Pharmacology

• For a patient with difficulty breathing, administer albuterol 2.5 mg in 3 mL via nebulizer. It can be administered 3 times total if symptoms persist

  • if in severe distress, considere epinephrine 0.3 mg IM if at or over 30 kg
• anaphylaxis - severe respiratory distress, facial or oral edema, or hypoperfusion, or has history of anaphylaxis and has had exposure to allergen and developing these symptoms

  • administer epinephrine via autoinjector 0.3 mg IM if ≥ 30 kg
  • 2x total if symptoms persist, 5 minutes apart, without medical control
  • syringe epi may be substituted
  • if patient is wheezing, administer albuterol 2.5 mg in 3 mL (unit dose) via nebulizer
  • 3x TOTAL if symptoms persist
• Cardiac related problem

  • administer aspirin 324 mg, only if patient can chew (not enteric coated)
  • 1x total (via four 81 mg tabs) chewed; you may give this 324 mg "additional" dose of aspirin if there is any concern about patient having received an effective dose prior to EMS arrival
  • administer patient's prescribed nitroglycerin
  • 3x total, 5 minutes apart with systolic BP higher than 120 mmHg
  • additional nitroglycerin (0.4 mg) SL, or equivalent, every 5 minutes with medical control
• Opioid (Narcotic) Overdose

  • for suspected opioid overdose and hypoventilation or respiratory arrest
  • NOTE: do not administer without a medical control order if there are adequate ventilations
  • administer naloxone 2 mg intranasal: 1 mg per nostril (4mg, one nostril if allowed)
  • 2x total 5 minutes apart if no significant improvement occurs
• absorption is the process by which medications travel through body tissues until they reach the bloodstream
• intramuscular (IM) injection - an injection into a muscle; a medication delivery route
• intranasal (IN) - a delivery route in which a medication is pushed through a specialized atomizer device called a mucosal atomizer device (MAD) into the naris
• intraosseous (IO) injection - an injection into the bone; a medication delivery route
• intravenous (IV) injection - an injection directly into a vein; a medication delivery route
• metered-dose-inhaler (MDI) - a miniature spray canister used to direct medications through the mouth and into the lungs
• mucosal atomizer device (MAD) - a device that is used to change a liquid medication into a spray and push it into a nostril
• per os (PO) - through the mouth; a medication delivery route; same as oral
• sublingual (SL) - under the tongue; a medication delivery route
• six rights of medication administration - patient, medication, dose, route, time, and documentation
• Right patient - If you are assisting the patient with his or her own medication, look at the medication label to ensure that it reads the same name as your patient.
• Right medication and indication. Check the medication label to makesure it is the right medication for the patient’s condition.
• Right dose - Check the medication label and take note of the dose. The dosing information should be on the medication container. If it is not,contact medical control or follow your local protocols.
• Right route - A medication given by the wrong route, even if it is the correct medication, may be ineffective or may even cause harm to the patient.
• Right time - Medications that can be repeated must be given at the correct time intervals. After administering the medication, document the time. After the proper time has passed, follow your local protocols or contact medical control again if the drug needs to be readministered.
• Right education. Advise the patient of the medication that you intend to give and confirm (or reconfirm) any allergies or other contraindications.
• Right to refuse. Remember that patients with decision-making capacity(or their surrogate decision makers) have the right to refuse any proposed interventions.
• Right response and evaluation. Monitor the patient for response to themedication, observe for adverse effects, and recheck vital signs at appropriate intervals.
• Right documentation. After administering any medication to any patient, you must document the drug, dose, route, time(s) of administration, and reassessment findings after the medication has been given. Proper documentation will ensure that the receiving facility is aware of the medications the patient received in the field and the effects they may have had