Indications

Question 1

ADRENALINE

Answer 1

CARDIAC ARREST
LIFE-THREATENING ASTHMA
ANAPHYLAXIS
SEVERE CROUP
POST ROSC

Question 2

AMIODARONE

Answer 2

Cardiac arrest with persistent/shock resistant VF/pulseless VT, post 3rd shock

Question 3

ASPIRIN

Answer 3

Patients with suspected ACS

Question 4

ATROPINE

Answer 4

Symptomatic bradycardia, haemodynamically unstable due to bradycardia and associated with poor perfusion

• HYPOTENSION
• ALTERED CONSCIOUS STATE
• DIAPHORESIS
• SOB +/- CYANOSIS
• SYNCOPE

Organophosphate poisioning with cholinergic effects

Question 5

COPHENYCAINE

Answer 5

• LOCAL PAIN - abrasions, small cuts and wounds
• RELIEF FROM MILD/MODERATE EPISTAXIS
• POST TONSILLECTOMY HAEMORRHAGE
• INTRA-ORAL HAEMORRHAGE

Question 6

FENTANYL

Answer 6

• MOD TO SEVERE PAIN

- ACS WHERE GTN HAS BEEN INEFFECTIVE

Question 7

GLUCAGON

Answer 7

For hypoglycaemia where oral glucose cannot be administered and IV access cannot be obtained in a safe and timely manner
- ALTERED CONSCIOUS STATE IN A KNOWN DIABETIC OR OF OTHERWISE UNKNOWN CAUSE WHERE BGL < 4 mmol/L

Question 8

SALBUTAMOL SULPHATE

Answer 8

BRONCHOSPASM AND RESP DISTRESS ASS/ W/ WHEEZE

• ACUTE BRONCHIAL ASTHMA
• BRONCHITIS
• SMOKE INHALATION
• SEV. ALLERGIC/ANAPHYLACTIC REACTIONS
• APO OF NON-CARDIAC ORIGIN
• SALT WATER ASPIRATION SYNDROME (SCUBA DIVERS)
• COPD

Question 9

PREDNISOLONE

Answer 9

• MILD/MODERATE CROUP

- SEVERE CROUP AFTER NEB ADRENALINE

Question 10

PARACETAMOL

Answer 10

• MILD/MOD PAIN
  —- HEADACHE, SPRAIN/STRAIN, TOOTHACHE
  —- COMPONENT OF MULTIMODAL ANALGESIC REGIME

Question 11

OXYGEN

Answer 11

ADULT
- 94-98% (OR 88 - 92% FOR COPD)

PAEDIATRIC

• ALL PTS WITH SIGNIFICANT ILLNESS/INJURY
• NEWBORN RESUS SHOULD BE STARTED WITH ROOM AIR FOR FIRST FEW BREATHS

Question 12

ONDANSETRON

Answer 12

• MOD/SEVERE NAUSEA
• ACTIVE VOMITING
• PROPHYLAXIS FOR EYE AND SPINAL INJURIES

Question 13

NALOXONE

Answer 13

• REVERSAL OF RESP DEP IN SUSPECTED NARCOTIC OD

Question 14

MIDAZOLAM

Answer 14

• PROLONGED SEIZURE ACTIVITY LASTING > 5/60 or RECURRENT/STATUS SEIZURE ACTIVITY
• FOCAL SEIZURE ACTIVITY
  - PROLONGED >5/60
  - GCS <= 12
• second-line IV agent for maintenance of sedation after DROPERIDOL administration for disturbed/abnormal behavior.

Question 15

METHOXYFLURANE

Answer 15

PAIN

Question 16

LIGNOCAINE

Answer 16

LOCAL ANALGESIA FOR

      - IV CANNULATION
      - IO INFUSION
      - SUTURING
      - FINGER THORACOSTOMY IN CONSCIOUS PT

Cardiac arrest with persistent/recurrent VF/pulseless VT, refractory to defibrillation strategies and max. dose of AMIODARONE as per cardiac arrest CPG

Question 17

KETAMINE

Answer 17

• IV: SECOND LINE FOR SEVERE TRAUMATIC PAIN POST IV FENTANYL ADMINISTRATION (ASMA consult needed if IV fentanyl minimum dose not given)
• IM: FIRST LINE AGENT FOR SEVERE TRAUMATIC PAIN WHERE OTHER ADMINISTRATION MEANS NOT AVAILABLE
• COMBATIVE TRAUMATIC BRAIN INJURY
• RASS 4: first line agent for severely disturbed or abnormal behavior where there is an immediate risk to safety and rapid tranquilisation is required and no other sedative medications have already been administered.

Question 18

IPRATROPIUM BROMIDE

Answer 18

SEVERE BRONCHOSPASM

ADULT: SEVERE TO LIFE-THREATENING ASTHMA/COPD

PAED: SEVERE TO LIFE-THREATENING ASTHMA

Question 19

SALINE

Answer 19

FLUID REPLACEMENT

• SHOCK
• FLUID LOSS
• CARDIAC ARREST

Question 20

HEPARIN SODIUM

Answer 20

PTS WITH STEMI GOING DIRECTLY TO CATH LAB AS PER RECEIVING HOSPITAL 12-LEAD ECG INTERPRETATION

Question 21

GTN

Answer 21

• CHEST PAIN/DISCOMFORT OF PRESUMED CARDIAC ORIGIN NOT RELIEVED BY REST/REASSURANCE WITH SYSTOLIC BP >90mmHg
• ACPO WITH BP >90mmHg
• AUTONOMIC DYSREFLEXIA WITH BP >160mmHg

Question 22

GLUCOSE 10% IV

Answer 22

• ALTERED CONSCIOUS STATE IN A KNOWN DIABETIC OR OF OTHERWISE UNKNOWN CAUSE WHERE BGL < 4 mmol/L
• CARDIAC ARREST - only if hypoglycaemia is suspected as a contributory cause of the arrest, not an early indication

Question 23

GLUCOSE ORAL GEL

Answer 23

ALTERED CONSCIOUS STATE IN A KNOWN DIABETIC
Altered conscious statebof unknown medical cause where BGL < 4 mmol/L

Question 24

DROPERIDOL

Answer 24

• Disturbed and abnormal behavior @(RASS 1-3) if considered appropriate where risk to safety is evident and de-escalation has not been effective.
• Dementia and frail patients where olanzepine cannot be administered or is ineffective

Question 25

OLANAZAPINE

Answer 25

- RASS 1-3: if considered appropriate where risk to safety is evident and de-escalation has not been effective. - patient is able to tolerate or self-administee an oral wafer. - preferred first line sedation agent in frail patients and those with dementia.

Question 26

TXA

Answer 26

- significant trauma (<3 hours) with signs of hypovolemia or - significant active haemorrhage that requires the use of - TOURNIQUETS - HAEMOSTATIC/PRESSURE DRESSINGS - suspected head injury (<3 hours) with a GCS motor score <4 - severe primary or secondary PPH (>1L) or PPH with signs of hypovolemia (birth/bleed occured <3hrs) - significant post-tonsillectomy haemorrhage