ACP2 DTPs Flashcards
What are the indications for adrenaline?
- Anaphylaxis/severe allergic reaction
- Severe life-threatening bronchospasm/silent chest
- Cardiac arrest
- Croup (with stridor at rest)
What are the contraindications for adrenaline?
Nil
What is the IM dose of adrenaline for an adult with anaphylaxis?
500 microg, repeated at 5 minute intervals, no max dose.
What is the IM dose of adrenaline for an adult with severe life-threatening bronchospasm/silent chest?
500 microg, repeated at 5 minute intervals, no max dose.
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?
300 microg
What is the NEB dose for an adult with anaphylaxis/severe allergic reaction? What is the additional requirement before administering nebulised adrenaline?
5mg, single dose only. IM adrenaline must first be administered.
What is the IV dose of adrenaline for an adult in cardiac arrest?
1mg, repeated at 3 - 5 minutes, no max dose.
What is the IM dose of adrenaline for a child >6 with anaphylaxis/severe life-threatening bronchospasm/silent chest?
300 microg, repeated at 5 minute intervals, no max dose.
What is the IM dose of adrenaline for a child aged 1 - 6 with anaphylaxis/severe life-threatening bronchospasm/silent chest?
150 microg, repeated at 5 minute intervals, no max dose.
What is the IM dose of adrenaline for a child aged 6 months - 1 year with anaphylaxis/severe life-threatening bronchospasm/silent chest?
100 microg, repeated at 5 minute intervals, no max dose.
What is the IM dose of adrenaline for a child < 6 months with anaphylaxis/severe life-threatening bronchospasm/silent chest?
50 microg, repeated at 5 minute intervals, no max dose.
What is the NEB dose of adrenaline for a paed with anaphylaxis? What else is required for administration of nebulised adrenaline?
5mg, single dose only. IM adrenaline must also be administered.
What is the IV dose of adrenaline for a paed > 10kg (> 1 year) in cardiac arrest?
10microg/kg, repeated at 3 - 5 minute intervals, no max dose.
What is the IV dose of adrenaline for a paed < 10kg (< 1 year) in cardiac arrest?
100microg, repeated at 3 - 5 minute intervals, no max dose.
What is the NEB dose of adrenaline for a paed with croup and stridor at rest?
5mg, single dose only.
Is IM or IV adrenaline indicated for paeds with croup and stridor at rest?
No
What are the indications for aspirin?
- Suspected ACS
- Acute cardiogenic pulmonary oedema
What are the contraindications for aspirin?
- KSAR
- Chest pain associated with psychostimulant overdose
- Bleeding or clotting disorders
- Current GI bleeding OR peptic ulcers
- Patients < 18 years
What is the max daily dose of aspirin?
450mg
What is the dose of aspirin for suspected ACS / acute cardiogenic pulmonary oedema?
300mg tablet, chewed and swallowed with water.
What is the indication for ceftriaxone?
Suspected meningococcal septicaemia (with a non-blanching petechial AND/OR purpuric rash)
What are the contraindications for ceftriaxone?
- KSAR
- Known anaphylaxis/severe allergic reaction to penicillin based drugs
What is the IM dose of ceftriaxone for an adult, and how is it prepared?
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.
What is the IV dose of ceftriaxone for an adult, and how is it prepared?
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.
What is the IM and IV dose of ceftriaxone per kg for paeds?
50mg/kg, rounded up to the nearest 5kg.
After preparing 1g/4mL ceftriaxone for paed IM, what dose and volume should be administered to a paed <5kg?
250mg, 1ml.
After preparing 1g/4mL ceftriaxone for paed IM, what dose and volume should be administered to a paed > 5 - 10kg?
500mg, 2mL.
After preparing 1g/4mL ceftriaxone for paed IM, what dose and volume should be administered to a paed > 10 - 15kg?
750mg, 3mL.
After preparing 1g/4mL ceftriaxone for paed IM, what dose and volume should be administered to a paed > 15kg?
1g, 4mL.
After preparing 1g/10mL ceftriaxone for paed IV, what dose and volume should be administered to a paed < 5kg?
250mg, 2.5mL
After preparing 1g/10mL ceftriaxone for paed IV, what dose and volume should be administered to a paed < 5 - 10kg?
500mg, 5mL
After preparing 1g/10mL ceftriaxone for paed IV, what dose and volume should be administered to a paed >10 - 15kg?
750mg, 7.5mL
After preparing 1g/10mL ceftriaxone for paed IV, what dose and volume should be administered to a paed > 15kg?
1g, 10mL
What are the indications for clopidogrel?
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.
What are the contraindications for clopidogrel?
