Section 10 CPGs Flashcards
Allergic reaction/anaphylaxis - Adult
Allergic reaction
-Mild, monitor reaction, consider chlorphenamine 4mg PO
-Moderate or severe, oxygen therapy
-Moderate, Give either chlorphenamine 4mg PO or chlorphenamine 10mg IM, if bronchospasm consider nebuliser salbutamol 5mg NEB, reassess, ECG and SpO2 monitoring, if patient does not deteriorate transport, if patient deteriorates, request ALS, administer adrenaline 500mcg IM
-Severe, determine if adrenaline was given pre arrival (within 5 mins of arrival) and effective
-If it was not administered or not effective, administer adrenaline 500mcg IM or 300mcg auto injector, request ALS
-if it was given or was effective, request ALS
-administer 10mg chlorphenamine IM
-If patient does not recurs/deteriorates/poor improvement, determine if bronchospasm is present, if bronchospasm occurs consider nebuliser, salbutamol 5mg nebuliser
-If patient recurs/deteriorates/has poor improvement monitor ECG and SpO2 levels
-Administer 500mcg adrenaline IM
-is the patient bradycardiac
-If the patient has bradycardia go to bradycardia CPG
-If the patient does not have bradycardia, determine if bronchospasm is present, if bronchospasm consider nebuliser, salbutamol 5mg via nebuliser
-Is there severe or recurrent reactions and/or patients with ronchospasm
-If yes, ALS must treat
-If no, transport
-ADRENALINE CAN BE REPEATED EVERY 5 MINUTES PRN
-AUTOINJECTORS SHOULD NOT BE USED BY HEALTHCARE PROFESSIONALS UNLESS IT IS THE ONLY SOURCE AVAILABLE
-MILD = UTICARIA
-MODERATE = MILD SYMPTOMS AND ANGIO OEDEMA SIMPLE BRONCHOSPASM
-SEVERE = MODERATE SYMPTOMS AND A, B OR C COMPROMISE (HAEMODYNAMIC AND OR RESPIRATORY COMPROMISE)
Posions - Adult
Determine if it is a poison source or a solid substance ingested and GCS 15
-If it is a poison source, was it ingested corrosive, if the ingested was corrosive, take sips of milk and continue to consider ALS, if it was not corrosive, consider ALS
-If it was a solid substance injected and GCS 15, is activated charcoal indicated, if it is indicated, consider administering 50g of activated charcoal PO and continue to request ALS, if it is not indicated, continue to consider ALS
-Determine the poison type
-If it is paraquat poisoning, do not administer oxygen therapy unless SpO2 levels are less than 92%, continue to consider oxygen therapy, ECG and SpO2 level monitoring, and transport
-If it is Alcohol, check blood glucose levels, if blood glucose levels are less than 4mmol/L or more than 20mmol/L go to glycemic emergency CPG, if blood glucose levels are more than 4mmol/L and less than 20mmol/L continue to consider oxygen therapy, ECG and SpO2 level monitoring and transport
-If it is opiate poisoning, determine if there is adequate ventilation, if there is not adequate ventilation, administer Naloxone 0.8mg (0.4mg per nostril), to 2mg IN, repeat x one prn to a max dose of 2mg, go to abnormal work of breathing CPG, if there is adequate ventilation, continue to consider oxygen therapy, ECG and SpO2 level monitoring and transport
-TAKE CAUTION WITH ORAL INTAKES ESPECIALLY WITH SIPS OF MILK
-SUBSTANCES THAT ARE ADSORBED BY ACTIVATED CHARCOAL ARE AVAILABLE IN PHECC FIELD GUIDE
