Pharmacologies

Dilute 1ml with 3mls Nacl which 1ml=100mcg

IV- 1ml every 2mins

IM- 1ml every 5 mins

1ml or 400mcg IM or IV every 2 mins to a max dose of 2mg or 5 doses if inadequate clinical response.

• Stimulates the alpha & Beta subdivision of the sympathetic nervouse system to cause fight or flight.
• Alpha stimulations causes peripheral vasoconsrtricion, it raises the perfusion pressure of vital organs during cardia arrest.
• Beta 1 stimulation causes increased myocardial excitablity withtachycardia and increased myocardial contractility.
• Beta 2 causes bronchial dilation.

• 5ml or 2mg undiluted IV or IM bolus dose
• Can be repeated every 5 mins until adequate clinical response.

• Can cause vomiting, sweating, tachycardia & hypertension.
• In patients with cardia disease VT, Vf and Pulmonary Oedemamay ocassionally occur particularly in patients with inadequate ventilation and high carbon dioxide levels.

• Buprenorphine
• Codeine
• Di-Gesic
• Lomitil
• Fentanyl
• Heroin
• Methadone
• Morphine
• Pethidine

• .25ml/kg undiluted Naloxone as a bolus IV or IM
• Each bolus dose nust not exceed the adult done of 400mcg.
• Can be repeated every 2 mins up to 2mg if inadequate clinical response

• Dilute 1ml (400mcg) with 3ml Nacl.
• IV .5ml as a bolus and repeat every 2mins until adequate clinical response
• IM 0.5ml initial boluse and repeat every 5 mins

Opioid Analgesic

• Pain Management
• Pulmonary Oedema

• Decreased LOC
• Hypotension
• Respiritory depression
• Nausia and Vomiting

• Altered LOC
• Patient is poorly perfused
• Women in Labour
• Known Allergy

• Initial regimen
• IV. 5ml(5mg) as an initial bolus
• Repeat 2.5ml- 5ml as required every 2 mins until pain is relieved or max dose of 0.5ml/kg

The initial pain regimen can be repeated after 30 mins

0.5ml-2ml (5mg-20mg) of undiluted to a max of 20mg

Dose should be halved with smaller than average pts, CAL and general debility.

• 0.1ml/gk of diluted Morphine
• Repeat every 5mins until either pain is relieved or max of 4 doses

Initial regimen can be repeated after 30 mins 01.ml/kg every 5mins to max of 4 doses

0.025ml/kg of undiluted morphine. dose must not exceed the adult dose

6mths

Antiemetic

• Supresses vomiting by acting on both the chemoreceptor trigger zone and stomach.
• Accelerates gastric emptying by stimulating the motility of the stomach and upper GIT

• Vomiting
• Prophylaxis to prevent vomiting in either eye or spinal injuries in adults
• Prophalaxis if the patients airway may be compromised due to vomiting

• Drowsiness, lethergy and dry mouth
• Extrapyranidal stimulation rarely results in spasm of facial muscles, trismus, speech difficulties and unnatural body positioning

Previous adverse reaction or allergy

2ml or 10mg IM or IV Slowly

crystalloid solutuion

Following intravenious infusion it is distributed throughout the extracellular fluid space. Approx 25% of the volume stays in the intravascular space

• Fluid replacement
• Dehydration
• Diving emergencies

• Hypovolaemia trauma-adult and Paed
• Hypovolaemia non trauma
• Meningococcyl Septicaemia
• Hyperglycaemia
• Burns
• Flush for drugs
• TKVO in limb realignment and or difficult extrication

• Excess administration can cause Pulmonary Oedema
• Over infusion will cause coagulpathy,hypothermia and acidosis in the trauma patient

• 100-200mls aliquots to maintain a radial pulse
• For traumatic brain injuries maintain a radial pulse >90mmhg

5ml/kg which can be repeated if any of the key signs of shock remain

1ltr Stat dose

20mls/kg rapis bolus infusion

20mls/kg up to 1ltr rapid bolus infusion

• 10mls/kg rapid infusion up to 1 ltr
• Then 10mls /kg every hour while signs of dehydration persists or with diving emergencies

Volume = BSA x Weight(kg) to be given over 4hrs from time of burn

20-30ml To Flush drugs for ADULT ONLY

1ltr rapid bolus infusion for Adults

20mls/kg rapis bolus infusion

A Liquid-soluble synthetic short acting analgesic

• Potent analgesic
• Effective drug for intranasal use because it is rapidly absorbed across mucous membranes

Management of moderate to severe pain in patients aged 1 and above

• Respiritory depression
• Hypotension
• Nausia and vomiting

• Altered LOC
• Patient is poorly perfused
• Pervious known allergy or advese effect
• Bleeding nose or occluded nasal passages
• Women in labour
• Patient <1yr old

