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ACP2 DTPs Flashcards

1
Q

What are the indications for adrenaline?

A
  • Anaphylaxis/severe allergic reaction
  • Severe life-threatening bronchospasm/silent chest
  • Cardiac arrest
  • Croup (with stridor at rest)
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2
Q

What are the contraindications for adrenaline?

A

Nil

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3
Q

What is the IM dose of adrenaline for an adult with anaphylaxis?

A

500 microg, repeated at 5 minute intervals, no max dose.

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4
Q

What is the IM dose of adrenaline for an adult with severe life-threatening bronchospasm/silent chest?

A

500 microg, repeated at 5 minute intervals, no max dose.

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5
Q

What is the IM dose of adrenaline for an adult with anaphylaxis/severe allergic reaction/severe life-threatening bronchospasm/silent chest when there is a known pregnancy?

A

300 microg

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6
Q

What is the NEB dose for an adult with anaphylaxis/severe allergic reaction? What is the additional requirement before administering nebulised adrenaline?

A

5mg, single dose only. IM adrenaline must first be administered.

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7
Q

What is the IV dose of adrenaline for an adult in cardiac arrest?

A

1mg, repeated at 3 - 5 minutes, no max dose.

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8
Q

What is the IM dose of adrenaline for a child >6 with anaphylaxis/severe life-threatening bronchospasm/silent chest?

A

300 microg, repeated at 5 minute intervals, no max dose.

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9
Q

What is the IM dose of adrenaline for a child aged 1 - 6 with anaphylaxis/severe life-threatening bronchospasm/silent chest?

A

150 microg, repeated at 5 minute intervals, no max dose.

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10
Q

What is the IM dose of adrenaline for a child aged 6 months - 1 year with anaphylaxis/severe life-threatening bronchospasm/silent chest?

A

100 microg, repeated at 5 minute intervals, no max dose.

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11
Q

What is the IM dose of adrenaline for a child < 6 months with anaphylaxis/severe life-threatening bronchospasm/silent chest?

A

50 microg, repeated at 5 minute intervals, no max dose.

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12
Q

What is the NEB dose of adrenaline for a paed with anaphylaxis? What else is required for administration of nebulised adrenaline?

A

5mg, single dose only. IM adrenaline must also be administered.

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13
Q

What is the IV dose of adrenaline for a paed > 10kg (> 1 year) in cardiac arrest?

A

10microg/kg, repeated at 3 - 5 minute intervals, no max dose.

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14
Q

What is the IV dose of adrenaline for a paed < 10kg (< 1 year) in cardiac arrest?

A

100microg, repeated at 3 - 5 minute intervals, no max dose.

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15
Q

What is the NEB dose of adrenaline for a paed with croup and stridor at rest?

A

5mg, single dose only.

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16
Q

Is IM or IV adrenaline indicated for paeds with croup and stridor at rest?

A

No

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17
Q

What are the indications for aspirin?

A
  • Suspected ACS

- Acute cardiogenic pulmonary oedema

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18
Q

What are the contraindications for aspirin?

A
  • KSAR
  • Chest pain associated with psychostimulant overdose
  • Bleeding or clotting disorders
  • Current GI bleeding OR peptic ulcers
  • Patients < 18 years
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19
Q

What is the max daily dose of aspirin?

A

450mg

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20
Q

What is the dose of aspirin for suspected ACS / acute cardiogenic pulmonary oedema?

A

300mg tablet, chewed and swallowed with water.

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21
Q

What is the indication for ceftriaxone?

A

Suspected meningococcal septicaemia (with a non-blanching petechial AND/OR purpuric rash)

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22
Q

What are the contraindications for ceftriaxone?

A
  • KSAR

- Known anaphylaxis/severe allergic reaction to penicillin based drugs

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23
Q

What is the IM dose of ceftriaxone for an adult, and how is it prepared?

A

1g. The powder is reconstituted with 3.6mL water for injection in a 10mL syringe to achieve a final concentration of 1g/4mL. Single dose only.

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24
Q

What is the IV dose of ceftriaxone for an adult, and how is it prepared?

