Special Considerations Flashcards
Adrenaline - 6
Dysrhythmias Hypertension Pupil dilation Tremor Anxiety Palpitations
Amiodarone - 8
Bradycardia Hypotension Polymorphic tachycardias Nausea Tremor Dizziness Paraesthesia Headaches
Aspirin - 3
Heart burn, nausea, GI bleeding.
Increased bleeding time.
Anaphylactic reaction (some patients, especially asthmatics) exhibit notable sensitivity to aspirin, which may provoke various hypersensitivity / allergic reactions)
Atropine Sulphate - 5
Tachycardia and/or palpitations Dilated pupils and/or blurred vision Dry mouth and/or urinary retention Confusion, restlessness (large doses) Hot, dry skin (large doses)
Cophenylcaine - 2
Oral administration may cause a transient bitter taste.
Pause between subsequent doses.
Droperidol - 4
Extrapyramidal effects / Dyskinesia
Increased falls risk
Hypotension
Apply monitoring as soon as practicable
Fentanyl - 5
Adopt a low threshold to engage with the ED team if pain remains difficult to control
Nausea/vomiting
Respiratory depression; monitor pulse oximetry for all patients having IV / IN Fentanyl
Cardiovascular effects:
Bradycardia
Hypotension (rare)
Glucagon - 3
Nausea/vomiting
Gastric pain
Transient rise of blood pressure for patients taking beta blockers.
Glucose 10% (IV) - 4
Hyperglycaemia
Diuresis
Tissue necrosis
Thrombophlebitis
Glucose Oral Gel - 1
Airway obstruction
Glyceryl Trinitrate - 4
Hypotension (rare)
Tachycardia
Flushing
Headache
Heparin - 1
Haemorrhage
Hydrocortisone - 1
Tachycardia
Intravenous Crystalloid Solution - 1
Hypervolemia
Ipratropium Bromide - 4
Headache.
Nausea.
Dry Mouth.
Skin rash.
Ketamine - 6
Blood pressure and pulse frequently elevated
Random purposeless movements, muscle twitching and rash are common
Hypersalivation
Emergence reactions (10%)
Transient laryngospasm
Transient apnoea or respiratory depression
Lignocaine - 3
Tinnitus, dizziness, anxiety, confusion, perioral numbness
Cardiovascular effects: Bradycardia, hypotension, dysrhythmias
CNS effects
Respiratory depression
Methoxyflurane - 5
Lightheaded Dizziness Drowsy Nausea Malignant hyperthermia
Midazolam - 4
Respiratory depression
Hypotension
Anterograde and retrograde amnesia
Myasthenia Gravis
Naloxone - 8
Withdrawal symptoms such as:
Aggression
Agitation
Nausea/vomiting
Dilated pupils and lacrimation
Take-Home-Naloxone (THN)
For patients that have required Naloxone, every attempt should be made to convince the ‘at risk’ patient to be transported to a healthcare facility.
Where attempts prove futile, IN Naloxone - Nyxoid® could be left with the patient. This is to avoid the risk of opioid related respiratory depression due to the short half-life of Naloxone.
In such circumstances please ensure to document leaving Nyxoid® with the person or a responsible other person in the PnT / ePCR.
Due to our SASA requirements, clinicians cannot supply scheduled medicines to persons who are not St John WA patients.
Olanzapine - 3
Extrapyramidal effects / Dyskinesia
Increased falls risk
Hypotension – Apply monitoring as soon as practicable
Ondansetron - 5
Headache Malaise/fatigue Drowsiness Dizziness Rash/allergic reaction
Oxygen - 2
Patients with acute episodes of COPD are at risk of developing carbon dioxide retention if they are given excessive supplemental oxygen. This can cause acidosis and subsequent organ dysfunction.
High oxygen concentrations can lead to increased production of reactive free radicals resulting in cellular damage. This may be responsible for the detrimental effects observed with the use of high flow oxygen in myocardial infarction and stroke.
Paracetamol - 1
Nil known at therapeutic doses.
Prednisolone - 2
Side effects occur following prolonged use and are of little consequence in an emergency setting
Vomiting
Salbutamol - 3
Muscle tremor
Tachycardia, palpitations
headache
Tranexamic Acid - 6
Hypotension (fast infusion rate) Headache Dizziness Convulsions (lowers seizure threshold) Nausea and/or vomiting Diarrhoea
