Dosage (Adult)

Question 1

Adrenaline

Answer 1

Cardiac arrest: 1 mg IV, repeated at 3-5 minute intervals, no maximum dose
Anaphylaxis/SAR: 500 microg IM, repeated at 5 minute intervals, no maximum dose; 5 mg NEB, single dose only
Severe life-threatening bronchospasm/silent chest: 500 microg IM, repeated at 5 minute intervals, no max dose

Question 2

Amiodarone

Answer 2

300 mg IV, slow pushover 1-2 minutes, repeated once at 150 mg if refractory to 5 DCCS
Total maximum dose - 450 mg

Question 3

Aspirin

Answer 3

> /= 18 years - 300 mg PO chewed and swallowed, followed by a small sip of water (if possible)

Question 4

Box jellyfish antivenom

Answer 4

If associated with current cardiac arrest: 20000 units combined with sodium chloride 0.9% to a volume of 20 mL, slow push over 2-5 minutes, repeated immediately up to 2 times, total maximum dose 60000 units
If associated with:
- Decreased level of consciousness
- Cardiac AND/OR respiratory distress or collapse
- Total surface area affected greater than half the surface area of one limb
- Intractable pain unrelieved by icepacks, methoxyflurane AND/OR narcotic analgesia
IM: 60000 units, single dose only
IV INF: 20000 units via SPRINGFUSOR combined with sodium chloride 0.9% to a volume of 20 mL, infusion over 20 minutes, single dose only

Question 5

Ceftriaxone

Answer 5

IM: 2 gm (2 × 1 gm IM injections), single dose only
Syringe preparation: Reconstitute two separate vials each containing 1 gm of ceftriaxone with 2.4 mL of water for injection or lidocaine 1% in a 3 mL syringe to achieve a final concentration of 1 gm/3 mL
IV: 2 gm, slow push over 5 minutes, single dose only
Syringe preparation: Reconstitute 2 gm of ceftriaxone with 18.8 mL of water for injection in a 20 mL syringe to achieve a final concentration of 2 gm/20 mL. Ensure syringe is appropriately labelled.

Question 6

Clopidogrel

Answer 6

Patients >/=18 years with STEMI where the receiving interventional cardiologist is requesting clopidogrel administration - 600 mg PO
Patients >/=18 years with STEMI who have received tenecteplase - 300 mg PO

Question 7

Dexamethasone

Answer 7

Not given to adults

Question 8

Droperidol

Answer 8

QAS Clinical Consultation and Advice Line consultation and approval required in all patients >/=65 OR 13-15 years
IV or IM
>/=65 years - 5 mg, may be repeated once at 15 minutes, total maximum dose 10 mg
16-<65 years - 10 mg, may be repeated once at 15 minutes, total maximum dose 20 mg
13-15 years - 0.1-0.2 mg/kg, single maximum dose 10 mg, may be repeated once at 15 minutes, total maximum dose 20 mg

Question 9

Enoxaparin

Answer 9

Patients with STEMI who have received QAS tenecteplase
Loading dose - 30 mg IV to be administered 15 minutes prior to SUBCUT maintenance dose
Maintenance dose - 1 mg/kg, single dose only, not to exceed 100 mg, to be administered 15 minutes after IV loading dose

Question 10

Fentanyl

Answer 10

NAS, IV, IM
>70 years/cachectic or frail - 25-50 microg, repeat at up to 50 microg every 10 minutes, total maximum dose 100 microg
<70 years - 25-100 microg, repeat at up to 50 microg every 10 minutes, total maximum dose 200 microg

Question 11

Glucagon

Answer 11

For all indicated presentations and routes - 1 mg, single dose only
Syringe preparation - Reconstitute 1 mg of glucagon with 1 mL of water for injection in a 3 mL syringe to achieve a final concentration of 1 mg/1 mL

Question 12

Glucose gel

Answer 12

15 gm PO, repeated once at 15 minutes if BGL </=4.0 mmol/L, total maximum dose 30 gm

Question 13

Glucose 10%

Answer 13

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

Question 14

Glyceryl trinitrate

Answer 14

For all indicated presentations - 400 microg (one spray) sublingual, repeated at 5 minute intervals, no maximum dose

Question 15

Heparin

Answer 15

5000 units IV OR dose requested by the receiving interventional cardiologist
Single dose only

Question 16

Hydrocortisone

Answer 16

Asthma, COPD exacerbation, adrenal crisis - 100 mg IM or IV, single dose only
Refractory anaphylaxis - 200 mg IM or IV, single dose only

Question 17

Hydroxocobalamin

Answer 17

5 gm over 15 minutes

Question 18

Ibuprofen

Answer 18

200-400 mg, must not be administered within 6 hours of previous ibuprofen administration

Question 19

Influenza vaccine

Answer 19

Inject pre-filled syringe slowly over a count of 5 seconds into the deltoid, single dose only

Question 20

Ipratropium bromide

Answer 20

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

Question 21

Loratadine

Answer 21

10 mg, single dose only, not to be administered within 24 hours of previous antihistamine administration without approval from consult line

Question 22

Magnesium sulphate

Answer 22

For box jellyfish envenomation and Irukandji syndrome only
10 mmol over 20 minutes, repeated once at 20 minutes, total maximum dose 20 mmol
Administer via SPRINGFUSOR 30 mL

Question 23

Methoxyflurane

Answer 23

3 mL, repeated once after 20 minutes, total max dose 6 mL, total max weekly dose 15 mL

Question 24

Midazolam

Answer 24

5 mg, total max dose 20 mg
Repeated every 10 minutes for NAS/IM or every 5 for IV

Question 25

Morphine

Answer 25

> 70 years/cachectic or frail - 2.5-5 mg IM or 2.5 only IV, repeated at up to 5 mg every 10 minutes, total max dose 10 mg
<70 years - 2.5-10 mg IM or 2.5-5 mg only IV, repeated at up to 5 mg every 5 minutes, total max dose 20 mg

Question 26

Naloxone

Answer 26

1.6 mg (4 ampoules) single dose only but split between two syringes to administer, one in each thigh

Question 27

Ondansetron

Answer 27

4-8 mg, total max dose 8 mg, must not be given within 8 hours of previous ondansetron administration

Question 28

Oxytocin

Answer 28

10 international units (1 ampoule) single dose only

Question 29

Oxygen

Answer 29

Titrate as needed

Question 30

Paracetamol

Answer 30

0.5-1 gram repeated every 4 hours, total max dose 4 grams in 24 hours

Question 31

Salbutamol

Answer 31

12 (1.2 mg) Metered Dose Inhaler inhalations, repeat at 10 minutes, no max dose
5 mg nebulised, repeated PRN, no max dose

Question 32

Sodium chloride 0.9%

Answer 32

Significant burns - mL/hr to be infused = 15 mL/hr x TBSA (nearest 10%), if >100 kg administer an additional 200 mL/hr
All other uses - titrate to presentation and response, use caution in TBI to avoid increasing intercranial pressure (titrate systolic BP to 100-120) and in fluid replacement for major haemorrhage (titrate to achieve radial pulse)

Question 33

Sucrose 24%

Answer 33

Not given to adults

Question 34

Tenecteplase

Answer 34

Dosage calculated by weight, refer to DTP for increments and solution volume

Question 35

Ticagrelor

Answer 35

180 mg

Question 36

Tranexamic acid

Answer 36

1 gram, single dose only

Question 37

Water for injection

Answer 37

As authorised on individual DTP’s