Asthma attacks without an inhaler

[Matthew99]

Say you're a first aider and you're called for an asthma attack case. You give the girl oxygen for now. But you have no inhalers in your bag and the patient forgot hers, but you have people offering to give her theirs.

Would you give her somebody else's inhaler to use? Or would you just wait for improvement and if condition doesn't improve-- call an ambulance? Seems like the latter makes more sense, but I guess using somebody else's inhaler isn't so detrimental-- particularly if the patient recognizes her medications. Right?

Edited August 31, 2011 by Matthew99

[uglyEMT]

Sorry Matthew remember your Rs

Right Name

Right Experation

Right Perscription

Right Dose

I would never give someone someone else's perscription. The only exception to that rule is Epi Pen, we carry our own in the lock box incase of anaphalaxsis.

Look at it this way, do you want to lose your liscense over a mistake that could have been prevented? Just because it is the same medication that the patient takes doesn't mean everything is the same. One thing you could do while waiting for the rig is add water to the O2. Sometimes moisting the O2 will realive some of the symptoms of the attack. Yes its not medication and no it won't completely fix the situation but it will buy you time and releave the patient discomfort to a degree.

Your best bet is to put a rush on the rig, have ALS respond as well, and keep an eye on your patient because an asthma attack could decompansate into respitory failure if it goes to long.

Edited August 31, 2011 by UGLyEMT

[JakeEMTP]

No I wouldn't immediately use someone else's medication, although I won't lie, I might consider it if an ambulance is going to take some time and the pt.'s condition worsens (which it will). A true asthma attack is nothing to play around with. Although Ugly is right about the "R's", most asthmatics have had albuterol or ipatropium before. Before the pt.'s airway closes completely, I'd have to consider using someone else's inhaler if it was in date.

I also wouldn't wait for that miracle drug O2 to work before calling for an ambulance. For a true Asthma attack, O2 is not going to cut it and the pt. needs and ambulance.

[BushyFromOz]

Jake got in before me

As a first aider, i doubt i would use another patients medication. As a paramedic however i would use someone elses, and i would use it if it were out of date, the same as i would use someone elses out of date epi pen.

Jake is right with the o2, setting up a better o2 / c02 gradient may help stave off hypoxia for a little bit but its unlikely to be of any real benefit. Remember acute asthma is an inflammatory codition of the small airways, characterised by bronchospasm, mucouse pluging and oedema, none of which 02 is going to change. Beta agonists in conjuction with an anticholinergic are the first line of attack, while plugging and oedema devope, bronchospam can be immediately dealt with through the above - 02 isn't going to change this.

So yea, i would use someone elses ventolin.

[Just Plain Ruff]

I would also use someone elses inhaler, like let's say my own. I have one for odd times when I get wheezy. It's not been used often.

I would only use it for specific circumstances, such as long time for ambulance to get there and the condition of the patient.

If you are working in a first aid capacity you should have some idea of what local hospital is your medical control or find out from the ambulance service in the area who their medical control is. You could always call medical control and see if the doctor on duty will give you orders to give the inhaler.

If I am working first aid and I have no ability to give meds I'll give medical control a call and ask them to allow me to use the inhaler. Giving them all the particualars as well as how far the ambulance is away. More than likely the doc will give the order to use the inhaler.

Ruff

[uglyEMT]

If I am working first aid and I have no ability to give meds I'll give medical control a call and ask them to allow me to use the inhaler. Giving them all the particualars as well as how far the ambulance is away. More than likely the doc will give the order to use the inhaler.

Ruff

Ruff I like this statement. This AM I wasn't even thinking along the lines of On-Line MedCon. Perfect way to CYA and still get the job done.

I will say if your in my area the Director will say NO let one of my Medics handle it. I was denied ASA for chest pain when we didn't have ALS available. Thankfully the wife remembered the Bayer commercials wink wink

[Just Plain Ruff]

Ruff I like this statement. This AM I wasn't even thinking along the lines of On-Line MedCon. Perfect way to CYA and still get the job done.

I will say if your in my area the Director will say NO let one of my Medics handle it. I was denied ASA for chest pain when we didn't have ALS available. Thankfully the wife remembered the Bayer commercials wink wink

I wonder who prompted her memory?

[tniuqs]

Sorry Matthew remember your Rs

Right Name

Right Experation

Right Perscription

Right Dose

I would never give someone someone else's perscription. The only exception to that rule is Epi Pen, we carry our own in the lock box incase of anaphalaxsis.

Look at it this way, do you want to lose your liscense over a mistake that could have been prevented? Just because it is the same medication that the patient takes doesn't mean everything is the same.

One thing you could do while waiting for the rig is add water to the O2. Sometimes moisting the O2 will realive some of the symptoms of the attack.

Yes its not medication and no it won't completely fix the situation but it will buy you time and releave the patient discomfort to a degree.

Your best bet is to put a rush on the rig, have ALS respond as well, and keep an eye on your patient because an asthma attack could decompansate into respitory failure if it goes to long.

In closing has anyone anywhere ever been convicted or legal precedent set of <gasp> allowing a bystander to volunteer medication in this situation .. ps stop living in fear of litigation, do the right thing.

[systemet]

I have to point this out or my head will explode. "Prescription".

[Just Plain Ruff]

I can see getting your hand slapped by the Pharmaceutical regulatory boards but if you gave the medication and it saved the life, you'd be hailed a hero.

If you gave it and it did nothing, no hero worship.

If you gave it and it killed the patient because they were allergic to the medication then no hero worship and a free trip to lock up ville or at least a huge judgement against you.

Seriously, Squint, that's a conundrum that we face. We have no orders for it, we are working out of our comfort zone with minimal equipment and no medications in this scenario except for oxygen. You are expected to work to the level of the job not to your medical education/licensure level. You are manning a first aid (not als) station. You are severely limited in what you can do. So yeah, I'm calling 911 and then medical control.

Now what's to say that I don't turn my back on the patient and a bystander gives them a puff or two??? How do you deal with that?

And one more thing, oxygen is a drug according to most that I know. Who gives the order to administer the oxygen? If you are a simple first aider with no licensure other than a first aid card and you are carrying oxygen, isn't that breaking the rules as well? Ambulance crews can't even give oxygen if it's not in the protocols or doctor's orders can they? So to extrapolate, if you are working a first aid station and there are no protocols or directions but you are given a bottle of oxygen to use, aren't you breaking the RX rule??

Just some questions