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Paramedic Revision > SAAS Guidelines > Flashcards

SAAS Guidelines Flashcards

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1
Q

What is the dose and route of administration of aspirin in suspected ischaemic chest pain?

A

300mg oral - chewable tablet

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2
Q

What is the dose and route of administration of GTN in suspected ischaemic chest pain?

A

300micrograms, sublingual dissolvable tablet

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3
Q

what is the dose and route of administration of GTN in ACPO?

A

300micrograms sublingual, every 5 mins prn

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4
Q

What general considerations need to be made before GTN is administered?

A
  • adequate blood pressure (SBP =/> 100mmHg)
  • adequate conscious state
  • caution in suspected right ventricular injury
  • no use of PDE-5 inhibitors within 24 hours (sildenafil, vardenafil, avanafil) or 48 hours (tadalafil)
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5
Q

What interventions can be done to prevent further heat loss in cases of hypothermia or trauma?

A
  • remove patient from wet or cold surfaces
  • remove patient from windy environments
  • remove wet clothing
  • dry the wet patient
  • insulate patient with cloth and space blankets
  • apply trauma cap
  • turn on heater in the ambulance
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6
Q

why should you avoid administering fluids hypothermia?

A

thermal after-drop
- fluid can cause cool blood that has been relatively static in the peripheries (as a result of shunting to major organs) to return to normal circulation and cause a reduction in core temperature

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7
Q

What changes are made in cardiac arrest management for patients who have a temperature below 30 degrees?

A

max of 3 shocks administered and cardiac drugs withheld

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8
Q

What changes are made in cardiac arrest management for patients who have a temperature between 30 and 35 degrees?

A

shocks should be administered as normal, drug interval should be doubled (i.e. 8 minutes between adrenaline)

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9
Q

What is the dose and route of administration of adrenaline in the treatment of anaphylaxis?

A

IM - 10 microg/kg to single max dose of 500 microg, repeat every 5 mins prn

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10
Q

what intervention should be prioritised in the treatment of suspected anaphylaxis?

A

IM adrenaline

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11
Q

what are the paediatric and adult doses of nebuliser adrenaline administered in anaphylaxis with upper airway angioedema?

A

=/> 6 months: 5mg/5mL (including adults)
< 6 months: 2.5mg/2.5mL (made up to 5mL with saline)

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12
Q

what is a primary post partum haemorrhage?

A

blood loss of 500mL or more form the vagina in the first 24 hours after birth

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13
Q

What are the 4 T’s and what do they refer to?

A
  • tone
  • trauma
  • tissue
  • thrombin
    refer to the aetiology of primary PPH
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14
Q

what is a secondary postpartum haemorrhage?

A

an acute and excessive bleed between 24 hours and 12 weeks post birth

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15
Q

What is Tranexamic Acid (TXA) and what are the indications and parameters for administration in PPH?

A

TXA is an antifibrinolytic haemostatic agent - it works by displacing plasminogen from fibrin resulting in inhibition of clot breakdown
- first dose must be administered within 3 hours of birth
- 1g slow push over 2 to 3 minutes
- must be clearly handed over to hospital
- typically given after all other interventions have been completed

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16
Q

what are the targets of permissive hypertension in PPH?

A

administration of fluid to maintain a level of alertness where the patient responds appropriately to verbal commands. If alertness is affected by other factors the presence of a radial pulse is a suitable target

17
Q

Give an overview of the guideline for PPH management

A

> universal care
clinical support (ICP, MedSTAR)
early EOC to liase with SAAS MO/ Perinatal Advise Line
temperature management
early transport
assess fundus
assess external labia and perineum
void bladder
facilitate skin to skin and breastfeeding where possible
2x large bore IV access
early notification
1g IV TXA for pts >16 years / consult for TXA in secondary PPH
IV saline 250mL aliquots up to 20mL/kg

