Albuterol/Atrovent and Epinephrine

[emt322632]

Are Basics where you're from allowed to give Albuterol/Atrovent or Epinephrine?

I know in NYS, in the REMAC system I'm in that is, a Basic can use Albuterol and Epi-Pens if they've had the REMAC class, or if their squad does an inserviec training with them.

A campus first response team I'm on carries both Albuterol and Epi, and all are fully able to use them. The paid agency I work for however, seems to think that since we have fully staffed ALS rigs, Basics are somehow incapable of giving Albuterol or Epinephrine.

There have been innumerable times where I have had to meet my ALS on scene, and he hasn't arrived yet. (We run a weird program here, ALS isn't required to stay in house if they live in town)

I've beaten the ALS to the scene before, and had a patient that could have used Albuterol, but all I could do was stand there with my ass cheeks clenched.

When is Epi and Albuterol better now or later eh? lol

anyway, enough ranting, some thoughts?

[Woody76559]

Our EMT-B's are allowed to administer albuterol/atrovent nebulized. We can not, however administer epi. We can assist with the pt's epi-pen, but can not give epi.

[craig]

basic or the qualified officer in my service can use both atrovent and adrenaline

the trainee on their first day here cab use atrovent (and has to with regards to protocol)

the dose pf the atrovent is 500mcg via neb and can be repeated once

this is in co junction with salbutamol

the adrenaline is a IM injection of 1:1000 up to 5 mls

stay safe

[678 Responding]

In NJ , we can administer albuterol only if its the patient's prescribed, same goes for epi. However they just approved a bill to allow us to carry epi with us and administer it without prescription, we're just waiting for protocols now.

[vs-eh?]

the adrenaline is a IM injection of 1:1000 up to 5 mls

That can't be right...

We give epi (for asthma) @ 0.01mg/kg 1:1000 up to 0.3mg or 30kg is maxed. I believe standard is that dosage up to 0.5mg SQ/IM max per dose.

We can repeat once in 10 mins provided they are still in extremus.

5ml of 1:1000 epi is 5mg. That is alot of epi no matter who you are, single dosage or not, you risk a lot of cardiac irritability, dysrythmias, increase mvo2, etc....

[craig]

sorry to miss led you

we can give it in increments to a max dose of 5ml nebulized

or im/sc in doses relating to the pt weight to a max dose of 3.6 mls

thats the trouble with trying to post while at work time is of the essence

stay safe

[9C1EMT]

Up in the Green Mountain State Basics can assist the patient with administering Rx epi-pen and the MDI albuterol, with clearance from med control (usually not a problem).

[ResQBtheEMT]

In PA, we can assist a patient in using an Albuterol MDI or Epi-Pen (prescribed for the patient)...We are not permitted to do nebulizer treatments or just give a dose of epi. Statewide protocols now allow us to carry epi-pens on the trucks, but the service I am at does not as of yet.

The training for these meds was included in my emt class, but the state protocols state that anyone without the modules must be trained prior to using the meds, in other words all our personnel must be trained if we carry it. Basics must contact command to administer meds...(However, with all of our units staffed ALS, basics never have to do this because of medics' standing protocols...)

[VillageEMT]

We just got Albuterol and Epi-Pens for the BLS bags on all our rigs. We normally run ALS but there are times when we respond BLS to an allergic reaction or a difficulty breathing. If it's the first call we will have an assigned crew with ALS, but a code 2 call you go with whoever comes and ALS can come later, if required. We run on the priciple that a good outcome is more likely if we can get treatment started sooner.

My view is that the first two or three minutes of a call is almost always BLS anyway. ABCs, O2, assessment, the sooner the better. I guess that we are lucky, from what I have read here not all squads have such "enlightened" ALS.

[EMT001]

In NJ , we can administer albuterol only if its the patient's prescribed, same goes for epi. However they just approved a bill to allow us to carry epi with us and administer it without prescription, we're just waiting for protocols now.

The protocols in New Jersey only allow us to assist with a MDI. I think the author of the post was referring to nebulized albuterol, which we cannot administer. Just curious, where in New Jersey do you work?