A

1g, slow pushed over 3 - 5 minutes. The powder is reconstituted with 9.6mL water for injection in a 10mL syringe to achieve a final concentration of 1g/10mL. Single dose only.

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25
Q

What is the IM and IV dose of ceftriaxone per kg for paeds?

A

50mg/kg, rounded up to the nearest 5kg.

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26
Q

After preparing 1g/4mL ceftriaxone for paed IM, what dose and volume should be administered to a paed <5kg?

A

250mg, 1ml.

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27
Q

After preparing 1g/4mL ceftriaxone for paed IM, what dose and volume should be administered to a paed > 5 - 10kg?

A

500mg, 2mL.

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28
Q

After preparing 1g/4mL ceftriaxone for paed IM, what dose and volume should be administered to a paed > 10 - 15kg?

A

750mg, 3mL.

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29
Q

After preparing 1g/4mL ceftriaxone for paed IM, what dose and volume should be administered to a paed > 15kg?

A

1g, 4mL.

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30
Q

After preparing 1g/10mL ceftriaxone for paed IV, what dose and volume should be administered to a paed < 5kg?

A

250mg, 2.5mL

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31
Q

After preparing 1g/10mL ceftriaxone for paed IV, what dose and volume should be administered to a paed < 5 - 10kg?

A

500mg, 5mL

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32
Q

After preparing 1g/10mL ceftriaxone for paed IV, what dose and volume should be administered to a paed >10 - 15kg?

A

750mg, 7.5mL

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33
Q

After preparing 1g/10mL ceftriaxone for paed IV, what dose and volume should be administered to a paed > 15kg?

A

1g, 10mL

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34
Q

What are the indications for clopidogrel?

A

Patients with STEMI and who have A) been accepted for pPCI as an adjunct to aspirin and heparin and the intervening cardiologist is requesting clopidogrel administration, or B) who have received tenecteplase and have been administered aspirin and enoxaparin.

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35
Q

What are the contraindications for clopidogrel?

A
  • KSAR
  • Patients contraindicated for pre-hospital fibrinolysis
  • Current clopidogrel or ticagrelor therapy
  • Patients < 18
  • Active bleeding
  • Prior intracranial haemorrhage
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36
Q

What is the dose of clopidogrel for patients with STEMI who have been accepted for pPCI as an adjunct to aspirin and heparin and the intervening cardiologist is requesting clopidogrel administration?

A

600mg PO, swallowed with a small quantity of water.

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37
Q

What is the dose of clopidogrel for patients with STEMI who have received tenecteplase and have been administered aspirin and enoxaparin?

A

300mg PO, swallowed with a small quantity of water.

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38
Q

What is the indication for droperidol?

A

Acute behavioural disturbance with a SAT score >/=2

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39
Q

What are the contraindications for droperidol?

A
  • KSAR
  • Parkinson’s disease
  • Previous dystonic reaction to droperidol
  • Patients < 8
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40
Q

What is the IM dose of droperidol for patients > 65 (with consult approval)?

A

5mg, repeated once at 15 minutes, max dose 10mg.

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41
Q

What is the IM dose of droperidol for patients aged 16 - 65?

A

10mg, repeated once at 15 minutes, max dose 20mg.

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42
Q

What is the IM dose of droperidol for patients aged 13 - 15 (with consult approval)?

A

0.1 - 0.2 mg/kg. Single max dose 10mg, repeated once at 15 minutes, total max dose 20mg.

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43
Q

What is the IV dose of droperidol for patients > 65 (with consult approval)?

A

5mg, repeated once at 15 minutes, max dose 10mg.

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44
Q

What is the IV dose of droperidol for patients aged 16 - 65?

A

10mg, repeated once at 15 minutes, max dose 20mg.

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45
Q

What is the IV dose of droperidol for patients aged 13 -15 (with consult approval)?

A

0.1 - 0.2 mg/kg, single max dose 10mg, repeated once at 15 minutes, total max dose 20mg.

