Entonox, Paracetamol and Ibuprofen

Question 1

What are the advantages of entonox

Answer 1

Pain relief is rapid
Minimal side effects
No cardiac or respiratory depression
Analgesic effect rapidly reverses
50% oxygen content is valuable in many medical or trauma conditions
Can be given by TEAC/EAC

Question 2

Where entonox is beneficial

Answer 2

Fractured
Sprains/strains/dislocations
Chest pain
Child birth

Question 3

Contra-Indications of entonox

Answer 3

Severe head inj with impaired consciousness
Decompression sickness (the bends)
Violently disturbed psychiatric patients

Question 4

How is paracetamol and ibuprofen given?

Answer 4

Paracetamol 120mg in 5ml (calpol)
Paracetamol 250mg in 5ml (calpol)
Paracetamol 16 x 500mg tablets
Ibuprofen 16 x 200mg tablets

Question 5

Indications for use

Answer 5

Paracetamol - relief of mild to moderate pain and/or high temperature
Ibuprofen - soft tissue injury

Question 6

Contra-indications for paracetamol

Answer 6

Known allergy to paracetamol
Do not give paracetamol if patient has taken a product containing paracetamol (eg calpol, co-codamol) already within the last 4 hours or if they have taken the maximum dose

Question 7

Contra-indications for ibuprofen

Answer 7

Do not give if the patient is
- dehydrated
- hypovolaemic
- known to have renal insufficiency
- suffering active upper gastrointestinal disturbance eg peptic ulcer
- pregnant
- avoid giving further NSAIDS (non steroidal anti inflammatory drugs)
(Naproxen) if the patient has already had them within the last 4 hours or had the maximum amount

Question 8

When should you use caution when giving ibuprofen?

Answer 8

Asthma - due to possible risk of hypersensitivity and bronchoconstriction
If an asthmatic has not previously used NSAIDS do not use acutely in the pre-hospital setting

Question 9

Composition and properties of Entonox

Answer 9

Is an analgesic gas
It is a 50:50 mix of nitrous oxide and oxygen
It is stored under pressure in cylinders