Aspirin, Adrenaline, Ceftriaxone, Dextrose 10%, Fentanyl, Glucagon, Gtn, Ipratropium Bromide, Lignocaine 1%, Methoxyflurane, Metoclopramide, Midazolam, Morphine, Naloxone, Normal Saline, Prochlorperazine & Salbutamol

Front 1

Acetylsalicylic acid (Aspirin) presentation

Back 1

300mg chewable tablets
300mg soluble/water dispersible tablets

Front 2

Acetylsalicylic acid (Aspirin) PEI

Back 2

ACS (To minimise platelet aggregation and thrombus formation in order to retard the progression of coronary artery thrombosis in ACS)

Front 3

Acetylsalicylic acid (Aspirin) contraindications

Back 3

1. Hypersensitivity to aspirin / salicylates
2. Actively bleeding peptic ulcers
3. Bleeding disorders
4. Suspected dissecting aortic aneurysm
5. Chest pain associated with psychostimulant OD if SBP >160 mmHg

Front 4

Acetylsalicylic acid (Aspirin) precautions

Back 4

1. Peptic ulcer
2. Asthma
3. Pts on anticoagulants

Front 5

Adrenaline presentation

Back 5

1 mg in 1 mL glass ampoule (1:1,000)
1 mg in 10 mL glass ampoule (1:10,000)

Front 6

Adrenaline PEI

Back 6

1. Persistent VF or unconscious, pulseless, VT
2. Asystole
3. PEA
4. Inadequate perfusion (cardiogenic)
5. Inadequate perfusion (non cardiogenic – non hypovolaemic)
6. Anaphylaxis
7. Severe asthma
8. Unconscious asthma with no recordable BP
9. Croup
10. Bradycardia with poor perfusion

Front 7

Adrenaline contraindications

Back 7

1. Hypovolaemic shock without adequate fluid replacement

Front 8

Adrenaline precautions

Back 8

1. Elderly Pts
2. Pts with cardiovascular disease
3. Pts on monoamine oxidase inhibitors
4. Pts on beta blockers as higher doses may be required

Front 9

Ceftriaxone presentation

Back 9

1 g sterile powder in a glass vial

Front 10

Ceftriaxone PEI

Back 10

1. Suspected meningococcal septicaemia 2. Severe sepsis (consult only)

Front 11

Ceftriaxone contraindications

Back 11

1. Allergy to Cephalosporin antibiotics

Front 12

Ceftriaxone precautions

Back 12

1. Allergy to Penicillin antibiotics

Front 13

Dextrose 10% presentation

Back 13

25 g in 250 mL infusion soft pack
50g in 500 mL infusion soft pack

Front 14

Dextrose 10% PEI

Back 14

1. Diabetic hypoglycaemia (BGL analysis < 4 mmol/L) in Pts with an altered conscious state who are unable to self-administer oral glucose

Front 15

Dextrose 10% contraindications

Back 15

Nil of significance

Front 16

Dextrose 10% precautions

Back 16

Nil of significance

Front 17

Fentanyl presentation

Back 17

100 mcg in 2 mL glass ampoule
600 mcg in 2 mL glass vial (IN use only)

Front 18

Fentanyl PEI

Back 18

1. Sedation to facilitate intubation
2. Sedation to maintain intubation
3. Drug facilitated intubation
4. Analgesia – IV/IN

Front 19

Fentanyl contraindications

Back 19

1. Known hypersensitivity
2. IV Amiodarone

Front 20

Fentanyl precautions

Back 20

1. Elderly patients
2. Impaired renal / hepatic function
3. Respiratory depression, e.g. COPD
4. Current asthma
5. Pts on monoamine oxidase inhibitors
6. Known addiction to opioids
7. Rhinitis, rhinorrhea or facial trauma (IN route) 8. Oral Amiodarone

Front 21

Glucagon presentation

Back 21

1mg in 1mL hypokit

Front 22

Glucagon PEI

Back 22

1. Diabetic hypoglycaemia (BGL < 4 mmol/L) in Pts with an altered conscious state who are unable to self-administer oral glucose

