Appendices

Question 1

Anaphylaxis guidelines:

Answer 1

Question 2

Asthma grading - Moderate:

Answer 2

1. Increasing Sx
2. PEF > 50-75% best or predicted
3. No fts. of acute severe asthma

Question 3

Asthma grading - Acute severe asthma:

Any one of:

Answer 3

1. PEF 33-50% best or predicted
2. RR ≥ 25 min
3. HR≥ 110 min
4. Inability to complete sentences in 1 breath

Question 4

Asthma grading - Life threatening asthma:

Any one of the following in a pt with severe asthma:

Answer 4

Clinical signs:
1. Altered conscious level
2. Arrhythmia
3. Cyanosis
4. Exhaustion
5. Hypotension
6. Poor expiratory effort
7. Silent chest

Measurements:
1. PEF < 33% best or predicted
2. SpO < 92%
3. PaO < 8 kPa
4. “normal’ PaCO2 (4.6-6.0 kPa)

Question 5

Asthma grading - Near fatal asthma:

Answer 5

1. Raised PaCO2
2. &/or requiring mechanical ventilation
3. With raised inflation pressures

Question 6

Adrenaline - Shockable (VF/pVT) - how to dose:

Answer 6

1. Dose: 1 mg (10 mL 1:10 000 or 1 mL 1:1000) IV
2. Given after the 3rd shock once compressions have resumed
3. Repeated every 3-5 min (alternate cycles)
4. Given without interrupting compressions

Question 7

Adrenaline - Non-Shockable (PEA/Asystole) - how to dose:

Answer 7

1. Dose: 1 mg (10 mL 1:10 000 or 1 mL 1:1000) IV
2. Given as soon as IV access achieved
3. Repeated every 3-5 min (alternate cycles)
4. Given without interrupting compressions

Question 8

What are the alpha-adrenergic effects of ADR?

Answer 8

1. Systemic vasoconstriction
2. Increases coronary perfusion pressures
3. Increases cerebral perfusion pressures

Question 9

What are the beta-adrenergic effects of ADR?

Answer 9

1. Inotropic
2. Chronotropic
3. May increase coronary blood flow
4. May increase cerebral blood flow

Question 10

Amiodarone - Shockable (VF/pVT) - how to dose:

Answer 10

1. Dose: 300 mg bolus IV diluted in 5% dextrose (or other suitable solvent) to a volume of 20 ml
2. Given during compressions after 3 defibrillation attempts
3. Further dose of 150 mg if VF/pVT persists after 5 defibrillation attempts

Question 11

Amiodarone - Non-Shockable (PEA/Asystole) - how to dose:

Answer 11

1. Not indicated

Question 12

MOA of amiodarone:

Answer 12

1. Membrane-stabilising drug
2. Increases the duration of the action potential & refractory period in atrial & ventricular myocardium
3. Atrioventricular conduction is slowed

Question 13

What to flush amiodarone with?

Answer 13

1. 0.9% sodium chloride
2. Or 5% dextrose