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46
Q

What is the IM dose of droperidol for patients aged 8 - 12 (with consult approval)?

A

0.1 - 0.2 mg/kg, single max dose 10mg, repeated once at 15 minutes, total max dose 20mg.

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47
Q

What is the IV dose of droperidol for patients aged 8 - 12 (with consult approval)?

A

0.1 - 0.2 mg/kg, single max dose 10mg, repeated once at 15 minutes, total max dose 20mg.

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48
Q

What is required for droperidol to be administered IV instead of IM?

A

An IV cannula must already be in situ; a cannula is not to be inserted for the sole purpose of droperidol administration.

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49
Q

What is the indication for enoxaparin?

A

Patients with STEMI who will receive tenecteplase as an adjunct to aspirin and clopidogrel.

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50
Q

What are the contraindications to enoxaparin?

A
  • KSAR

- Patients contraindicated for pre-hospital fibrinolysis

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51
Q

What is the dose of IV enoxaparin?

A

30mg, administered 15 minutes prior to SUBCUT dose.

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52
Q

What is the dose of SUBCUT enoxaparin, and when is it given?

A

1mg/kg, not to exceed 100mg, single dose only, given 15 minutes after IV loading dose.

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53
Q

What are the indications for fentanyl?

A
  • Significant pain

- Autonomic dysreflexia (systolic BP > 160mmHg)

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54
Q

What contraindicates fentanyl administration?

A

KSAR

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55
Q

Which is the preferred narcotic for patients presenting with ACS, morphine or fentanyl?

A

Fentanyl

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56
Q

What is the NAS dose of fentanyl for patients >70?

A

25 - 50 microg, repeated at up to 50 microg every 10 minutes, total max dose 100 microg.

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57
Q

What is the NAS dose of fentanyl for patients <70?

A

50 - 100 microg, repeated at up to 100 microg every 10 minutes, total max dose 200 microg.

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58
Q

What is the IM dose of fentanyl for patients >70?

A

25 - 50 microg, repeated at up to 50 microg every 10 minutes, total max dose 100 microg.

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59
Q

What is the IM dose of fentanyl for patients <70?

A

25 - 100 microg, repeated at up to 50 microg every 10 minutes, total max dose 200 microg.

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60
Q

What is the IV dose of fentanyl for patients >70?

A

25 microg, repeated at up to 25 microg every 5 minutes, total max dose 100 microg.

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61
Q

What is the IV dose of fentanyl for patients <70?

A

25 - 50 microg, repeated at up to 50 microg every 5 minutes, total max dose 200 microg.

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62
Q

What is the paed dose of NAS fentanyl for paeds > 1?

A

1.5 microg/kg, repeated once at 1 microg/kg at 10 minutes, total max dose 100 microg.

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63
Q

What is the paed dose of IM fentanyl for paeds > 1?

A

1 - 2 microg/kg, single max dose 50 microg, total max dose 2 microg/kg.

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64
Q

What is the paed dose of IV fentanyl for paeds > 1?

A

1 microg/kg, single max dose 25 microg, repeated at 0.5 microg/kg at 5 minute intervals (same single max dose), total max dose 2 microg/kg.

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65
Q

What are the indications for glucagon?

A
  • Symptomatic hypoglycaemia (with inability to self-administer glucose)
  • Refractory anaphylaxis (unresponsive to 3x IM adrenaline and adequate fluid resuscitation)
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66
Q

What contraindicates glucagon administration?

A

KSAR

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67
Q

What is the dose of glucagon IM and IV for adults, and how is it prepared?

A

1mg, single dose only. The powder is reconstituted with 1mL of water for injection in a 3mL syringe to achieve a final concentration of 1g/1mL.

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68
Q

When should glucagon be administered IM instead of IV for patients with refractory anaphylaxis?

A

When paramedics cannot obtain IV access.

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69
Q

What is the dose of glucagon IM and IV for paeds > 25 kg, and how is it prepared?

A

1mg, single dose only. The powder is reconstituted with 1mL of water for injection in a 3mL syringe to achieve a final concentration of 1g/1mL.

