Pain relief in the Emergency Department.
Which of the following best describes Nitrous oxide use in the ED?
Good for brief procedures. May be given as Entonox (50/50 Nitrous/02) or via a blender than ensures a minimum of 30% 02.
Which of the following is NOT true about Methoxyflourane?
It was used as a general anaesthetic in the 1960s and 1970s but was removed because of concerns of nephrotoxicity at high doses. The FDA in the USA banned Methoxyflourane in 2015. Pentrox---the single use "green whistle" was developed in Australia and remains a great asset to pre hospital and ED pain relief.
Which of the following dose of Ketorolac (Toradol) would be best for a patient with biliary colic?
Ketorolac can be given by many routes. Orally is probably unwise as the dose is low and the patient would be NBM. Does not come in a rectal form unlike Indocid. Intranasal formulation (Sprix--15.75mg per spray) is available in USA--not here. Ketorolac can be used IV at the same dose as IM but tends to be used less often that way.
In what year was the first "Visual analog pain score" developed?
Hayes and Patterson developed the first one in 1921 however its widespead adoption and adaptation did not occur till the 1970s.
Nitrous oxide is used in cream whippers and the bulbs are a drug of abuse. Which of the following is a recognised street name for them?
Nangs is the most recognisable Australian slang. The others I made up.
In most countries the sale is restricted----however in Germany (2024 info) use for recreational use was still legal. Makes you laugh.
What is approximately the cost of 1gram of IV Paracetamol.
Using IV is useful and not that expensive in the big scheme of things. Cost was taken from buying online with 10 for $88.
Concerning Fentanyl which of the following is the best answer?
50 to 100 times more potent than morphine it causes less hypotension and causes less histamine release. A major street drug, especially in US cities like San Francisco and Los Angeles.
What dose of Ketamine would be reasonably expected to use to suture a childs face?
In ED it is usually given IM or IV. The dissociative dose IV is 1-2mg/kg, IM 4mg/kg.
Which of the following is INCORRECT about the topical anaesthetic "Laceraine"?
It can be used on 1 to 3 yr olds at a dose of 0.1ml/kg to a maximum of 2mls.
Its use can remove the requirement for infiltrating local anaesthetic and can reduce the number of paediatric sedations in the ED.
How is the "Buzzy Bee" (pictured) meant to work.
Can be a useful adjunct.
Buzzy bee is about $105 and 5 ice wings cost $37.50 (multi use).