MEDICAL CONDITIONS
Adrenaline – severe allergic reaction
How
IM injection
Check before
giving
Side effects
Do not give if
Consider
Quantity
Kids
Half of 1 ampoule (0.5 ml of 1:1000 Yes, but need medic
solution)
advice re dose
Have previous doses been given eg casualty’s own Epipen and
how long ago. If given more than 10 minutes ago then give
further dose.
Tremor, anxiety
None
Further dose can be given if no effect after 5 mins
Monitor ABC’s very closely in these casualties
Hypostop / Glucogel – Low blood sugar/diabetes
How
Mouth
Check before
giving
Side effects
Do not give if
Consider
Quantity
Kids
1 tube
Yes
Can the casualty maintain their own airway?. Get casualty into
recovery position and use carefully if casualty not fully
conscious
None
Casualty is unconscious
Give further sugar as casualty improves
Glucagon - Low blood sugar/diabetes if hypostop/glucogel not possible.
Kit 3 only, use only under instruction or direction of Doctor/Paramedic
How
IM injection
Check before
giving
Side effects
Do not give if
Consider
Quantity
Kids
1mg powder in vial reconstituted
Yes, ½ dose for under
with water from kit
8 years
Patients blood glucose level – only give glucagon if level is
under 5.
Nausea, vomiting, diarrhoea. Rarely allergic reaction.
Recent use of glucagon
Check blood glucose level after 10 minutes to ensure it has
improved to over 5
Salbutamol – Asthma attack, ie expiratory wheeze/breathing difficulties
How
Quantity
Kids
Inhaled from pressurised inhaler or Inhaler – 2 effective puffs (up
Yes
to max of 10); Nebuliser 5mg
oxygen driven nebuliser
Check before
giving
Side effects
Tremor, increased pulse rate if higher doses used
None in acute situation
Do not give if
Consider
Use nebuliser if inhaler not effective or casualty unable to use
due to high respiratory rate or anxiety. Assess casualties ability
to speak in longer sentences as evidence of improvement
Aspirin – suspected heart attack
How
Mouth, chew tablet
Check before
giving
Quantity
Kids
300 mg
No
Check if patient is allergic or has been advised by GP not to
take aspirin.
Side effects
Do not give if
None in this situation but ask about allergies
Allergic
Glyceryl Trinitrate – Angina pain
How
Spray under tongue
Check before
giving
Side effects
Do not give if
Consider
Quantity
Kids
1-2 sprays, rpt after 30 mins if req.
No!
Has GTN already been taken. If not effective then check expiry
date on canister.
Headaches, facial flushing
Low BP - check for radial pulse and level of consciousness
Canister may not work at low temperatures and needs to be
protected from cold
OPEN WOUNDS
Betadine (Iodine solution) – dirty wounds or wounds from open fractures
How
Quantity
Kids
Directly onto wound on gauze soaked in solution
50 ml max.
Yes
Check before
Allergies
giving
Side effects
None if volume not exceeded
Do not give if
Burned skin or allergic to iodine solutions
Use sterile dressings and gloves even when dealing with
Consider
contaminated wounds
Cefuroxime - Major contaminated wounds (inc open fractures) + over 4 hours
to hospital
How
Mouth
Check before
giving
Side effects
Do not give if
Consider
Quantity
Kids
2 x 250 mg tablets
Yes, 1 x 250 mg tablet
Allergies to antibiotics, particularly a definite allergy to Penicillin
Allergic reaction
Allergic to antibiotics
Ask for medical advice if required
PAIN RELIEF
Paracetamol – mild pain, sprains
How
Mouth with drink
Check before
giving
Side effects
Do not give if
Consider
Quantity
Kids
1000 mg (2 tablets) 6-12 yrs 500 mg
Ask if casualty has taken any other paracetomol in the
previous 24 hours. No more than 8 tablets should be
taken in 24 hours.
None in acute situation
None
Use other simple methods of pain relief such as
reassurance, position, cold packs and always emphasise
to the casualty the positive effects of the drug. Can be
combined with a dose of Diclofenac or Codeine
Codeine Phosphate – Mild to moderate pain
How
Mouth
Check before
giving
Side effects
Do not give if
Consider
Quantity
Kids
2 x 30 mg tablets 6-12 years, 1 x 30 mg tablet
Conscious level, breathing rate, can you feel a pulse at
the wrist, is the casualty having an asthma attack.
Allergies.
Nausea and drowsiness
Morphine already given
Reduced conscious level – particularly if due to head
injury
Can be combined with a dose of Paracetamol
Give Buccastem to prevent nausea
Diclofenac – moderate pain
How
Mouth with drink
Check before
giving
Side effects
Do not give if
Consider
Quantity
Kids
75 mg (3 tablets) No
Ask if casualty has had breathing problems or rashes
when taking diclofenac or similar drugs like aspirin or
ibuprofen.
None in this situation but ask about allergies
Definite allergy. Casualty is unconscious or unable to
swallow
Use other simple methods of pain relief such as
reassurance, position, splinting, cold packs and always
emphasise to the casualty the positive effects of the drug.
Can be combined with a dose of Paracetamol
1
Morphine – moderate to severe pain, broken bones, heart attack
How
IM injection
Check before
giving
Side effects
Do not give if
Consider
Quantity
Kids
1 ampoule 10 mg Yes, get advice on dose
Conscious level, breathing rate, radial pulse, allergies
Nausea and vomiting (Buccastem), drowsiness, reduced
breathing rate, lowered blood pressure, small pupils
Respiratory rate < 10bpm
Reduced conscious level < GCS 12
Known to be allergic to morphine
Absence of radial pulse
Severe liver or kidney problems
Time of administration – give the drug time to work if you
are moving a broken limb to put a splint on. Monitor
conscious level and breathing rate after injection.
Buccastem to prevent vomiting.
Buccastem - Preventing vomiting when giving Morphine injection
How
Quantity
Tablet between cheek and gum
2 x 3 mg tablets
Not to be swallowed
Check before
Allergies
giving
Side effects
Muscle spasm may occur in the elderly
Do not give if
None
Consider
Kids
No
Naloxone – to reverse effects of morphine or in case of opioid overdose
Kit 3 only, use under instruction or direction of Doctor/Paramedic
How
IM injection
Quantity
2 x 400  g ampoule
Check before
giving
Side effects
Do not give if
Consider
Check patients pupil size
Kids
Yes, get advice on dose
for under 12’s
Withdrawal symptoms in narcotic addicts
Effects are shortlived, patient may relapse once effect
wears off. Consider repeating after 2-3 minutes. Max
dose 10 mg (25 repeat doses of above).
Pain relief will also be reversed, consider alternative
2