Tuesday, 12 August 2008


Back again, now for the drugs bit. There are quite a few drugs so bare with me.

Let's see, ok Heart attacks (myocardial infarction/MI). The majority of ambulance services are providing what is known as 'Prehospital thrombolysis', you may have read in the press about clotbusting drugs. Thrombolysis is the process when 3 drugs are given, they are aspirin, heparin and tenecteplase. A heart attack is when a coronary artery is blocked by a clot. The heart muscle below the clot doesn't get enough or any oxygen. These drugs act in different ways by stopping the red blood cells sticking to the original clot and preventing it getting any bigger, breaking down the clot and the prevention of it forming again. Therefore once the clot is broken down, oxygenated blood can get back to the heart muscle again. we use a saying 'Time is heart muscle'. Once heart muscle dies that is it!
Staying on the cardiac side of things we can give nitrate spray or tablets for angina/MI or heart failure. For slow heart rate we can give Atropine, we also use this in cardiac arrest and organophosphate poisoning.
Adrenaline 1:10,000 in cardiac arrest, the other strength of adrenaline is used for anaphylaxis/allergies/asthma.
Amiodarone is used in cardiac arrest when shocks are not working (basically).
Nebuliser therapy, 2 drugs salbutamol and ipratropium bromide which help widen the airways.
Antibiotic therapy for the potentially deadly meningococcal septicaemia (bacterial meningitis).
Anticonvulsant medication to treat seizures and also drug toxicity.
Glucose drip, glucagen injection and gel for low blood sugar (hypoglycaemia)
Various fluids for dehydration, fluid loss and maintenance of blood pressure.
Antihistamines/steroids IV/IO and injection for anaphylaxis/allergies.
We also use steroids in asthma and adrenal crisis.
Naloxone for OD/poisoning with opiates.
Morphine for pain relief.
Metoclopramide for anti sickness.
Syntometrine for severe haemorrhage up until 24hrs after birth.
Furosemide for heart failure, although I am trained/educated to give it we don't have it where I am.
There's a few to be getting on with. I hope the last couple of posts have helped give you a slight insight into our skills. I'll sign off now and return with something a little more interesting...............................................I hope.
Here endeth the lesson.

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