Emergency Medication Protocols: Dosage and Indications

Posted on Jan 28, 2025 in Medicine & Health

Metered-Dose Inhaler (MDI) / Small Volume Nebulizer (SVN)

Indications

  • Respiratory distress.
  • Patient has a physician-prescribed metered-dose inhaler prepared to be delivered by nebulization.
  • The EMT received approval from Medical Director.

Contraindications

  • Patient unresponsive.
  • MDI/SVN Not prescribed for the patient.
  • Medical direction has not granted permission.
  • The patient has already taken the maximum allowed dose(s) prior to arrival.

Dose

  • The total number of times the medication can be administered is determined by medical direction.
  • SVN usually takes 5-10 minutes for the patient to inhale the medication, until the SVN no longer produces a mist.

Nitroglycerin

Indications

  • Signs and symptoms of chest pain.
  • The patient has physician-prescribed nitroglycerin.
  • The EMT has received approval from Medical Direction to administer.

Contraindications

  • Suspected head injury.
  • Heart rate less than 50 bpm or greater than 100 bpm.
  • Infant or a child.
  • Three doses have already been taken by the patient.
  • Baseline systolic BP is below 90 mmHg, or a decrease greater than 30 mmHg from the baseline systolic.
  • Patient taking sexual enhancing drugs.

Doses

  • One tablet, or one spray under the tongue.
  • Most commonly prescribed dose is 0.3 mg per tablet or metered spray.

Aspirin

Indications

  • Chest discomfort that is suggestive of a heart attack.
  • EMT received approval from Medical Direction to administer medication.

Contraindications

  • Allergic to the drug.

Dosage

  • 160-325 mg as soon as possible after the onset of the chest discomfort and symptoms of heart attack.

Oral Glucose

Indications

  • Altered mental status.
  • History of diabetes controlled by medication or a blood glucose level less than 60 mg/dL.
  • The ability to swallow the medication.

Contraindications

  • Unresponsive or unable to swallow the medication.
  • Blood glucose level greater than 60 mg/dL.

Dosage

  • Is viscous gel typically packaged in toothpaste-type tubes. One tube is the typical dose.

Epinephrine

Indications

  • Signs and symptoms of a moderate-to-severe anaphylactic reaction, respiratory distress, and shock.
  • Medication prescribed to the patient.
  • EMT has received an order from Medical Direction for administration.

Contraindications

There are no contraindications.

Dosage

  • The adult auto-injector delivers a dose of 0.3 mg for patients > 66 lb of epinephrine.
  • Infant and child auto-injector delivers 0.15 mg for children < 66 lb of epinephrine.
  • Single dose administered to the patient.

Charcoal

Indications

  • Patient who has ingested poison by mouth, upon specific orders from medical direction.
  • Most effective when administered within 1 hour after the ingestion of the poison and only in specific cases of poison.

Contraindications

  • Altered mental status.
  • Swallowed acid or alkalis.
  • Unable to swallow.
  • Overdoses on cyanide.

Dosage

  • 1 gram of activated charcoal per kilogram of body weight.

Oxygen

Indications

  • SpO2 reading of <94%.
  • Complains of dyspnea or respiratory distress.
  • Signs of poor perfusion.
  • Signs of heart failure.
  • Suspected shock.
  • Hypoxia or hypoxemia suspected.