Intranasal drug administration

[Doczilla]

Doczilla, one other one which I forgot that is quite useful for nasal intubations - neosynephrine which comes in a spray, but is given IN anyway. Though nasal intubations are falling out of favor very quickly with the more widespread use of RSI/DAI in ground services. I believe I've only had one nasal in an 8 year career.

+1 on the Afrin. Epi will also work. We still do quite a few nasal intubations in this area, as damn few of the ground services are utilizing RSI.

'zilla

[Richard B the EMT]

For many years, I have been taught how to do the "Combi-Tube", but the state (New York) is waiting for a "Pilot" program.

As for the nasal intubation, I have been trained in them for so many refreshers, I forget when I first heard of them, but have never actually inserted one, in over 35 years, now.

[zippyRN]

biggest problewm with IN morhpine is the volumes

smaller is better - in the ED i worked in before moving to Emergency Assessment unit were were giving meds In mainly diamorphine and aiming for a 02 or 0.4 ml volume - IN morphine sulphate was discussed t it was felt that the standard 10 mg / ml presentation left too great a volume

[stcommodore]

We have protocol for IN Narcan in Pa and the rumor is will soon have a protocol for IN Glucagon. There was a recent publication (JEMS?) that covered the myriad of medications that can be given IN. So in other wards there is no excuse why EMS isn't catching onto this trend.