INDICATIONS, CONTRAINDICATIONS + CAUTIONS (PARA)

• What are the indications for CEFAZOLIN?

  • sepsis where the cause is soft tissue or joint and the patient is over 12yr, has one or more clinical features and time to hospital is more than 30mins.
  • cellulitis
• What are the contraindications and cautions for CEFAZOLIN?

  contraindications:

  • known severe allergy

  cautions:

  • none
• What are the indications for CEFTRIAXONE?

  • suspected meningococcal septicemia
  • sepsis where cefazolin is not indicated and the pt is over 12yr, one or more clinical features and time to hospital is more than 30mins
• What are the contraindications and cautions for CEFTRIAXONE?

  contraindications:

  • anaphylaxis to cephalosporins

  cautions:

  • none
• What are the indications, contraindications and cautions of LEVETIRACETAM?

  indications:

  • seizures that continue or recur after 2 doses of midazolam

  contraindications:

  • known severe allergy

  cautions:

  • none
• What are the indications, contraindications + cautions for NALOXONE?

  indications:

  • suspected opiate poisoning and pt has significant ALOC or impaired breathing
  • excess adverse effects from the administration of opiates

  contraindications:

  • known severe allergy

  cautions:

  • chronic opiate use (rapid withdrawal)
• What are the indications, contraindications + cautions for OXYTOCIN?

  indications:

  • following normal birth
  • PPH

  contraindications:

  • known severe allergy

  cautions:

  • none
• What are the indications for TXA?

  • PPH
  • hypovolaemia from uncontrolled bleeding
  • any other severe bleeding
  • cardiac arrest from trauma
  • crush injury
• What are the contraindications + cautions for TXA?

  contraindications:

  • known severe allergy
  • trauma when TXA will be administered more than 3hr after the time of injury

  cautions:

  • none
• What are the other indications + contraindications for MIDAZOLAM?

  Indications:

  • seizures for over 5min or recurrent
  • acute behavioural disturbance
  • pain associated with severe muscle spasms or severe anxiety
  • sedation
  • post-intubation sedation
  • severe anxiety with COPD
  • control of anxiety or SOB that does not respond to opiate during end of life care

  contraindications:

  • known severe allergy
  • age less than 12 (analgesia only)
• What are the cautions of MIDAZOLAM?

  • ALOC
  • resp depression or at high risk
  • signs of shock
  • concurrent administration of opiates or ketamine
  • age greater or equal to 75, particularly is frail
• What are the indications, contraindications + cautions for LIGNOCAINE?

  Indications:

  • subcutaneous injection for prophylaxis of pain associated with IV cannulation
  • subcutaneous injection for digital ring blocks for analgesia when transport time is less than 60min or ropivacaine not available
  • IO injection for significant bone pain with IO.

  Contraindications:

  • known severe allergy
  • local infection of injection area

  Cautions:

  • taking an anticoagulant (ring blocks)
• What are the indications + contraindications for KETAMINE?

  indications:

  • severe pain that has not been controlled with opiates
  • inducing dissociation
  • acute behavioural disturbance causing severe to life-threatening risk to safety
  • RSI
  • significant moving during CPR
  • asthma with severe agitation

  Contraindications:

  • known severe allergy
  • aged <1yr
• What are the cautions for KETAMINE?

  • ALOC
  • signs of shock
  • current myocardial ischaemia
  • concurrent administration of opiates or midazolam
  • aged greater than or equal to 75yr
• What are the indications + contraindications for FENTANYL?

  Indications:

  • moderate to severe pain
  • CPO with severe anxiety
  • RSI
  • sedation post-intubation
  • control of pain, agitation or SOB during end of life care

  Contraindications:

  • known severe allergy
• What are the cautions for FENTANYL?

  • ALOC
  • aged <1yr
  • respiratory depression
  • labour
  • concurrent administration of other opiates, ketamine or midazolam
  • aged greater than or equal to 75yr
  • signs of shock