- KSAR
- Patients contraindicated for pre-hospital fibrinolysis
- Current clopidogrel or ticagrelor therapy
- Patients < 18
- Active bleeding
- Prior intracranial haemorrhage
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?
600mg PO, swallowed with a small quantity of water.
What is the dose of clopidogrel for patients with STEMI who have received tenecteplase and have been administered aspirin and enoxaparin?
300mg PO, swallowed with a small quantity of water.
What is the indication for droperidol?
Acute behavioural disturbance with a SAT score >/=2
What are the contraindications for droperidol?
- KSAR
- Parkinson’s disease
- Previous dystonic reaction to droperidol
- Patients < 8
What is the IM dose of droperidol for patients > 65 (with consult approval)?
5mg, repeated once at 15 minutes, max dose 10mg.
What is the IM dose of droperidol for patients aged 16 - 65?
10mg, repeated once at 15 minutes, max dose 20mg.
What is the IM dose of droperidol for patients aged 13 - 15 (with consult approval)?
0.1 - 0.2 mg/kg. Single max dose 10mg, repeated once at 15 minutes, total max dose 20mg.
What is the IV dose of droperidol for patients > 65 (with consult approval)?
5mg, repeated once at 15 minutes, max dose 10mg.
What is the IV dose of droperidol for patients aged 16 - 65?
10mg, repeated once at 15 minutes, max dose 20mg.
What is the IV dose of droperidol for patients aged 13 -15 (with consult approval)?
0.1 - 0.2 mg/kg, single max dose 10mg, repeated once at 15 minutes, total max dose 20mg.
What is the IM dose of droperidol for patients aged 8 - 12 (with consult approval)?
0.1 - 0.2 mg/kg, single max dose 10mg, repeated once at 15 minutes, total max dose 20mg.
What is the IV dose of droperidol for patients aged 8 - 12 (with consult approval)?
0.1 - 0.2 mg/kg, single max dose 10mg, repeated once at 15 minutes, total max dose 20mg.
What is required for droperidol to be administered IV instead of IM?
An IV cannula must already be in situ; a cannula is not to be inserted for the sole purpose of droperidol administration.
What is the indication for enoxaparin?
Patients with STEMI who will receive tenecteplase as an adjunct to aspirin and clopidogrel.
What are the contraindications to enoxaparin?
- KSAR
- Patients contraindicated for pre-hospital fibrinolysis
What is the dose of IV enoxaparin?
30mg, administered 15 minutes prior to SUBCUT dose.
What is the dose of SUBCUT enoxaparin, and when is it given?
1mg/kg, not to exceed 100mg, single dose only, given 15 minutes after IV loading dose.
What are the indications for fentanyl?
- Significant pain
- Autonomic dysreflexia (systolic BP > 160mmHg)
What contraindicates fentanyl administration?
KSAR
Which is the preferred narcotic for patients presenting with ACS, morphine or fentanyl?
Fentanyl
What is the NAS dose of fentanyl for patients >70?
25 - 50 microg, repeated at up to 50 microg every 10 minutes, total max dose 100 microg.
What is the NAS dose of fentanyl for patients <70?
50 - 100 microg, repeated at up to 100 microg every 10 minutes, total max dose 200 microg.
What is the IM dose of fentanyl for patients >70?
25 - 50 microg, repeated at up to 50 microg every 10 minutes, total max dose 100 microg.
What is the IM dose of fentanyl for patients <70?
25 - 100 microg, repeated at up to 50 microg every 10 minutes, total max dose 200 microg.
What is the IV dose of fentanyl for patients >70?
25 microg, repeated at up to 25 microg every 5 minutes, total max dose 100 microg.
What is the IV dose of fentanyl for patients <70?
25 - 50 microg, repeated at up to 50 microg every 5 minutes, total max dose 200 microg.
What is the paed dose of NAS fentanyl for paeds > 1?
1.5 microg/kg, repeated once at 1 microg/kg at 10 minutes, total max dose 100 microg.
What is the paed dose of IM fentanyl for paeds > 1?
1 - 2 microg/kg, single max dose 50 microg, total max dose 2 microg/kg.
What is the paed dose of IV fentanyl for paeds > 1?
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.
What are the indications for glucagon?
- Symptomatic hypoglycaemia (with inability to self-administer glucose)
- Refractory anaphylaxis (unresponsive to 3x IM adrenaline and adequate fluid resuscitation)
What contraindicates glucagon administration?
KSAR
What is the dose of glucagon IM and IV for adults, and how is it prepared?
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.
When should glucagon be administered IM instead of IV for patients with refractory anaphylaxis?
When paramedics cannot obtain IV access.
What is the dose of glucagon IM and IV for paeds > 25 kg, and how is it prepared?
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.