EMT-B Pharmacology

  Maryland Fire and Rescue Institute Drill of the Month – March 2002 EMT-B Pharmacology Instructor Guide Topic: EMT-B Pharmacology Time Required: Three Hours Materials:    · Oxygen delivery system...

              i. depress the inhaler as patient begins deep inhalation

              j. ask patient to hold breath as long as comfortable

             k. reattach oxygen

             l. administer 2nd puff after a few breaths

            m. record name, dose, route and time of administration

  B. Epinephrine Auto-Injector

       1. Indications

            a. moderate to severe allergic reaction with respiratory distress

            b. mild allergic reaction with history of life-threatening allergic reaction

            c. pediatric patients with severe asthma

      2. Actions

            a. increases heart rate

            b. increases blood pressure

            c. decreases muscle tone of bronchiole tree

            d. dilates passages in lungs

            e. constricts blood vessels

      3. Adverse Effects

            a. tachycardia/palpitations

            b. angina

            c. headache

           d. nausea/vomiting

           e. dizziness

           f. hypertension

           g. nervousness/anxiety

           h. tremors

      4. Precautions

           a. requires Medical Consultation in pregnant patients unless

                  1) patient is in severe allergic reaction

                  2) patient is in severe asthma

      5. Contraindications

            a. none in the presence of anaphylaxis

      6. Dosage

            a. adult

                    1) 0.3 mg IM

                              a) Medical Consultation required prior to administration to adult asthma patients

            b. pediatric

                     1) 0.15 mg IM

            c. additional doses require Medical Consultation

      7. Administration

             a. Obtain patient’s prescribed autoinjector

             b. insure medication is not discolored

             c. Medical Consultation if required

            d. remove cap from auto-injector

            e. place tip against patient’s thigh

                   1) lateral aspect

                   2) midway between waist and knee

            f. push firmly against thigh until injector activates

            g. hold at least 10 seconds

            h. record name, dose, route and time of administration

            i. properly dispose of auto-injector

  C. Nitroglycerin

       1. Indications

             a. patient must have own physician prescribed nitroglycerin

             b. chest pain

        2. Actions

             a. increases blood flow to the heart

                    1) relieve vascular spasms

                    2) dilate arteries

                    3) relaxes veins so less blood is returned to the heart

        3. Adverse Effects

              a. hypotension

              b. headache

              c. dizziness

              d. tachycardia

       4. Precautions

              a. reassess blood pressure before and after administration

              b. if systolic pressure drops more that 20 mmHg, Medical Consultation is required before

                  further administration

        5. Contraindications

              a. Blood pressure below 90 mmHg systolic

              b. heart rate less than 60

              c. medication not prescribed for the patient

             d. pediatric patient under the age of 12 years

             e. Viagra™ ingestion with the last 24 hours

        6. Dosage