TC protocol Medications

Question 1

Albuterol indications/contraindications

Answer 1

Indications: Treatment of moderate to severe bronchospasm Suspected hyperkalemia

Contraindications: None

Cautions: May cause tachycardia/chest discomfort

Question 2

albuterol dose

Answer 2

Adults: Nebulized initial dose – 5 mg
Repeat as needed
MDI via BiPAP: 5 puffs
Repeat as needed
Nebulized 15 mg (hyperkalemia dose)

Pediatric: Nebulized 2.5 mg in 2.5 ml of saline if less than 2 y/o;
otherwise use adult dose

EMT MDI: Repeat every minute as needed for a total of 10 puffs

Question 3

Aspirin

Answer 3

Indications: Signs or symptoms of acute coronary syndrome

Contraindications: Allergy to Aspirin

Cautions: None

Suggested Dose: Adults: 325 mg PO chewed 4 81mg aspirin
Pediatric: Not indicated

Question 4

Epinephrine

Answer 4

Indications: Patient is displaying signs or symptoms of anaphylaxis:
respiratory distress or shock or difficulty swallowing (throat
edema), and consents to treatment

Cautions: May increase blood pressure, cause tachycardia or cardiac ischemia

Suggested Dose:
Adults: IM (1:1,000) 0.3 mg

Pediatric: IM (1:1,000) 0.15 mg

Question 5

Glucose

Answer 5

Indications: Suspected or confirmed symptomatic hypoglycemia

Contraindications: Patient unable to swallow

Cautions: Use caution to prevent aspiration of the glucose paste

Suggested Dose: 1 tube

Notes: Following administration, check blood glucose levels and ensure patient is able to maintain a continued oral intake of carbohydrates balanced with protein.

Question 6

oxygen

Answer 6

Indications: Patients with symptoms of shock, shortness of breath, hypoxia, respiratory distress, respiratory arrest, carbon monoxide poisoning, over-sedation, chest pain, and stroke

Contraindications: None

Cautions: Supplemental oxygen may cause decreased respirations for patients with chronic hypoxia

Suggested Dose:
2-6 lpm via nasal cannula,
8-15 lpm via non-rebreather mask,
15-25 lpm via bag valve mask

Question 7

metered dose inhaler

Answer 7

Indications: Patient believes symptoms are related to asthma or COPD, or shortness of breath following epinephrine admin for allergic reaction

If a patient has a home nebulizer machine and albuterol, the EMT may assist the patient with use of the machine in place of an MDI. Once the patient has a nebulizer set up, the EMT should connect it to an oxygen source at 6 lpm.

EMT MDI Dose: Repeat every minute as needed for a total of 10 puffs