Medication Administration/Assisstance (EMT 2026)

General Steps in Administering Medication

1. Obtain medical control order. 2. Verify medication/prescription. 3. Verify form, dose, and route. 4. Check expiration/condition. 5. Cross-check procedure. 6. Reassess vitals (BP/HR) every 5 mins. 7. Document actions and response.

The 9 "Rights" of Medication Administration

Right patient, Right medication/indication, Right dose, Right route, Right time, Right education, Right to refuse, Right response/evaluation, and Right documentation.

Skills Exam Critical Failures

1. Failure to confirm indications/contraindications. 2. Wrong "rights." 3. Administering outside of protocol. 4. Incorrect equipment/technique. 5. Compromising provider or patient safety.

Nitroglycerin (Vasodilator)

Indication: Suspected cardiac chest pain. Contraindications: Systolic BP < 100, ED drugs in 24 hrs. Dose: 0.4mg sublingual. Protocol: May assist 1 dose without command

Epinephrine (Sympathomimetic)

Indication: Anaphylaxis (respiratory distress/hypotension). Dose: 0.30mg Adult / 0.15mg Pedi. Protocol: Administer without command

Naloxone (Narcan)

Indication: Suspected opioid OD with respiratory depression (< 8/min). Dose: 2mg Intranasal (1mg per nostril) or 0.4mg IM. Repeat in 5 mins if no return of respirations.

Aspirin (Antiplatelet)

Indication: Cardiac scenario. Dose: 324mg oral chewable. Contraindications: GI bleed, stomach ulcer, or known allergy.

Oral Glucose

Indication: Hypoglycemia. Dose: 15g. Requirement: Patient MUST have patent airway and ability to swallow. Route: Under tongue or inside cheek.

Nebulizer Bronchodilator (Albuterol)

Indication: Bronchoconstriction/Respiratory illness. Dose: Albuterol 2.5mg in 3ml. Setup: O2 flow at 6 L/min to establish misting effect.

MDI (Metered Dose Inhaler)

Indication: Patient's own prescribed rescue inhaler. Steps: Shake vigorously, have patient exhale deeply, depress inhaler as they inhale, hold breath for 3-5 seconds.

Acetaminophen & Ibuprofen

Indications: Febrile, headache, mild pain, or muscle soreness. Protocol: Must contact Medical Command for use and dosing.

Nausea Treatment

Alcohol Prep Pad. Protocol: Have patient smell/inhale it. No contraindications per PA protocol 201.

Glucagon

Indication: Diabetic emergency/hypoglycemia. Protocol: Use "if available" per PA protocol. Dose: 1mg IM auto-injection OR 3mg IN nasal powder.

Epi-Pen Administration

1. Form fist, pull blue safety release. 2. Place orange end against outer mid-thigh. 3. Push down hard until click, hold for 3 seconds.

Oral Glucose BGL Threshold

Administer when blood glucose level (BGL) is under 60 mg/dL.

Oral Glucose Requirements

Patient must be CONSCIOUS, able to follow directions, and able to protect their own airway.

Oral Glucose Administration

Administer 1 tube (15 grams) under the tongue or in the buccal space

Glucagon Indications

BGL under 60 mg/dL AND patient is unresponsive or unable to protect their own airway/swallow.

Glucagon Dose and Routes

3mg nasal powder spray (Baqsimi) OR 1mg intramuscular (IM) auto-injector.

Metered-Dose Inhaler (MDI) Prep

Verify patient/med/dose/expiration. Ensure inhaler is at room temperature or warmer and shake vigorously.

MDI Administration Steps

1. Remove O2 mask. 2. Patient exhales deeply. 3. Patient presses inhaler and inhales one puff. 4. Patient holds breath. 5. Reapply O2.

Epi-Pen Safety Phrase

"Blue to the Sky, Orange to the Thigh." (Remove blue safety cap, place orange tip against lateral thigh).

Epi-Pen Skill Drill Steps

1. Remove safety cap. 2. Push firmly against lateral thigh until click. 3. Hold for 3 seconds. 4. Rub area for 10 seconds.

Stroke Assessment (F.A.S.T.)

Face drooping, Arm weakness, Speech difficulty, Time to call 911 (Time is tissue).

Altered Mental Status (AMS) Ruling

Rule out all other reasons for AMS using AEIOUTIPS, with heavy emphasis on assessing for stroke vs. hypoglycemia.

Normal BGL Range

80 to 120 mg/dL.

Stroke vs Hypoglycemia Protocol

If BGL is low: treat with glucose. If BGL is normal with positive stroke symptoms: Rapid transport, O2 via Nonrebreather, and call ALS.

Stroke Priority Questions

When was the patient last seen normal? (