Front 23

Glucagon contraindications

Back 23

Nil of significance

Front 24

Glucagon precautions

Back 24

Nil of significance

Front 25

GTN (Glyceryl Trinitrate) presentation

Back 25

0.6 mg tablets
Transdermal GTN Patch (50 mg 0.4 mg/hr release)

Front 26

GTN (Glyceryl Trinitrate) PEI

Back 26

1. Chest pain with ACS
2. Acute LVF
3. Hypertension associated with ACS
4. Autonomic dysreflexia
5. Preterm labour (consult)

Front 27

GTN (Glyceryl Trinitrate) contraindications

Back 27

1. Known hypersensitivity
2. Systolic blood pressure < 110 mmHg tablet
3. Systolic blood pressure < 90 mmHg patch
4. Sildenafil Citrate (Viagra) or Vardenafil (Levitra) administration in the previous 24 hr or Tadalafil (Cialis) administration in the previous 4 days (PDE5 inhibitors)
5. Heart rate > 150 bpm
6. Bradycardia HR < 50 bpm (excluding autonomic dysreflexia)
7. VT
8. Inferior STEMI with systolic BP < 160 mmHg
9. Right ventricular MI

Front 28

GTN (Glyceryl Trinitrate) precautions

Back 28

1. No previous administration
2. Elderly Pts
3. Recent MI
4. Concurrent use with other tocolytics

Front 29

Ipratropium Bromide presentation

Back 29

250 mcg in 1 mL nebule or polyamp

Front 30

Ipratropium Bromide PEI

Back 30

1. Severe respiratory distress associated with bronchospasm

Front 31

Ipratropium Bromide contraindications

Back 31

1. Known hypersensitivity to Atropine or its derivatives

Front 32

Ipratropium Bromide precautions

Back 32

1. Glaucoma
2. Avoid contact with eyes

Front 33

Lignocaine 1% (IM) presentation

Back 33

50 mg in 5 mL amp (1%)

Front 34

Lignocaine 1% (IM) PEI

Back 34

1. Diluent for Ceftriaxone for IM administration in suspected meningococcal disease

Front 35

Lignocaine 1% (IM) contraindications

Back 35

1. Known hypersensitivity

Front 36

Lignocaine 1% (IM) precautions

Back 36

1. When using Lignocaine 1% as diluent for IM Ceftriaxone it is important to rule out inadvertent IV administration due to potential CNS complications

Front 37

Methoxyflurane (Penthrane) presentation

Back 37

3mL glass bottle

Front 38

Methoxyflurane (Penthrane) PEI

Back 38

1. Pain relief

Front 39

Methoxyflurane (Penthrane) contraindications

Back 39

1. Pre-existing renal disease / renal impairment
2. Concurrent use of tetracycline antibiotics
3. Exceeding total dose of 6 mL in a 24 hr period

Front 40

Methoxyflurane (Penthrane) precautions

Back 40

1. The PenthroxTM inhaler must be hand-held by the Pt so that if unconsciousness occurs it will fall from the Pt’s face. Occasionally the operator may need to assist but must continuously assess the level of consciousness
2. Pre-eclampsia
3. Concurrent use with Oxytocin may cause hypotension

Front 41

Metoclopramide (Maxolon) presentation

Back 41

10 mg in 2 mL polyamp

Front 42

Metoclopramide (Maxolon) PEI

Back 42

1. Nausea / vomiting associated with
- Chest pain / discomfort of a cardiac nature - Opioid administration for pain
- Cytotoxic or radiotherapy
- Previously diagnosed migraine
- Severe gastroenteritis
2. Prophylaxis:
- Awake spinal immobilised Pts - Eye trauma

Front 43

Metoclopramide (Maxolon) contraindications

Back 43

1. Children
2. Suspected bowel obstruction or perforation
3. Gastrointestinal haemorrhage

Front 44

Metoclopramide (Maxolon) precautions

Back 44

1. Undiagnosed abdominal pain
2. Adolescents (< 20 yrs)
3. Administer slowly over 1 min to minimise risk of extrapyramidal reactions

Front 45

Midazolam presentation

Back 45

5 mg in 1 mL glass ampoule
15 mg in 3 mL glass ampoule

Front 46

Midazolam PEI

Back 46

1. Continuous tonic-clonic seizures
2. Sedation to maintain intubation
3. Sedation to enable intubation
4. RSI
5. Sedation to enable synchronised cardioversion
6. Sedation in the agitated Pt
7. Sedation in psychostimulant OD