18
Q

Give an overview of the guideline for anaphylaxis

A

> IM adrenaline 10microg/kg - single dose 500microg, repeat every 5 min prn
request clinical support (adults = consider, paeds = must)
in case of bronchospasm follow asthma guideline
upper airway angioedema - nebuliser adrenaline 5mg/5mL >/=6 months, 2.5mg/2.5mL <6months
hypotension - IV saline 10mL/kg to max 250mL aliquots, up to 20mL/kg
- aiming for SBP =/>100 or in lower end of normal range for age
persistent wheeze - oral prednisolone 50mg (pads 1mg/kg)
persistent itch after systemic signs resolved - oral fexofenadine 180mg (over 12)

19
Q

What key things should be done in the ambulance when a code stroke has been initiated?

A
  • bi-lateral access (minimum 18 gauge)
  • 12-lead ECG
  • notify receiving hospital
20
Q

In the ‘general approach to fluid resuscitation’ guideline, what are the amounts of fluid given to adults and pads?

A

Adults -

21
Q

what is the IV dose of naloxone given to an adult showing signs of narcotic overdose and respiratory compromise?

A

50 - 100 microg every 2-3 mins prn

22
Q

how do naloxone vials come and how do you draw it up for IV administration?

A

comes in a 400microg/1mL vial, draw it up with 3 mL of saline to make 100microg/1mL

23
Q

what is the IM dose of naloxone given to an adult showing signs of narcotic overdose and respiratory compromise?

A

400 microg every 2-3 min prn (consider that IM dose may take time to disperse into circulation)

24
Q

what is the IN dose of naloxone given to an adult showing signs of narcotic overdose and respiratory compromise?

A

120 microg

25
Q

what is the IM dose of naloxone given to a paediatric showing signs of narcotic overdose?

A

400 microg every 2-3 mins prn - aim for complete reversal

26
Q

what is the IV dose of naloxone given to a paediatric showing signs of narcotic overdose?

A

50 - 100 microg every 2-3 mins prn - aim for complete reversal

27
Q

why is naloxone not administered to a newborn with respiratory depression due to maternal narcotic use?

A

not administered due to risk of seizures
- consult EOC
- consider clinical support
- transport and notify receiving facility

28
Q

What is the aim of naloxone administration is paeds and adults?

A

paeds - doses are designed to cause complete reversal
adults - the aim is to re-establish airway control and effective ventilation through the use of oxygen and the minimum dose of naloxone, IV administration is preferred in adults as it better allows for the dose to be titrated to effect

29
Q

what are the intervention options for a patient presenting with hypoglycaemia?

A
  • oral carbohydrates or glucose
  • IM glucagon
  • IV glucose
30
Q

what is required for the administration of oral carbohydrates or glucose?

A

A GCS that allows for oral intake

31
Q

what is the dose of IM glucagon in adults?

A

1mg - reconstitute vial with 1mL water

32
Q

what is the dose of IV glucose administered to adults with hypoglycaemia?

A

IV glucose is titrated against patient GCS and BGL

33
Q

what factors are important when administering IV glucose?

A
  • ensure line is patent with saline flush
  • follow infusion with 100mL saline flush
34
Q

what is the dose of glucagon administered to a paediatric with a BGL <3.5?

A

<25kg IM glucagon 0.5mg
>/= 25kg IM glucagon 1mg

35
Q

can we administer IV glucose to paediatrics under a paramedic scope of practice?

A

yes but post oral glucose administration where possible, ineffective glucagon administration and consult with EOC clinician

36
Q

what is the dose of oral glucose administered to a neonate and how is it administered?

A

0.5mL/kg of oral glucose gel (draw up using 3mL syringe)
administer by drying the buccal mucosa with a dressing and gently massaging glucose paste into mucosa with a gloved hand

37
Q

what is the BGL parameter to determine if a paediatric is hypoglycaemic?

A

BGL <3.5 mol/L

38
Q

what is the BGL parameter to determine if a neonate is hypoglycaemic?

A

BGL <2.5 mmol/L

Paramedic Revision (22 decks)

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