Treatments

Question 1

Asthma mild/moderate

Answer 1

Salbutamol pMDI with spacer, 4-12 doses

4 breaths per dose, repeat after 20mins if needed

Question 2

Asthma severe

Answer 2

Salbutamol 10mg (5mL) nebulised (5mg every 5min)
Ipratropium bromide 500mcg (2mL) nebulised
Dexamethasone oral 8mg in 2mL
Adrenaline 500mcg IM

Question 3

APO

Answer 3

GTN 50mg patch, 300/600mcg tablet

Nasal prongs and CPAP

Question 4

COPD

Answer 4

Refer to adult severe asthma

Question 5

Pain relief

Answer 5

IV access:
Morphine 5mg (0.5mL), repeat 5 mins, check after 20mg
Fentanyl 50mcg (1mL), repeat 5 mins, check after 200mcg

Paracetamol 1000mg (500mg elderly/frail)

Question 6

ACS NSTEMI/unstable angina

Answer 6

GTN 50mg patch, 300mcg or 600mcg tablet
Aspirin 300mg tablet
If GTN doesn’t erase pain refer to IV pain relief

Question 7

ACS STEMI

Answer 7

Treat as NSTEMI/unstable angina
If located in inferior leads, no GTN
Apply defib pads, gain IV access and early notification to hospital (STEMI capable)

Question 8

Cardiac arrest (adult)

Answer 8

CPR and defib, (30:2 no airway, 15:1 SGA)
Adrenaline 1mg (1mL) every 4 minutes IV

Question 9

Cardiac arrest (paed)

Answer 9

Start with airway OPA and ventilations

Question 10

Stroke/TIA

Answer 10

Rule out stroke mimics
Stroke ACT-FAST and MASS assessment
Monitor and transport, IV access

Question 11

Seizures

Answer 11

Reposition head laterally for protection and to move tongue
Maintain airway ventilations if needed
If status epilepticus:
Midazolam IM 10mg (2mL), 5mg (1mL) for elderly/frail
Repeat elderly/frail 5mg after 5 minutes
Repeat adult 10mg after 10 minutes

Question 12

Hyperthermia

Answer 12

Environment induced:
Remove from environment
Strip, spray, fan
Cooled normal saline IV (20mL/kg)

Drug induced:
Remove from environment
Perform cooling methods but focus on fluids
Cooled normal saline 20-40mL/kg IV

Question 13

Hypothermia

Answer 13

Remove from environment
Remove wet clothes, dry off body
Thermal wrap with protective sheet underneath
Any fluid treatments need to be warmed

Question 14

Agitated

Answer 14

+1 (anxious, restless, talkative)
Olanzapine 10mg ODT (5mg elderly/frail), 20min repeat

+2 (very anxious, agitated, loud outbursts)
Midazolam IM 5-10mg (2.5-5mg elderly/frail), 10min repeat, max 20mg

\+3 (combative, violent, out of control, loud outbursts)
Ketamine IM, single dose
<60kg - 200mg
60-90kg - 300mg
>90kg - 400mg

Question 15

Opioid overdose (heroin)

Answer 15

Manage/maintain airways and ventilations

Naloxone 1.6-2mg IM, single dose

Question 16

Opioid overdose (other opioids)

Answer 16

Manage/maintain airways and ventilations
Naloxone 100mcg IV every 2 minutes, max 2mg
If IV n/a 400mcg IM single dose

Question 17

TCA overdose

Answer 17

Monitor and reassure

Question 18

Psychostimulant overdose

Answer 18

Manage agitation and poor perfusion, monitor airways and wellness

Question 19

Organophosphate poisoning

Answer 19

PPE, decontaminate

Question 20

Hypoglycaemia

Answer 20

<4, responsive: glucose 15g paste
<4, unresponsive:
Dextrose 10% 15mg (150mL) IV, 10mL normal saline flush, repeat 10mg (100mL) after 10 min (with flush)
If no IV access then Glucagon 1(IU) IM

Question 21

Hyperglycaemia

Answer 21

Normal saline 20mL/kg IV

Question 22

Autonomic Dysreflexia

Answer 22

Attempt to remove painful/strong stimulus

GTN 300/600mcg tablet, 10min repeats

Question 23

Suspected sepsis

Answer 23

Call MICA

If MICA N/A 20mL/kg normal saline over 30mins, if chest clear (no APO)

Question 24

Meningococcal

Answer 24

Ceftriaxone 1g sterile powder in water for injection 10mL IV, administer over 2 minutes

Question 25

Anaphylaxis

Answer 25

Adrenaline 500mcg (5mL) (IM) every 5 minutes
RASH assessment

Question 26

Nausea/vomiting

Answer 26

Ondansetron 4mg tablet, repeat once if needed for max of 8mg.

If contraindicated then Prochlorperazine 12.5mg (1mL) IM injection