Mod D Tech 23 Assisting the Paramedic Drug administration

Question 1

Drug Recognition –
Presentation & Administration

Answer 1

Forms of Presentation:

• Tablet - aspirin
• Liquid in glass ampoule – Morphine Sulphate
• Pre-filled syringe – cardiac drugs (Adrenaline / Amiodarone)
• Spray containing metered doses- GTN
• Sachet of liquid – liquid paracetamol (Calpol)
• Compressed in gas cylinder – Entonox
• Plastic tubes – Dextrose 40% Gel
• Nebules - Salbutamol

Question 2

Routes of Administration

Answer 2

• Oral – by mouth, swallowed and absorbed into the blood from the gut (30-40mins)
• Inhaled (INH) – Gaseous drugs absorbed by the lungs
• Nebulised (Neb) – Liquid drugs agitated in a stream of Oxygen create fine droplets that are absorbed rapidly from the lungs
• Sublingual – Tablet or aerosol spray absorbed from the

mucous membrane beneath the tongue (2-3mins)

• Transdermal (TD) – Absorption through the skin
• Endotracheal (ET) – Not recommended any longer but was a route where drugs were administered down an endotracheal tube
• Rectal – the drug is absorbed from the wall of the rectum – used in patients who are having a seizure where IV access cannot be gained or it would be unsafe to either or both the patient / staff to even attempt it (5-15 mins)
• Intramuscular (IM) – Injection of the drug into the muscle, which is then absorbed into the blood

•

•Intra-osseous (IO) – Rigid needle inserted directly into the bone marrow – usually used for resuscitation drugs and fluid administration. Absorption is as quick as by the intravenous route

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•Intravenous (IV) – Direct introduction of the drug into the cardiovascular system through a vein that normally delivers the drug to the

target organs very quickly

•

•Subcutaneous (SC) – Injection of the drug into the

subcutaneous tissue. This has a slower rate of absorption

than from an Intramuscular (IM) injection

Question 3

Medicine bag (Black)

Answer 3

•Glucagon (Hypokit) 1mg/1ml

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•Salbutamol 2.5mg/2.5ml

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•Ipratropium Bromide (Atrovent) 250mcg/1ml

Question 4

Medicine bag (Blue)

Answer 4

•Diazepam Solution - Rectal tubes

–2.5mg/1.25ml

–5mg/2.5ml

•Diazepam Emulsion (Diazemuls)

–10mg/2ml

• Benzylpenicillin 600mg
• Chlorphenamine (Piriton) 10mg/2ml ampoules
• Ondansetron 4mg/2mls
• Efcortesol (Hydrocortisone Sodium Phosphate 100mg/1ml ampoule or…
• Solu-Cortef 100mg vial (powder for reconstitution)

Question 5

Medicine bag (Red)

Answer 5

• Atropine Sulphate – 1mg/1ml
• •Adrenaline (Epinephrine) 1:1000 – 1mg/1ml
• Adrenaline (Epinephrine) 1:10,000 – 1mg/10ml pre-filled syringe
• •Amiodarone - 300mg/10ml pre-filled syringe
• •Furosemide 20mg/2ml
• •Naloxone (Narcan) 1mg/1ml
• •Tranexamic Acid (Cyklokapron) 100mg/5ml

Question 6

Safety Checks

Answer 6

If a clinician asks for a drug to be passed to them then certain safety checks should be carried out after the appropriate drug has been selected:

•That the drug selected is in fact the one requested

•

• That the correct strength / presentation of the drug has been selected as requested by the clinician
• That the packaging / container is intact and has not been tampered with, contaminated or broken
• That the drug is in date

•

•If the drug is a bag of fluid then also check the clarity of the liquid

Question 7

Sharps injury or contamination incident

Answer 7

• Inoculation of blood by a needle/other sharp
• Contamination of broken skin with blood
• Blood splashes to eyes/mouth/nose
• Human or animal bites/scratches
• Body exudates/secretions via wound/sore
• Where clothes have been soaked by blood

Question 8

First aid/reporting the incident

Answer 8

• Bleed the wound-DO NOT SUCK
• Wash the wound
• Cover it with a waterproof dressing
• Wash the eyes and/or mouth
• Assess the infection risk-unused or clean sharp versus used sharp, bite/scratch/splash
• Report it

Question 9

Safe use and disposal of Sharps

Answer 9

• Sharps must never be passed between people
• The Sharps bin should always be within close proximity to the user, stood on a stable base with the receptacle ready to receive the sharp – i.e. lid open

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• It is not good practice for your colleague to hold the Sharps bin ready for when you need it – this will increase the risk of a Sharps injury – it needs to be on a firm, stable surface
• The temporary closure should be in place when not being used
• Replace the Sharps bin before it gets too full