an aerosol inhaler with a metered dose of 0.1 mg.

Front 62

Salbutamol - Indications

Back 62

CBS

* COPD - Exacerbation of COPD;

* Bronchospasm;

* Submersion - Respiratory distress following submersion incident.

Front 63

Salbutamol - Contraindications

Back 63

KSAR.

Front 64

Salbutamol - Usual dosages

Back 64

Paediatric - <5 years 2.5 mg NEB (or 0.1 mg spray x 3). Repeat at 5 mins prn.

>= 5 years 5 mg NEB (or 0.1 mg spray x 5). Repeat at 5 mins prn.

Front 65

Salbutamol - Side effects

Back 65

The 3 T's

* Tachycardia;

* Tachyarrhythmia;

* Tremors;

* High doses may cause hypokalaemia (low level of potassium leading to Cardiac Arrest).

Front 66

Salbutamol - Additional information

Back 66

It is more efficient to use a volumiser in conjunction with an inhaler;

If an O2 driven NEB is used for a patient with acute exacerbation of COPD it should be limited to 6 minutes max.