Contraindications

Question 1

Adrenaline

Contraindications

Answer 1

There are no absolute contraindications to adrenaline

Question 2

Amiodarone

Contraindications

Answer 2

No contraindications in cardiac arrest
Not compatible with Saline (if infusion dose is advocated by a specifically authorised person)

Question 3

Aspirin

Contraindications

Answer 3

Known hypersensitivity to aspirin / salicylates / NSAIDs.
Children < 16 years of age.

Question 4

Atropine

Contraindications

Answer 4

Known hypersensitivity.
Patients with cardiac transplant.

Question 5

Cophenylcaine

Contraindications

Answer 5

Hypersensitivity to phenylephrine, lidocaine or other anaesthetics
Children <2yrs
Pregnancy

Question 6

Droperidol

Contraindications

Answer 6

Known allergy
Known Parkinson’s Disease
Where Ketamine has been administered to sedate this episode
Age < 6 years old
Post-ictal Disturbed & Abnormal Behaviour
Patients known or suspected to be pregnant

Question 7

Fentanyl

Contraindications

Answer 7

Hypersensitivity to fentanyl
Child <1 year of age (for IV / IO only)
Occluded nasal passages or epistaxis (for IN only)

Question 8

Glucagon

Contraindications

Answer 8

Hypersensitivity
Known pheochromocytoma, insulinoma, glucagonoma

Question 9

Glucose 10%

Contraindications

Answer 9

Not to be used if there is no patent IV access

Question 10

Glucose Oral Gel

Contraindications

Answer 10

Nil

Question 11

GTN

Contraindications

Answer 11

Hypersensitivity
Hypotension < 90 mmHg
Ventricular Tachycardia (VT)
Recent use of medications used for sexual dysfunction or specific regular medication used in the treatment of pulmonary arterial hypertension (brand names below are not exhaustive):
Sildenafil (Viagra® / Revatio®), Vardenafil (Levitra®) or Avanafil (Spedra®) use in the previous 24 hours
Tadalafil (Cialis®) use in the previous 3 days
Riociguat (Adempas®)

Question 12

Heparin

Contraindications

Answer 12

Hypersensitivity to heparin
Active bleeding (excluding menses) or disease states with an increased risk of bleeding (e.g. haemophilia)

Question 13

Hydrocortisone

Contraindications

Answer 13

Hypersensitivity to hydrocortisone

Question 14

Normal Saline

Contraindications

Answer 14

Severe Pulmonary Oedema

Question 15

Ipratropium Bromide

Contraindications

Answer 15

Hypersensitivity

Question 16

Ketamine

Contraindications

Answer 16

Hypersensitivity
Active cardiovascular disease including cardiac chest pain, heart failure, severe or poorly controlled hypertension
Patients with delayed transfer of care (i.e. ‘ramped’)
Non-pregnant Disturbed and abnormal behaviour that are clearly not RASS 4 or where other sedative agents have already been administered (ASMA authority required)
Rapid Tranquilsation ONLY: Age < 16 years old
Age < 1 years old

Question 17

Lignocaine

Contraindications

Answer 17

Hypersensitivity

Question 18

Loratadine

Contraindications

Answer 18

Children < 30 kg1,2,4,5
Hypersensitivity to loratadine

Question 19

Methoxyflurane

Contraindications

Answer 19

Hypersensitivity to fluorinated anaesthetics2,3
Children under 1 year of age1
Patients who are unable to understand or co-operate including those affected by alcohol or illicit drugs3.
Patients with a severe head injury and altered state of consciousness2,3.
Patients susceptible to malignant hyperthermia1,2,3

Question 20

Midazolam

Contraindications

Answer 20

Hypersensitivity
Use of Midazolam for sedation after Ketamine requires ASMA authority (non-pregnant patient) or STORC consult (pregnant patients)

Question 21

Naloxone

Contraindications

Answer 21

Hypersensitivity to Naloxone

Question 22

Olanzapine

Contraindications

Answer 22

Known Allergy
Known Parkinsons Disease
Age < 6 years old

Question 23

Ondansetron

Contraindications

Answer 23

Hypersensitivity to ondansetron
Treatment with apomorphine: risk of severe hypotension and loss of conciousness2
Paediatrics less than 2 years old3

Question 24

Oxygen

Contraindications

Answer 24

Explosive or flammable environments
Normoxia

Question 25

Paracetamol ## Footnote Contraindications

Answer 25

Hypersensitivity to paracetamol Patients less than 6 months of age (oral solution) Patients less than 3 years of age 120mg (chewable tablets) Patients less then 9 years of age (500mg tablets) Patients less than 1 month of age (IV) Any paracetemol containing product within the last four hours (including prior to SJWA arrival)

Question 26

Prednisolone ## Footnote Contraindications

Answer 26

Known hypersensitivity to prednisolone or prednisone2 Vaccinations with "live" vaccines against common childhood illnesses within the last 48 hours, as this may result in severe attacks of these illnesses2 (MMR, Varicella (Chicken Pox), Yellow Fever, BCG, Rotavirus, Typhoid)

Question 27

Salbutamol ## Footnote Contraindications

Answer 27

Known hypersensitivity to salbutamol Cardiogenic pulmonary oedema Age <12 months

Question 28

TXA ## Footnote Contraindications

Answer 28

Known hypersensitivity to Tranexamic Acid. Injury time more than 3 hours (associated with increase in mortality).