Emergency drugs.

/10

Which drug am I? I'm an anti arrthythmic. Often given at 5mg/kg IV over 60min in a Dextrose solution. Used in the Australian Resuscitation Guidelines for refractory VT and VF?

Good for stabilising supraventricular and ventricular rhythm disturbances in the ED. Probably not the greatest anti arhythmic ongoing orally because of it's side effect profile.

Verapamil.

Metoprolol.

Amiodarone.

Flecanide.

/10

Which of the following statements is INCORRECT about Ketamine?

Fortunately Ketamine has a large therapeutic window which means that the dose between a therapeutic and toxic dose is wide.

For complete dissociation the dose is about 1 to 1.5mg/kg IV.

It is a bronchodilator.

One of it's "street names" is Cat valium.

It has a narrow therapeutic window.

/10

Which of these statements about Propofol is TRUE.

Children generally need a higher mg/kg dose for induction. Propofol is somewhat painful to inject IV and causes hypotension.

It does not have any analgesic effect.

You usually need a lower mg/kg induction dose in children.

It causes hypertension on induction.

It is not painful to inject IV.

/10

Which of the following is not a recognised side effect of giving Adenosine IV.

So avoid its use in asthma and make sure the patient is aware that they will feel dreadful for a short period after its administration.

Ventricular tachycardia.

A feeling of dread.

Bronchospasm.

SOB.

/10

Only one of the following doses of Adrenaline is correct. Pick the correct one.

It is very easy to give the wrong dose, often by a magnitude of 10, so check and check again.

10 mls of 1.1000 given intra cardiac in adult cardiac arrest.

100 mic/kg IV in paediatric cardiac arrest.

1 ml of 1.1000 Adrenaline nebulised in croup.

0.5mg IM in anaphylaxis with an EpiPen in an adult.

/10

In which of the following conditions would Nitrous Oxide be contraindicated?

The nitrous oxide enters and expands the air space of the pneumothorax so this is an absolute contraindictation to it's use.

For the insertion of an IV cannula in a child.

For analgesia initially in a patient with a fractured forearm.

For analgesia in a traumatic pneumothorax.

For analgesia when doing a lumbar puncture.

/10

Which of the following statements is correct about Fentanyl?

The picture shows intranasal Fentanyl using a MAD atomiser. Dose is 1.5mic/kg.

Below is a link to a brief instructional article for your perusal.

https://emed.ie/Analgesia/IN_INF_Paeds.php

It's duration of action when given IV is 1 to 2 hours.

It is the worst narcotic to use in renal failure.

1mg of Fentanyl = 10mg of Morphine.

It is a natural opioid.

/10

One of these four options is true about Methoxyflourane (green whistle).

Max daily dose is 6mls and the 10 pack costs about $320.

Its effects continue for several minutes after inhaling.

A 10 pack of 3ml containers costs about $900.

The daily maximum volume you can breathe is 20 ml.

The pain relief lasts about 2 hours after you stop inhaling.

It is an effective analgesic for transport of patients with fractures.

/10

In which of these situations should you NOT use Naloxone (Narcan)

Unfortunately the Naloxone here can often precipitate a withdrawal seizure in the newborn. Bad.

To reverse respiratory depression in a heroin overdose.

To reverse the respiratory depression when you accidentally gave too much morphine to an elderly patient.

To reverse the respiratory depression in the newborn of a known opiod dependant mother.

To reverse the respiratory depression in the newborn of a mother who had Fentanyl during labour.

/10

Which of the following has IV Magnesium not been used for?

The acute stroke work comes from Glasgow with the IMAGES trial.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC56206/

Magnesium IV has been used for Irikanji but not to my knowledge in the treatment of box jellyfish stings.

Acute stroke.

Torsade de Points.

Pre eclampsia.

Box jellyfish stings.

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