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70
Q

What is the dose of glucagon IM and IV for paeds < 25 kg, and how is it prepared?

A

0.5mg, single dose only. The powder is reconstituted with 2mL of water for injection in a 3mL syringe to achieve a concentration of 1g/2mL. Decant 1mL of the solution to achieve a final concentration of 0.5mg/1mL.

71
Q

What is the indication for glucose gel?

A

Symptomatic hypoglycaemia with the ability to self-administer oral glucose.

72
Q

What are the contraindications for glucose gel?

A
  • Unconsciousness
  • Difficulty swallowing
  • Patients < 2 years
73
Q

What is the dose of glucose gel for adults and paeds?

A

15g (one tube), repeated once at 15 minutes if BGL <4.0mmol/L, total max dose 30g.

74
Q

What is the indication for glucose 10%?

A

Symptomatic hypoglycaemia with the inability to self-administer oral glucose.

75
Q

What are the contraindications for glucose 10%?

76
Q

What is the IV INF dose of glucose 10% for adults?

A

15g (150mL), repeated at 10g (100mL) boluses every 5 minutes until BGL > 4.0mmol/L.

77
Q

What is the IV INF dose of glucose 10% for paeds?

A

0.25g/kg (2.5mL/kg), repeated at 0.1g/kg (1mL/kg) boluses every 5 minutes until BGL > 4.0mmol/L.

78
Q

What are the indications for GTN?

A
  • Suspected ACS
  • Acute cardiogenic pulmonary oedema
  • Autonomic dysreflexia (with systolic BP >160mmHG)
  • Irukandji syndrome (with systolic BP >160mmHg)
79
Q

What are the contraindications for GTN?

A
  • KSAR
  • HR < 50 or > 150 bpm
  • Systolic BP < 100mmHg
  • Acute CVA
  • Head trauma
  • Phosphediesterase inhibitor medication in the previous 24 hours
80
Q

What is the dose of GTN in one spray?

A

400 microg

81
Q

What is the dose of GTN for adults?

A

400 microg, repeated at 5 minute intervals, no max dose.

82
Q

What is the indication for heparin?

A

Patients with STEMI who have been accepted for pPCI as an adjunct to aspirin and either ticagrelor or clopidogrel.

83
Q

What are the absolute contraindications for heparin?

A
  • KSAR
  • Patients < 18 years
  • Active bleeding or clotting problem
  • Prior intracranial haemorrhage
  • Current use of anticoagulants
84
Q

What are the relative contraindications (require consultation prior to administration) for heparin?

A
  • Uncontrolled HTN
  • Known cerebral disease
  • Ischaemic stroke or TIA in the last 3/12
  • Hx significant closed head/facial trauma in the last 3/12
  • Hx major trauma or surgery in last 6/52
85
Q

What is the dose of IV heparin?

A

5000 units, single dose only.

86
Q

What is the indication for hydrocortisone?

A

Symptomatic adrenal insufficiency (with known hx)

87
Q

What is the contraindication for hydrocortisone?

88
Q

What is the IM dose of hydrocortisone for adults, and how is it prepared?

A

100mg, single dose only. The 100mg vial is reconstituted with 2mL NaCl 0.9% or water for injection.

89
Q

What is the IV dose of hydrocortisone for adults, and how is it prepared?

A

100mg slow pushed over 1 minute, single dose only. The 100mg vial is reconstituted with 2mL NaCl 0.9% or water for injection.

90
Q

What is the IM dose of hydrocortisone for paeds > 10 years?

A

100mg, single dose only.

91
Q

What is the IM dose of hydrocortisone for paeds aged 5 - 10 years?

A

50mg, single dose only.

92
Q

What is the IM dose of hydrocortisone for paeds aged 0 - 4 years?

A

25mg, single dose only.

93
Q

What is the IV dose of hydrocortisone for paeds > 10 years?

A

100mg, slow pushed over 1 minute, single dose only.

94
Q

What is the IV dose of hydrocortisone for paeds aged 5 - 10 years?

A

50mg, slow pushed over 1 minute, single dose only.

