Indications

Question 1

Atropine

Answer 1

Bradycardia (with poor perfusion)
Envenomation (with increased parasympathetic activity)
Hypersalivation (secondary to ketamine administration)
Organophosphate toxicity (with cardiac AND/OR respiratory compromise)

Question 2

Benzatropine

Answer 2

Acute dystonic reaction

Question 3

Calcium gluconate

Answer 3

Suspected hyperkalaemic cardiac arrest
Severe hyperkalaemia (with haemodynamic compromise AND/OR significant cardiac rhythm disturbance)
Verapamil AND/OR diltiazem toxicity
Hypotension associated with a magnesium infusion (that fails to respond to IV fluid therapy)
Hydrofluoric acid inhalation
Following pre-hospital blood product transfusion (adults - every unit, paediatrics - every 10 mL/kg OR unit)

Question 4

Extended life plasma - Group A (low titre)

Answer 4

Ongoing haemodynamic instability secondary to haemorrhage (following an appropriate volume resuscitation strategy)

Question 5

Fentanyl and midazolam (combined)

Answer 5

Sedation for the maintenance of an established ETT/SAD (when transport is longer than 30 minutes)

Question 6

Furosemide (frusemide)

Answer 6

Congestive cardiac failure
Fluid overload (with compromised renal function)
Oliguria (after correction of hypotension and hypovolaemia)

Question 7

Glucose 5%

Answer 7

As a vehicle for drug delivery during IV/IO drug infusion administration
For the dilution and reconstitution of medications

Question 8

Human fibrinogen

Answer 8

Suspected traumatic haemorrhage (requiring pre-hospital blood product transfusion AND a point of care INR > 1.3)

Question 9

Hypertonic saline 7.5%

Answer 9

Traumatic head injury with a GCS <8 AND one or more of the following criteria:
- fixed dilated pupil/s
- unilateral neurological signs
-GCS deterioration of a further 2 points (<6) while in QAS care

Question 10

Insulin - short-acting neutral

Answer 10

Diabetic ketoacidosis (DKA)
Hyperosmolar hyperglycaemic syndrome (HHS)
Critical care patients during interfacility transport

Question 11

Isoprenaline

Answer 11

Bradycardia with poor perfusion unresponsive to transcutaneous pacing (TCP)

Question 12

Ketamine

Answer 12

Severe traumatic pain (following 0.1-0.2 mg/kg morphine OR 1-2 microg/kg fentanyl) associated with: fracture reduction and splinting; multiple or significant fractures requiring facilitated extrication; patients with splinted fractures requiring ongoing narcotic analgesia for transport requirements
Severe traumatic pain associated with burns (following 0.2-0.3 mg/kg morphine OR 2-3 microg/kg fentanyl AND 1-2.5 mg (adult) OR 0.05 (paediatric) midazolam)
Induction of anaesthesia
Ongoing traumatic pain unresponsive to narcotics (following 0.2-0.3 mg/kg morphine OR 2-3 microg/kg fentanyl)
Acute behavioural disturbance (with a SAT score of >/=2 unresponsive to droperidol (max dose) administration

Question 13

Levetiracetam

Answer 13

Convulsive Status Epilepticus continuing > 20 minutes post first midazolam administration

Question 14

Lidocaine 1% (lignocaine 1%)

Answer 14

Pain associated with IO drug and fluid administration following EZ-IO needle insertion
Local anaesthesia (for the purpose of radial artery line replacement, skin closure - suturing, fishhook removal AND/OR thoracostomy)
To reconstitute ceftriaxone for the purpose of IM injection

Question 15

Loperamide

Answer 15

Acute diarrhoea (Disaster Assistance Response Team members only)

Question 16

Lorazepam

Answer 16

Post-ictal acute psychosis (as specifically authorised in AMP 139/12)

Question 17

Metaraminol

Answer 17

Hypotension (without hypovolaemia)
prevention and treatment of the acute hypotensive state occurring with anaesthesia

Question 18

Metoprolol

Answer 18

ACS (unresponsive to nitrates)
Heart rate control (in the setting of ACS)

Question 19

Morphine and midazolam (combined)

Answer 19

Sedation for the maintenance of an established ETT/SAD (when transport is longer than 30 minutes)

Question 20

Noradrenaline (norepinephrine)

Answer 20

Shock unresponsive to adequate fluid resuscitation (excluding haemorrhagic causes)

Question 21

Packed Red Blood Cells (PRBC)

Answer 21

Ongoing haemodynamic instability secondary to haemorrhage (following an appropriate volume resuscitation strategy)

Question 22

Propofol

Answer 22

Induction of anaesthesia (in haemodynamically stable and euvolaemic patients)
Sedation for the maintenance of an established SAD/ETT)

Question 23

Rocuronium

Answer 23

To facilitate paralysis (for endotracheal intubation)
To maintain paralysis (following endotracheal intubation)

Question 24

Sodium bicarbonate 8.4%

Answer 24

Cardiac arrest:
- secondary to suspected hyperkalaemia (e.g. chronic renal failure)
- secondary to tricyclic antidepressant (TCA) OR propranolol overdose
Significant injury with potential for crush syndrome
TCA poisoning (with QRS >0.14 AND terminal R wave in aVR)
Sodium channel blockade due to non-TCA poisoning (with QRS >0.24 AND terminal R wave in aVR)
Suspected hyperkalaemia (with QRS widening AND/OR AV dissociation)

Question 25

Tirofiban

Answer 25

Reduction of ischaemic events associated with ACS and prior to PCI
Critical care patients during interfacility transport