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ASPIRIN
Indications
Any conscious Adult patient
who is suspected of having an acute MI and who presents with any or all
of the following; Severe chest pain for more than 15 mins. Severe
pressure in the chest for more than 15 mins, Severe tightness in the
chest for more than 15 mins
Contraindications
Known allergy to aspirin, Pregnancy
Side effects
None at dosage given
Presentation
Foil wrapped 300mg oral Aspirin tablet
Administration and
dosage
ONE 300 mg oral aspirin dissolved under
the tongue. Maximum dosage 300mg
ATROPINE
SULPHATE
Where
possible an ECG print out is required to confirm rhythm prior to drug
administration
Indications
Sinus bradycardia.
When accompanied by symptomatic hypotention.Pulse rate <50 Systolic
<90 mmHg. PEA with ventricular rate below 60
Junctional rhythm.
With pulse rate < 50. Systolic bp < 90 2nd,
3rd degree heart block. with heart rate <
50 Systolic Bp < 90 mmHg. Asystole. As
per asystole protocol.
Contraindications
Atrial flutter or atrial fibrillation
where there is a rapid ventricular response.Glaucoma
Side Effects
Blurred vision, Dry mouth, Thirst, Flushing skin, Confusion, increased
body surface temperature.
Presentation
Prefilled syringe 1mg/10ml
Prefilled syringe 3mg/10ml
Administration and dosage
Symptomatic bradycardias
0.5mg/5ml IV. repeat once after 5-10 mins if necessary
Asystole / PEA ECG
print out not required prior to drug administration
3mg IV once as per asystole protocol
6mg ET once as per asysole protocol
Post arrest patients who have received atropine
must not receive further doses
DIAZEPAM
(Diazemuls)
Indications
Prolonged convulsions
from whatever cause in adults and children over six.
Status epilepticus.Eclampsia
Contraindications
None in the above context.It should be noted that if other CNS
depressants are involved e.g.
alcohol the patient is
more likely to develop respiratory depression.
Side
effects. Continued above.. |
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DIAZEPAM
Continued
Drowsiness, Respiratory depression,Coma
Presentation
Ampoule. 10mg diazepam/2ml (5mg/ml).
Administration and dosage
Adults and children over
six2.5mg (0.5ml) IV every 30 seconds until fitting controlled to a
maximum of 10mg (2ml).Repeat once after five mins if necessary Maximum
dose 20mg. Rectal
stesolid
Presentation. Pre-packed
tube with introducer. 5mg and 2.5mg
Administration and
dosage
Adults and children over 6 years. 5mg rectally
every minute until fitting controlled. maximum dosage 20mg
Children over 3 to 6 years. see above
Children over 1 to 3 years. 5mg rectally. Repeat once after 5
mins if necessary to a maximum of 10mg. Children 0 to 1 year. 2.5
rectally. Repeat once if necessary to a maximum of 5mg
EPINEPHRINE
1:10,000
Indications
In cardiac arrest with the
following presenting rhythms; VF and pulsless VT,Asystole,PEA (EMD)
contraindications
None in cardiac arrest
Presentation
prefilled syringe 1mg /10mls
Administration and dosage
1mg IV, 2mg ET as per arrest protocol.
EPINEPHRINE
1:1,000
Indications
Paediatric advanced life
support see ETO5. Anaphylaxis where the patient presents
with dyspnoea, rapid pulse >100bpm, Progressive hypotension
Contraindications
None as regard to the above
Presentation
Ampoule 500mcg 1:1,000 in 0.5mls.
Ampoule 10mg 1:1,000 in 10mls.
Administration and dosage.
Paediatrics ALS refer to ETO 5
Patients over 10 years 1mg/1ml
Patients between 5-10 years 250mcg/0.25ml
Patients between 2-4 years 125mcg/0.125ml.The
above dosages may be repeated after 10 mins if there is no improvement
GLYCERYL
TRINITRATE
Indications
Angina pectoris.MI without
related hypotension
Contraindications
MI with related hypotension (pulse>100 BP systolic
>90).Intracranial pressure, Glaucoma,Hypotension. Patients who have
taken viagra within the previous 25 hrs.
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GTN
Continued
Side effects
Headaches, Dizziness, Weakness, Hypotension
Presentation
Aerosol spray giving a metered dose of
400mcg
Administration and dosage
800mcg sublingually.(two sprays)
GLUCAGON
Indications
Known diabetic patients on
insulin therapy where symptomatic hypoglycemia has been confirmed by a
BM test reading of 4mmols or below. Unconscious patient without known
cause where a BM test of 4 mmols or below has been confirmed.
Contraindications
None as regard to the above.
Side effects
None
Presentation
1ml syringe prefilled with water and vial containing 1mg of
glucagon powder
1ml vial of glucagon powder and 1ml bottle of sterile water.
Administration and dosage
Patients age 13 years and over 1mg in1ml
Patients age under 13years 0.5mg in 0.5mls.
Routes; IM,IV,Subcut
40%
Dextrose Gel (HYPOSTOP)
Indications
Hypoglycemia
in the Conscious
patient. The
signs and symptoms exhibited may include the following. Known history of
hypo attacks, Weakness and lightheadedness, Fatigue, confusion,
sweating, slurred speech ataxia, Irritable and bizarre behaviour,
falling levels of consciousness, falling blood sugar level.
Contraindications
Any
unconscious patient
Any
conscious patient that has difficulty in swallowing.
Side
effects
None
in adult patients.May cause vomiting in patients under 5 years if
administered too quickly
Presentation
Pack
of three single dose bottles. Each bottle contains 9.2g of
dextrose 40% as the active ingredient.
Administration
and dosage.
Max
dose 2 bottles (18.4)g).Ensure patient is conscious and able to
swallow. Administer O2.Take and record blood sugar level. If <4mmols
consider Glucagon.
Patients
over 5years.Squeeze contents of 1 bottle into patients mouth
and ask patient to swallow.
Patients
under 5 years.
Squeeze
small amount into patients mouth and gently massage into buccal cavity.
Repeat until patient responds to treatment
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