95
Q

What is the IV dose of hydrocortisone for paeds aged 0 - 4 years?

A

25mg, slow pushed over 1 minute, single dose only.

96
Q

What are the indications for ipatropium bromide?

A

Moderate - severe bronchospasm unresponse to initial salbutamol NEB.

97
Q

What are the contraindications for ipatropium bromide?

A
  • KSAR

- Patients < 1 year

98
Q

What is the NEB dose of ipatropium bromide for adults?

A

500 microg, repeated at 20 minute intervals, total max dose 1.5mg.

99
Q

What is the NEB dose of ipatropium bromide for paeds > 6 years?

A

500 microg, repeated at 20 minute intervals, total max dose 1.5mg.

100
Q

What is the NEB dose of ipatropium bromide for paeds aged 1 - 5 years?

A

250 microg, repeated at 20 minute intervals, total max dose 750 microg.

101
Q

What is the indication for methoxyflurane?

102
Q

What are the contraindications for methoxyflurane?

A
  • KSAR
  • Patients < 1 year
  • Hx significant liver or renal disease
  • Hx malignant hyperthermia
103
Q

What is the dose of INH methoxyflurane for adults?

A

3mL, repeated once after 20 minutes, max dose 6mL.

104
Q

What is the dose of INH methoxyflurane for paeds > 1 year?

A

3mL, single dose only.

105
Q

What is the indication for midazolam?

A

Seizure (with GCS < 12)

106
Q

What is the contraindication for midazolam?

107
Q

What is the NAS dose of midazolam for adults > 70?

A

2.5mg, repeated every 10 minutes, max dose 10mg.

108
Q

What is the NAS dose of midazolam for adults < 70?

A

5mg, repeated every 10 minutes, max dose 20mg.

109
Q

What is the IM dose of midazolam for adults > 70?

A

2.5mg, repeated every 10 minutes, max dose 10mg.

110
Q

What is the IM dose of midazolam for adults < 70?

A

5mg, repeated every 10 minutes, max dose 20mg.

111
Q

What is the NAS dose of midazolam for paeds?

A

200microg/kg, single dose not to exceed 5mg. Repeated at half initial dose at 10 minute intervals, total max dose 10mg.

112
Q

What is the IM dose of midazolam for paeds?

A

200microg/kg, single dose not to exceed 5mg. Repeated at half initial dose at 10 minute intervals, total max dose 10mg.

113
Q

What are the indications for morphine?

A
  • Significant pain

- Autonomic dysreflexia (with systolic BP > 160mmHg)

114
Q

What are the contraindications for morphine?

A
  • KSAR

- Renal failure

115
Q

What is the IM dose of morphine for adults > 70?

A

2.5mg - 5mg, repeated at up to 5mg every 10 minutes, max dose 10mg.

116
Q

What is the IM dose of morphine for adults < 70?

A

2.5mg - 10mg, repeated at up to 5mg every 10 minutes, max dose 20mg.

117
Q

What is the IV dose of morphine for adults > 70?

A

2.5mg, repeated at up to 2.5mg every 5 minutes, max dose 10mg.

118
Q

What is the IV dose of morphine for adults < 70?

A

2.5 - 5mg, repeated at up to 5mg every 5 minutes, total max dose 20mg.

119
Q

What is the IM dose of morphine for paeds > 1 year?

A

100 - 200 microg/kg, single max dose 5mg, total max dose 200microg/kg.

120
Q

What is the IV dose of morphine for paeds > 1 year?

A

100microg/kg, single max dose 2.5mg, repeated at 50microg/kg at 5 minute intervals, total max dose 200microg/kg.

121
Q

What is the indication for naloxone?

A

Respiratory depression, secondary to administration of narcotic drugs.

122
Q

What are the contraindications for naloxone?

A
  • KSAR

- Newly born patient

123
Q

What is the IM dose of naloxone for adults?

A

1.6mg, single dose only.

124
Q

What is the IM dose of naloxone for paeds?

A

20microg/kg, not to exceed 800 microg, single dose only.

