* Hypotension (Actual NOT ETIMATED systolic BP <90 Adults <80 School Children <70 preschool children.
* Head injury with impaired level of consciousness e.g. below P on the AVPU scale or GCS below 9.
* Known Hypersensitivity to Morphine.
There are no contra-indications for buccal Midazolam.
GARPP* Gastrointestinal obstruction.
* Aged less than 20 years.
* Renal Failure.
* Pheochromocytoma (adrenal tumour)
* Perforation/haemorrhage/3-4 days after GI surgery
There are no contra-indications to Ipratropium bromide in the emergency situation.
Hydrocortisone is contra-indicated where there is Known allergy (which will be to the sodium succinate or sodium phosphate rather than the hydrocortisone itself)
* Hypotension (actual or estimated blood systolic blood pressure less than 90mmHg)
* Unconscious patients
* Head Trauma
* Cerebral Haemorrhage
* Sidenafil (Viagra) and other related drugs – GTN must not be given to patients who have taken Viagra or other related rugs within the previous 24 hours. As profound hypotension may occur.
Glucose 40% Oral Gel
There are no contra-indications for Glucose 40% gel.
There are no contra-indications for the use of 10% glucose.
* Low glycogen stores (e.g. recent use of glucagon)
* Hypoglycaemic seizures - glucose 10% is the preferred intervention.
* Pre-comatose state secondary to liver cirrhosis.
* Severe renal failure with anuria
* Decompression sickness (the bends) where Entonox can cause nitrogen bubbles within the blood stream to expand, aggravating the problem further. Consider anyone who has been diving within the past 24 hours to be at risk.
* Severe head injuries with an impaired level of consciousness
* Violently disturbed psychiatric patients.
There are no contra-indications to the use of Diazepam
* Active bleeding such as peptic ulcer or intracranial haemorrhage
* Severe Liver impairment
* Known allergy or sensitivity to Clopidogrel
Children less than 1 year of age.
Benzylpenicillin (Penicillin G)
Known severe penicillin allergy (more than simple rash alone)
Should NOT be given to treat bradycardia in suspected hypothermia.
* Severe hepatic disease
* Haemophilia or other known clotting disorders.
* Active gastrointestinal bleeding.
* Children under 16 years of age
* Known aspirin allergy or sensitivity
No contra-indications in the context of the treatment of cardiac arrest.
Do not give repeated doses of adrenaline in hypothermic patients.