Albuterol/Atrovent and Epinephrine

[dahlio]

I can't belive a basic would want these.

I am a basic too. And I am pretty sure I went through the same course everyone else did. And I know we didn't cover the physiology behind these medications.

I know the indications and contraindications. But do we know what they do to the body as a whole?

Maybe with an expanded basic curriculum with more anatomy and physiology involved, I could go for this. But right now with the training I have had, I don't want this responsiblity on my shoulders.

Well, When I went for the training, there was anat/phys, and what the epi does. So in a way, we learned a bit more. There are no contraindications for an epi, at least, thats what we were told, so it's hard to screw that up. In my opinion, I think it's a great idea. The wider the scope of practice for a Basic, the better, as long as we have been trained. There have been talks of also putting albuterol on BLS ambulances in NJ. Whether or not they will institue On-Line Medical Control is another issue, since everything is standing order for BLS in NJ, but the wider the scope, the potential for better care. Notice I used potential.

[katbemeEMT-B]

I am an EMT-B with a volunteer BLS service. I am also on a full-time ALS service. As a Basic with the ALS service we are allowed to admin. Albuterol and Atrovent via neb. We are also allowed to admin Epi-pen under the direction of the medic we are with. As a Basic on the volunteer service we work under standing orders that allow us to admin. Albuterol via neb. If we are dealing with an asthmatic we try their prescribed inhaler first. If there is no relief or they are unable to inhale deep enough for the med to be effective we will then use the neb. While administering the neb we contact medical control for any further instructions. We do not carry Atrovent. As far as the Epi-pen, we are required to ask if the patient carries his/her own and help them to administer it. If they do not have one we are required to get pt. history and confirm that it is an allergic reaction and to what, then we contact medical control to confirm the use of the pen. We are trained both in our EMT-B classes and through CME as to all aspects of these medications along with Glucagon. I guess we are lucky in the fact that we live in rural area and the local college takes great care in ensuring that we are properly trained. We also have yearly drug variance training that gives us the most recent and up-to-date information on the meds we are allowed to carry and administer.

[CBEMT]

Epi 1:1000- by auto-injector or drawn from ampule by the EMT, whether the patient has a script or not. Med Control IF the patient is over 50 or has a cardiac hx. 5mg nebulized for adults and pedis if indicated. Pedis with MC.

Albuterol- with MC, does not have to be the patient's own. That said I don't think anyone's ever called for clearance to give it, and if somebody actually did the doc would probably be so confused that he'd deny it.

[EMSm0nster]

In L.A County, we are only able to assist in administration of both.

[EMS_GIRL]

Here in Alberta an EMR can Administer ASA and Oral Glucose, we can assist with Atrovent, Salbutamol and Epi-pen's only if it is the pt. prescription. We cant start a neb treatment here but we can continue it if it has been started at a hospital.