125
Q

What is the indication for ondansetron?

126
Q

What are the contraindications for ondansetron?

A
  • KSAR
  • Congenital long QT syndrome
  • Current apomorphine (dopamine agonist, Parkinsons rx) therapy
  • Patients < 3 years
127
Q

What is the PO/IM/IV dose of ondansetron for adults?

A

4 - 8mg, max dose 8mg.

128
Q

What is the PO dose of ondansetron for paeds > 5 years?

A

4mg, single dose only.

129
Q

What is the IM dose of ondansetron for paeds?

A

100microg/kg, not to exceed 4mg, single dose only.

130
Q

What is the IV dose of ondansetron for paeds?

A

100microg/kg slow pushed over 2 - 3 minutes, not to exceed 4mg, single dose only.

131
Q

What are the contraindications for oxygen?

A
  • Known paraquat poisoning with SpO2 > 88%

- Hx bleomycin therapy with SpO2 > 88%

132
Q

What is the target oxygen saturation range for patients requiring controlled/low dose oxygen therapy (i.e. COPD)?

133
Q

What are the indications for oxytocin?

A
  • Active management of the third stage of labour

- Prevention and/or treatment of PPH

134
Q

What are the contraindications for oxytocin?

A
  • KSAR

- Undelivered foetuses

135
Q

What is the IM dose of oxytocin?

A

10 IU, single dose only.

136
Q

What are the indications for paracetamol?

A
  • Minor pain

- Fever

137
Q

What are the contraindications for paracetamol?

A
  • KSAR

- Patients < 1 month

138
Q

What is the adult dose of paracetamol?

A

0.5 - 1g, repeated every 4 hours, max dose 4g/24h.

139
Q

What is the paed dose of paracetamol?

A

15mg/kg, at least 4 hours after previous administration, single dose only.

140
Q

What is the indication for salbutamol?

A

Bronchospasm

141
Q

What are the contraindications for salbutamol?

A
  • KSAR

- Patients < 1 year

142
Q

What is the NEB dose of salbutamol for adults?

A

5mg, repeated PRN, no max dose.

143
Q

What is the NEB dose of salbutamol for paeds aged 1 - 5 years?

A

2.5mg, repeated PRN, no max dose.

144
Q

What is the NEB dose of salbutamol for paeds > 6 years?

A

5mg, repeated PRN, no max dose.

145
Q

What are the indications for NaCl 0.9%?

A
  • Inadequate tissue perfusion/shock
  • Hypovolaemia
  • Significant burns (TSA > 20% adults, > 10% paeds)
  • To dissolve/dilute drugs
  • As a flush following IV administration
146
Q

What are the contraindications for fluid therapy?

147
Q

What is the measureable target of fluid therapy in the setting of uncontrolled haemorrhage (without TBI)?

A

Minimum amount of fluid required to maintain a radial pulse.

148
Q

What is the target of fluid therapy in a hypotensive adult patient with TBI?

A

Minimum amount of fluid required to maintain a systolic BP of 100 - 120mmHg.

149
Q

What is the dose of NaCl 0.9% for adults with inadequate perfusion/shock/hypovolaemia?

A

PRN, titrated according to indication and response.

150
Q

What is the dose of NaCl 0.9% for adults with significant burns (TSA > 20%)?

A

insert equation

151
Q

What is the dose of NaCl 0.9% for paeds with inadequate perfusion/shock/hypovolaemia (with consult approval)?

A

10 - 20mL/kg, may be repeated twice after reassessment, total max dose 60mL/kg.

152
Q

What are the indications for sucrose 24%?

A
  • Short term procedural pain management (e.g. IV cannulation)
  • Distress due to pain
153
Q

What are the contraindications for sucrose 24%?

A
  • Patients > 12 months
  • Sucrose intolerance (CSID)
  • Fructose intolerance
  • Glucose-galactose malabsorption
  • Concurrent muscle relaxant/paralysis therapy
154
Q

What is the dose of sucrose 24% for paeds aged 0 - 1 month?

A

0.1 mL (2 drops) PO, repeated once at 5 minutes.

