What is the basic treatment for an amputation?
- Direct pressure
- indirect pressure
- Consider ICP backup
- Arterial torniquets
- Seal body part if complete amputation
- Transport and notify
What is the treatment for a mild or moderate allergy in adults?
- Basic care
- Fexofenadine 180mg PO
- Transport if required
What is the treatment for a mild or moderate allergy in a paediatric?
- Basic care
2. Transport for further care
What is the treatment for adults with severe or life threatening allergy or anaphylaxis?
- basic care
- IPPV with slow ventilations
- Consider ICP backup
- Adrenaline 0.1mg/kg max 0.5mg, repeat every 5 mins PRN
- NS to maintain adequate BP
- Transport and notify
What is the treatment for paediatrics in anaphylaxis (hypotension, severe bronchospasm, respiratory distress due to angioedema?
- Basic care
- IPPV with slow vents
- Consider ICP backup
- Adrenaline 0.1mg/kg up to 0.5mg, repeat every 5 mins PRN
- Transport and notify
Where should patients with parenteral medication administered for severe asthma should be transported to which hospitals?
- Spine
2. TQEH
Treatment for Adult with Mild asthma?
- basic care and follow asthma management plan if appropriate
- MDI and spacer - 12 puffs of salbutamol = 1200mcg, 4 inhalations per puff
- reassess between each 100mcgs
Treatment for adult with moderate asthma?
- Basic are and follow Mx plan if appropriate
- MDI and spacer, 1200mcg salbutamol, 160mcg atrovent (8 puffs)
- repeat Salbutamol 1200mcg every 20 mins or earlier if patient fails to improve
OR
Nebs - Salbutamol 5mg and atrovent 500mcg
- repeat salbutamol every 20 mins or earlier if fails to improve, up to 3 doses (15mg)
- If no improvement escalate to severe
- If improves consult with GP, Tx to GP or hospital
Treatment for Adult in Severe Asthma?
- Basic care and high flow oxygen
- early ICP backup
- Salbutamol 15mg and atrovent 500mcg nebs, repeat if required
- If no improvement or deteriorates move to life threatening
- Transport and notification
Treatment for adult with life threatening asthma?
- basic care and high flow oxygen
- Early ICP backup
- Nebs, continuous salbutamol and atrovent every 20 mins
- Fluid bolus 500mL IV
- Consider IM adrenaline 0.01mg/kg up to 0.5mg, repeat if no response
- Transport and notify
Treatment for adult with life treatening asthma requiring IPPV?
- continuous nebs whenever possible
- early ICP backup
- IPPV with small tidal volumes and slow rates
- fluid bolus 500mL IV
- Consider IM adrenaline 0.01mg/kg, repeat if no response
- transport and notify
What are the symptoms of mild asthma in adults?
Talks in sentences, conscious, normal pulse, RR normal or raised, expiratory wheeze (maybe), SpO2 >95% RA,
What are the symptoms of moderate asthma in adults?
Speaks in phrases, mild accessory muscle use, tachycardia, tachypnoea, moderate to loud wheeze (insp and exp), SpO2 92-95% RA
What are the symptoms of Severe asthma in adults?
Speaking in words, agitated and distressed, visibly breathless, increased work of breathing, moderate accessory muscle use, tachycardia, tachypnoea, low volume wheeze due to poor air movement, SpO2 90-94% RA, may have central cyanosis, unable to lie supine, pursed lip breathing, hyper inflated thorax
What are the symptoms of life threatening asthma?
Unable to speak (silent chest), drowsy or collapsed, exhausted, severe accessory muscle use, or minimal due to tiring, tachy or pre-arrest brady, poor resp effort or apnoeic, no wheeze as no air movement, hypoxic SpO2 <90% RA, centrally cyanosed, pursed lip breathing, unable to lie supine, hyper-inflated thorax
What are the elements of basic care and life support?
- Scene safety
- Airway
- Breathing
- Circulation
- Disability
- Exposure
- reassurance and basic physiological support, posture and temp control
Continuous vitals, BGL, Specific treatment & meds, transport and notify
What is the treatment for chemical burns?
- Basic care
- monitor patient closely for signs of deterioration or airway compromise
- Local Mx plans or irrigate with cold running water for minimum of 20mins
- consider SOT
- do NOT use hydrogel products
What is the treatment for thermal burns?
- cool with cold running water for 20 minutes
- if no water apply hydrogel to cover burn, for neonates use for max 10 minutes, adults and paeds max 20 mins
- Cover with cling wrap once cooled
- Fluids IV - to re-establish and maintain normovolaemia
- Transport and notify; adults to RAH and paeds/neonates to WCH
Treatment for adult medical cardiac arrest with shockable rhythm?
30:2 compressions, assess rhythm, shockable then shock, 2 minutes of CPR and repeat.
1mg adrenaline after every 2nd shock, then every 2nd loop, amiodarone 300mg after 3 shocks
Airway adjuncts, Oxygen, IV access, plan all actions before interupting compressions.
Treatment for adult in medical cardiac arrest with non-shockable rhythm?
30:2 compressions, assess rhythm, non-shockable, 2 mins CPR and repeat.
Adrenaline 1mg immediately (then every 2nd loop).
Correct 5Hs and 5Ts
What is the treatment for an adult in traumatic cardiac arrest?
- Control haemorrhage; direct pressure, torniquet, pelvic binder, fracture Mx and splinting
- Control airway; open airway, early SGA
- Bi-lateral chest decompression
- Fluid resuscitation 20mL/kg rapid, and further 10ml/kg if indicated
What forms post ROSC care?
- re-evaluate ABCDE
- 12 lead ECG
- treat precipitating causes
- Aim for SpO2 94-98%
- check BGL and control
- Manage temp
What is the treatment for Acute Cardiogenic Pulmonary Oedema?
- Basic Care
- Consider early ICP backup
- Consider GTN 400mcg Sublingual, repeat every 5 mins PRN
- Transport and notify