Initial dose 180mcg-240mcg pending on patients size

• To give 180mcg
• 0.4ml =120mcg
• 0.3ml =90mcg

• To Give 240mcg
• 0.4ml =120mcg
• 0.3ml = 90mcg
• 0.3ml = 90mcg

WAIT 5 MINS

• Subsequent Doses:
• 0.2ml (60mcg) - up to 0.4ml (120mcg) every 5 mins pending on response

Initial dose of 120mcg or 0.3ml (90mcg) then 0.2ml (60mcg)

• Subsequent dose
• 0.2ml every 5 mins depending on response

• Initial dose 30mcg or
• 1 spray of 0.2ml or 60mcg allowing for 30mcg deadspace

• Subsquent dose
• Aged 1-3 = 0.1ml or 30mcg at 10min intervals depending on response
• Aged 4-5 =0.1ml or 30mcg at 5 min intervals

May only be repeated to a max of 2 doses

For Persisitant pain 30 mcg can be given and repeated after 10 mins

Initial dose of 60mcg or 75mcg

• To administer 60 mcg = 0.3ml or 90mcg allowing for deadspace of 30mcg
• To Administer 75mcg = 0.35ml or 105mcg

• Subsequent dose
• 0.1ml or 30mcg at 5 min intervals depending on response

Anti-convulsant and minor tranquilliser

Reduces seizure activity and has a tranquillising and amnesic effect

To control seizures

• Upper airway obsrtruction due to depression of consciousness
• Respiritory and cardiovascular depression

Vital signs must be carefully monitiredand equipment to support respiration must be available. Apnea can occur in elderly and Pts with respiritory disease. Adverse effect are in crease with opiates and alcohol

• 1.5mls or (7.5mg) by IM injection.
• Repeat once after 5 mins

3 mls or 3mg of diluted Midazolam by IV slowly.If fitting continues repeat every 3 mins to a max of 15mg or 15ml

0.03ml/kg or 0.15mg/kg repeat once after 5 mins

0.06ml/kg or .3mg/kg via a MAD. Repeat once after 10 mins

Each IN dose must not exceed the adult dose of 7.5mg or 1.5 ml

0.15ml/kg or 0.15mg/kg of diluted midazolam

Repeat every 3 mins to max of 3 doses or 0.45mg/kg

Hypertonic sugar solution for IV use

Principle energy source for body cells especially the brain

Correction of hypoglycaemia

• Tissue necrosis if extravasation from vein occurs
• May aggrivate brain damage in head injuriess and strokes
• May precipitate Werneicks encephalopathy in alcoholics with thiamine deficiency

INitial dose of 150ml or 15g via a burette and then flush with 10ml Nacl.

If inadequate response and GCS < 15 after 3 mins, give 100mls or 10g titrating to patients state and then flush

Can be repeated once if no response

• Single dose of 5ml/kg or 0.5g/kg and then flush with 10ml Nacl
• Repeat once if no response

Antiemetic and anit nauseant

Blocks central and peripheral 5-ht3 receptors

• Nausia and vomiting in adult where Maxalon is ineffective or contraindicated
• Nausia and vomiting in children
• Prophylazis to prevent vomiting in eye or spinal injuries
• Prophylaxis if the patients airway may be compromised due to vomiting

• Headache and or flushing
• Seizures and movement disorders
• visual disturbances
• hypersensativity including anaphylaxis

• Previous known allergy or adverse reaction
• Paediatric patients under 2 years of age

• Age 2-7 = 1ml or 2mg IM or iIV
• Age 8 and above = 2ml or 4mg IM or IV

Antihistamine

Antagonises the action of histamine onH1 receptors

Mild allergic reactions eg. rash/urticaria, allergic rhinitis

• Headache
• Drowsieness
• Nausia
• Dry mouth

• Known allergy or hypersensativity to fexofenadine
• Severe renal impairment

180mg tablet

1 tablet daily

Not for children under 12

• Asthma if severe or extreme with decreased LOC or minimal air movement
• Sever croup in children with stridor at rest or any one of Altered LOC, Retractions or cyanosis
• Patients with moderates to severe allergies and anaphylaxis reactions

• Dysrythmias including VF
• Tachycardia
• Hypertensionn
• Pupilary dilation
• Anxiety
• Nausia and vomiting

• 0.5ml or 500mcg of adrenaline 1:1000 inthe lateral aspect of the thigh
• Can be repeated eery 5 mins
• Must be used for only extreme cases

• 1ml or Adrenaline 1:10,000 or 100mcg every 60 secs.
• Must be used only for extreme and immediatly lifethreatening situations and when there are no delays in gaining IV access

• 0.1ml/kg of adrenaline1:1000 or 10mcg/kg IM
• Repeat every 10 mins

• 0.1ml/kg of adrenaline 1:1000 or 10mcg/kg over 3 mins.
• Can be repeated every 5 mins