155
Q

What is the dose of sucrose 24% for paeds aged 2 - 12 months?

A

0.5 mL (10 drops) PO, repeated once at 5 minutes.

156
Q

What is the indication for tenecteplase?

A

Patients with STEMI (who meet the criteria for administration by the coronary artery reperfusion checklist)

157
Q

What are the contraindications for tenecteplase?

A
  • < 18 or > 75 years
  • Uncontrolled HTN
  • KSAR to tenecteplase, enoxaparin, or clopidogrel
  • LBBB
  • Current or hx of thrombocytopenia
  • Active tuberculosis
  • Ischaemic stroke or TIA in 3/12
  • Hx significant closed head/facial trauma in 3/12
  • Suspected aortic dissection
  • Hx major trauma or surgery in 6/52
  • Bleeding or clotting disorder
  • Current use of anticoagulants
  • Non-compressible vascular punctures
  • CPR for > 10 minutes
  • Known pregnancy or delivery in 2/52
  • Hx serious systemic disease
  • Resident of aged care facility requiring significant ADL
  • AMI in trauma setting
158
Q

What is the indication for ticagrelor?

A

Patients with STEMI who have been accepted for pPCI as an adjunct to aspirin and heparin and the intervening cardiologist is requesting ticagrelor administration.

159
Q

What are the contraindications for ticagrelor

A
  • KSAR
  • Patient currently taking ticagrelor or clopidogrel
  • Patients < 18 years
  • Active bleeding
  • Prior intracranial haemorrhage
  • Hx hepatic impairment
160
Q

What is the dose of ticagrelor?

A

180mg PO, swallowed with a small quantity of water.

161
Q

What is the indication for tranexamic acid?

A

Recent traumatic injury (< 3 hours) with a COAST score > 3

162
Q

What is the contraindication for tranexamic acid?

163
Q

What is the adult IV dose of tranexamic acid?

A

1g, slow pushed over 2 - 3 minutes, single dose only.

164
Q

What is the paed IV dose of tranexamic acid (with consult approval)?

A

15mg/kg, single max dose 1g, slow pushed over 2 - 3 minutes, single dose only.

165
Q

What are the indications for box jellyfish antivenom?

A

Box jellyfish envenomation associated with:

  • Cardiac arrest
  • Decreased LOC
  • Cardiac and/or respiratory distress or collapse
  • TSA greater than half the surface area of one limb
  • Intractable pain unrelieved by icepacks, methoxyflurane, and/or narcotic analgesia
166
Q

What is the contraindication for box jellyfish antivenom?

167
Q

What is the IM dose of box jellyfish antivenom?

A

60 000 units, single dose only.

168
Q

What is the IV INF dose of box jellyfish antivenom?

A

20 000 units (mixed with NaCl 0.9% to reach 20mL), infusion over 20 minutes, single dose only.

169
Q

What is the IV dose of box jellyfish antivenom for patients in cardiac arrest?

A

20 000 units (mixed with NaCl 0.9% to reach 20mL), slow pushed over 2 - 5 minutes, repeated immediately up to 2 times, total max dose 60 000 units.

170
Q

What are the indications for magnesium sulphate?

A
  • Box jellyfish envenomation unresponsive to antivenom

- Irukandji syndrome with intractable pain unrelieved by narcotic analgesia and/or systolic BP > 160mmHg

171
Q

What are the contraindications for magnesium sulphate?

A
  • KSAR
  • AV block
  • Renal failure
172
Q

What is the IV INF dose of magnesium sulphate for adults?

A

10mmol (mixed with 15mL NaCl 0.9% to reach 20mL) over 20 minutes, repeated once at 20 minutes, max dose 20mmol.

173
Q

What is the IV INF dose of magnesium sulphate for paeds?

A

0.1mmol/kg rounded up to the nearest 0.5mmol and not to exceed 5mmol (mixed with NaCl 0.9% to reach 15mL) given over 15 minutes, repeated once at 10 minutes, total max dose 10mmol.

QAS (2 decks)

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