Indications

Question 1

Adrenaline - 5

Answer 1

Anaphylaxis
Life-threatening asthma
Severe croup
Cardiac Arrest
Post ROSC

Question 2

Amiodarone - 1

Answer 2

Cardiac Arrest with persistent/shock resistant Ventricular Fibrillation/pulseless Ventricular Tachycardia, post 3rd shock.

Question 3

Aspirin - 1

Answer 3

Chest pain / discomfort of presumed cardiac origin.

Question 4

Atropine Sulphate - 2

Answer 4

Symptomatic Bradycardia, haemodynamically unstable due to the bradycardia and associated with poor signs of perfusion, including:
Hypotension
Altered conscious state
Diaphoresis
Shortness of breath, and/or cyanosis
Syncope

Organophosphate poisoning with cholinergic effects

Question 5

Cophenylcaine - 4

Answer 5

Local pain: abrasions, small cuts and wounds
Relief of mild and moderate epistaxis
Post tonsillectomy haemorrhage
Intra-oral haemorrhage

Question 6

Fentanyl - 2

Answer 6

Moderate to severe pain.

Acute Coronary Syndromes where GTN has been ineffective

Question 7

Glucagon - 2

Answer 7

For demonstrated 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 blood glucose level is below 4mmol/L.

Question 8

Glucose (IV) - 3

Answer 8

Demonstrated hypoglycaemia where oral glucose administration is inappropriate in:

Altered conscious state in known diabetic or of otherwise unknown cause where blood glucose level is below 4mmol/L.
Cardiac arrest, only if hypoglycaemia is suspected as a contributory cause of the arrest, not an early indication.

Question 9

Glucose Oral Gel - 2

Answer 9

Demonstrated hypoglycaemia in:

Altered conscious state in a known Diabetic.
Altered conscious state of unknown medical cause, where blood glucose level is below 4mmol/L.

Question 10

Glyceryl Trinitrate - 3

Answer 10

Chest pain/discomfort of presumed cardiac origin not relieved by rest and reassurance with systolic BP > 90mmHg.
Acute Cardiac Pulmonary Oedema with systolic BP >90mmHg.
Autonomic Dysreflexia with systolic BP > 160mmHg.

Question 11

Heparin - 1

Answer 11

Patients with STEMI going directly to Cardiac Catheterisation Laboratory as per receiving hospital 12-lead ECG interpretation.

Question 12

Hydrocortisone - 1

Answer 12

Patients with known adrenal insufficiency who are symptomatic of adrenal crisis

Question 13

Intravenous Crystalloid Solutions (Normal Saline) - 1

Answer 13

Fluid replacement (volume expansion) for the treatment of shock, fluid loss, and cardiac arrest.

Question 14

Ipratropium Bromide - 2

Answer 14

Severe bronchospasm:

Adult: Severe to life-threatening asthma or COPD

Paediatric: Severe to life-threatening asthma

Question 15

Ketamine - 4

Answer 15

IV: Second line agent for severe pain of traumatic origin post IV Fentanyl administration. ASMA consult needed if IV Fentanyl minimum dose (age dependent as per CPG) has not been given prior to IV Ketamine administration.

IM: First line agent for severe pain of traumatic origin should other means of administering pain medication not be available

Actively disturbed patients requiring sedation where midazolam has already been utilised

Combative Traumatic Brain Injury

Question 16

Lignocaine 1% - 4

Answer 16

Local anaesthesia for:

IV cannulation
IO infusion
Suturing
Finger thoracostomy in the conscious patient

Question 17

Methoxyflurane - 1

Answer 17

Pain

Question 18

Midazolam - 3

Answer 18

Prolonged seizure activity - generalised seizure lasting ≥ 5 minutes OR recurrent / status seizure activity as per CPG
Focal seizure activity which is prolonged (≥ 5 minutes) and is associated with a GCS ≤ 12 as per CPG
Disturbed and/or abnormal behaviour that poses a threat to others or themselves as per CPG

Question 19

Naloxone - 1

Answer 19

Reversal of respiratory depression in a suspected narcotic overdose.

Question 20

Ondansetron - 3

Answer 20

Moderate to severe nausea
Active vomiting
Prophylaxis for eye and spinal injuries

Question 21

Oxygen - Adult and Paed

Answer 21

Adult: Oxygen should be titrated to achieve oxygen saturations of between 94 – 98%, (or 88 – 92% for COPD patients). These are achieved through the use of different flow rates and oxygen masks.

Paediatric: All paediatric patients with significant illness or injury should receive oxygen. Newborn resuscitation should ideally be commenced with room air for the first couple of breaths.

Question 22

Paracetamol - 2

Answer 22

Mild to moderate pain
For example, headache, sprain/strain, toothache, etc.
As a component of a multimodal analgesic regime.

Question 23

Prednisolone - 2

Answer 23

Mild / Moderate croup

Severe croup after nebulised Adrenaline administration

Question 24

Salbutamol - 7

Answer 24

Bronchospasm and respiratory distress associated with wheeze:
Acute Bronchial Asthma
Bronchitis
Smoke inhalation
Severe allergic / anaphylactic reactions
Acute Pulmonary Oedema of non-cardiac origin
Salt Water Aspiration Syndrome (SCUBA divers)
Chronic Obstructive Pulmonary Disease (COPD)

Question 25

Olanzapine - 2

Answer 25

Disturbed and Abnormal Behaviour (RASS 1 ~ 2) where risk to safety is evident and the patient is able to tolerate or self-administer an oral wafer
Preferred first line sedation agent in frail patients and those with Dementia

Question 26

Tranexamic Acid - 4

Answer 26

Significant trauma (< 3 hours) with signs of hypovolaemia or
Significant active haemorrhage that requires the use of
o Tourniquet/s
o Haemostatic/pressure dressing/s
Suspected head injury (< 3hours) with GCS motor score of 4 (withdrawing from pain) or below
Severe Post-Partum Haemorrhage (> 1000 mL) or PPH with signs of hypovolaemia (birth occurred < 3hrs)

Question 27

Droperidol - 2

Answer 27

Disturbed and Abnormal Behaviour (Generally RASS 1 ~ 3) where risk to safety is evident
Dementia or frail patients where Olanzapine cannot be administered or is ineffective