GFR Medication Training

What Medications Can GFR Give? Epinephrine Narcan/Naloxone Albuterol Oxygen Oral Glucose Aspirin Nitroglycerin (WE DO NOT CARRY THIS IN OUR BAG)

Epinephrine

Epinephrine Indications: Option 1: Exposure to known allergen: Hypotension and/ or Respiratory Distress Option 2: Exposure and true history of anaphylaxis: Hypotension and/or Respiratory Distress and/or RASH Contraindications: No true contraindications, but be aware of patients who have cardiac issues Dosage: 0.3 mg for adults, 0.15 mg for pediatric patients Route: IM (check and inject) How many times can we administer in the field: ONE TIME (then call medical control) Asthma

Auto Injector Epi Pens

Narcan

Narcan Indications: Respirations <8, pinpoint pupils, altered level of consciousness, suspected opioid overdose Contraindications: none if the indications are present, it won’t hurt the patient if it was not an opioid overdose. However, be aware that if the patient has done opioids that are laced with things like Molly, if you give narcan they might go into spontaneous cardiac arrest.    Dosage: 4mg Nasal Spray in one nostril- both adult and pediatric Route: Intranasal How many times We can give 2 doses total (repeat in 5 minutes if no improvement)  keep in mind UPD has extra doses

Narcan Training Video https://www.youtube.com/watch?v=pWjlh8OG6co&feature=youtu .be

Albuterol

Albuterol Indications: Pt. has a known history of asthma and is prescribed albuterol and is wheezing Contraindications: no prescriptions for albuterol/ diagnosis of asthma (can call med control for orders), allergy, if you have already given 3 doses Dosage: 2.5 mg in 3 ml (one tube) for adult + pediatric patients Route: Via Nebulizer How many times three times- every five minutes Consider calling medical control for epi if asthma is not getting better, also be sure to consider anaphylaxis even if the patient has a history of asthma

Nebulizer

Oxygen Indications: SPO2 < 92% CO poisoning Smoke inhalation Patients who are having difficulty breathing should first be “coached” with their breathing as long as SPO2 is above 92%.

Oxygen Flow Rates Non Rebreather: 12-15 LPM Nasal Cannula 2-6 LPM Nebulizer 4-8 LPM BVM 15+ LPM

Oral Glucose

Oral Glucose Indications: BG less than 60, altered mental status, patient is cool and clammy Contraindications: Patient can not maintain their own airway Dosage: 15-24 grams for adult and pediatric patients Route: Buccally (between tongue and cheek) How many times Have the patient suck on the tube as needed Be aware that oral glucose lasts for ~30 minute time periods. Be ready for patient crashes. This is the only time that food would be appropriate during an EMS call

Aspirin

Aspirin Indications: Chest Pain Contraindications: recent surgery, major internal/external bleeding, allergy, they already took it in the past 6 hours Dosage: 4- 81 mg tablets: 324 mg total Route: chewable How many times One in 6 hours, unless you suspect the full dose was not delivered (i.e. vomiting right after administration) You can not give Aspirin to patients under 18 years of age. Call medical control if you are concerned about patients between 18 and 21

Nitroglycerin

Nitroglycerin Indications: Chest pain with prescription for Nitro! Contraindications: Systolic BP < 120, ED medications within the past 72 hours, they already took 3 doses Dosage: 1 tablet Route: Sub-Lingual How many times We can give one tablet every 5 minutes up to 3 times! Check BP every single time- systolic must be above 120. If the patient already took 2 doses before you got there, then you only have one dose left to give