Front 47

Midazolam contraindications

Back 47

1. Known hypersensitivity to benzodiazepines

Front 48

Midazolam precautions

Back 48

1. Reduced doses may be required for the elderly, Pts with chronic renal failure, CCF or shock
2. The CNS depressant effects of benzodiazepines are enhanced in the presence of narcotics and other tranquillisers including alcohol
3. Can cause severe respiratory depression in Pts with COPD
4. Pts with myasthenia gravis

Front 49

Morphine presentation

Back 49

10 mg in 1 mL glass ampoule

Front 50

Morphine PEI

Back 50

1. Pain relief
2. Acute LVF with shortness of breath and full field crackles
3. Sedation to maintain intubation
4. Sedation to enable intubation
5. RSI

Front 51

Morphine contraindications

Back 51

1. Known hypersensitivity
2. Late second stage of labour

Front 52

Morphine precautions

Back 52

1. Elderly Pts
2. Hypotension
3. Respiratory depression
4. Current asthma
5. Respiratory tract burns
6. Known addiction to opioids
7. Acute alcoholism
8. Pts on monoamine oxidase inhibitors (MAOIs)

Front 53

Naloxone (Narcan)presentation

Back 53

0.4 mg in 1 mL glass ampoule 2 mg in 5 mL (prepared syringe)

Front 54

Naloxone (Narcan) PEI

Back 54

1. Altered conscious state and respiratory depression secondary to administration of opioids or related drugs.

Front 55

Naloxone (Narcan) contraindications

Back 55

Nil of significance

Front 56

Naloxone (Narcan) precautions

Back 56

1. If Pt is known to be physically dependent on opioids, be prepared for a combative Pt after administration.
2. Neonates.

Front 57

Normal Saline (NaCl) presentation

Back 57

10 mL polyamp
500 mL and 1000 mL infusion soft pack

Front 58

Normal Saline (NaCl) PEI

Back 58

1. As a replacement fluid in vol-depleted Pts
2. To expand intravascular vol in the non-cardiac, non-hypovolaemic hypotensive Pt
e.g. anaphylaxis, burns, sepsis
3. As a fluid challenge in unresponsive, non-hypovolaemic, hypotensive Pts (other than LVF). e.g. PEA; asthma
4. Fluid for diluting and administering IV drugs
5. Fluid TKVO for IV administration of emergency drugs

Front 59

Normal Saline (NaCl) contraindications

Back 59

Nil of significance

Front 60

Normal Saline (NaCl) precautions

Back 60

1. Consider modifying factors when administering for hypovolaemia

Front 61

Prochlorperazine (Stemetil) presentation

Back 61

12.5 mg in 1 mL glass ampoule

Front 62

Prochlorperazine (Stemetil) PEI

Back 62

1. Rx or prophylaxis of nausea / vomiting for
- Motion sickness
- Planned aeromedical evacuation
- Known allergy or C/I to Metoclopramide administration - Headache irrespective of nausea / vomiting
- Vertigo

Front 63

Prochlorperazine (Stemetil) contraindications

Back 63

1. Circulatory collapse
2. CNS depression
3. Previous hypersensitivity
4. Children

Front 64

Prochlorperazine (Stemetil) precautions

Back 64

1. Hypotension
2. Epilepsy
3. Pts affected by alcohol or on anti-depressants

Front 65

Salbutamol presentation

Back 65

5 mg in 2.5 mL polyamp
500 mcg in 1 mL glass ampoule
5 mg in 5 mL glass ampoule
pMDI (pressurised metered dose inhaler - Ventolin)

Front 66

Salbutamol PEI

Back 66

1. Respiratory distress with suspected bronchospasm: - asthma
- severe allergic reactions
- COPD
- smoke inhalation
- oleoresin capsicum spray exposure

Front 67

Salbutamol contraindications

Back 67

Nil of significance

Front 68

Salbutamol precautions

Back 68

Large doses of IV Salbutamol have been reported to cause intracellular metabolic acidosis