MIEMMS Medication

Acetaminophen dose

Under 3 months: NOT indicated

5-12: 325mg

13+: 650mg

Acetaminophen contraindications

Head Injury

Hypotension (systolic under 100)

Taken in the last 4 hours 

Allergy to Acetaminophen 

Activated Charcoal Contraindications

Altered mental status

Ingestion of:

emetic, corrosive, petroleum 

Activated Charcoal Notes:

Have suction ready 

Dual Consult with Poison control & base station

Albuterol Dose (MDI, Neb, How many doses?)

MDI:

2 doses (4 puffs) over a 30 min period

Nebulized:

(0-2) 1.25mg

(2+) 2.5mg

Contraindications for Albuterol

Hypersensitivity

MDI not prescribed to Pt

Albuterol Side FX

Tachycardia 

Hypertension 

Angina 

Palpitations 

Sore throat 

Albuterol NOTES

• Shake well & ensure room temp

• Neb @ 8L/min

• Repeated excessive use may cause severe bronchospasm

• Consult for more than 2 doses

Aspirin Dose

Ped: not indicated

Adult: 324mg (81× 4)

Aspirin Indications 

Suspected ST Elevated MI 

(Platelet inhibitor)

Aspirin Contraindications

Hypersensitivity

Full dose taken prior to EMS

Liver damage

Asthma

History of GI bleeds!!

Epi Dose

PEN:

(0-4) 0.15mg

(5+) 0.3mg 

DRAW-UP:

(0-4) 0.15mg 

(5+) 0.5mg

Epi indications

Mild w history of severe

Moderate/ Severe w/ respiratory distress

Anaphylaxis

Sever Asthma

Epi Side FX

Tachycardia

Palpitations

Angina

N/V

Oral Glucose Dose 

10 - 15 GRAMs 

Oral Glucose Indications

AMS /w diabetic history

Hypoglycemia (BGL < 70)

Oral Glucose NOTES

• have suction ready

• Consider 1 additonal dose after 10 mins with no effect

Naloxone Dose

2mg (1mg each nare) 

Narcan contraindications & side FX

Under 28 days old

Opioid withdrawal

Narcan Notes

Action duration of 40 mins (keep administering to keep respiration in tact)

Consult if patient refuses 

Nitroglycerin dose

0.4mg (1 spray/ tablet)

may repeat 2x in 5 min intervals

MAX 3 doses (consult for additional)

Nitro Contraindications

• not Px to patient

• Under 13 YOA

• SBP < 90

• SBP drops 20 between doses

• Pulse < 60 or > 150

• ED or Pulmonary Hypertension drugs taken in last 48h

List of ED/ Pulmonary Hypertension drugs

• Viagra 

• Levitra

• Cialis 

• Adcirca 

• Revatio

Nitro NOTES

CONSULT IF…

BP drops more that 20

for more than 3 doses

for under 13 YOA

if ED drugs taken

Nitroglycerin Side FX

Hypotension

Headache

Dizziness

Tachycardia

Scene Size-Up

• Is my scene safe?

• MOI/NOI to my understanding

• I am taking appropriate BSI precautions

• Is this my only patient?

• Consider additional resources (PD, Engine, ALS)

• I would consider C-Spine if trauma is suspected

Primary Assessment

• General Impression:

age, sex, position, level of distress, chief complaint 

• AVPU

• (Conscious) Airway- patent, Breathing- rate/ quality, Circulation- Skin & Pulse

• (Unconscious) Circulation- Carotid & Radial, Airway- Patent? Open, Breathing- Chest rise/fall

• Full body sweep for gross bleeds

• determine patient PRIORITY

Secondary Assessment

• Have partner get: BP, HR, O2, BGL, PEERL

• SAMPLE, OPQRST

• Focused exam

Con Medical: system involved, UnCon Medical: head to toe, Trauma: head to toe, Iso Trauma: focused