Medications

EMT (BLS) Medications - Nationally Recognized Summary of EMT Medication Authority

Overview of Medications Administered and Assisted by EMTs

  • Administer (carry on the ambulance):
      - Oxygen
      - Aspirin
      - Oral Glucose
      - Naloxone
      - Epinephrine (for anaphylaxis)
      - Activated Charcoal
      - Albuterol (in many states)

  • Assist with patient's prescribed medications:
      - Nitroglycerin
      - Albuterol MDI (Metered Dose Inhaler)
      - Epinephrine auto-injector

1. Oxygen

  • Class: Medical gas

  • Action: Increases oxygen concentration in the blood to improve tissue oxygenation.

Indications:

  • Hypoxia or suspected hypoxia.

  • Respiratory distress.

  • Shock.

  • Trauma.

  • Cardiac arrest.

  • Altered mental status (confusion, unconsciousness).

Contraindications:

  • None in a life-threatening emergency.

Dosage:

  • Nasal cannula: 2−6ml∣min⁡2-6ml\vert\min

  • Non-rebreather mask: 10−15ml∣min⁡10-15ml\vert\min

  • BVM (Bag-Valve-Mask) with reservoir: 15ml∣min⁡15ml\vert\min

2. Aspirin (ASA)

  • Class: Antiplatelet, Nonsteroidal Anti-Inflammatory Drug (NSAID).

  • Action: Inhibits platelet aggregation, reduces clot formation.

Indications:

  • Suspected acute coronary syndrome (ACS) / cardiac chest pain.

Contraindications:

  • Allergy to aspirin.

  • Active bleeding, known bleeding disorders (e.g., hemophilia).

Dosage:

  • 160−325mg160-325mg , chewable, oral.

3. Nitroglycerin (Assist Only)

  • Class: Vasodilator.

  • Action: Dilates coronary arteries, reduces cardiac workload.

Indications:

  • Chest pain of cardiac origin (ACS).

  • Must be prescribed to the patient.

Contraindications:

  • Systolic blood pressure (BP) < 90mm⁡Hg90\operatorname{mm}Hg .

  • Erectile dysfunction medications within the last 24-48 hours.

  • Head injury or suspected stroke.

Dosage (assist only):

  • 0.4mgSL0.4mgSL sublingually (SL).

  • May repeat every 5 minutes, maximum of 3 doses, with medical direction.

4. Albuterol (MDI or Nebulizer)

  • Class: Beta-2 bronchodilator.

  • Action: Relaxes bronchial smooth muscle, improves airflow.

Indications:

  • Asthma.

  • COPD (Chronic Obstructive Pulmonary Disease) with wheezing.

  • Bronchospasm.

Contraindications:

  • Known hypersensitivity to Albuterol.

  • Severe tachycardia (relative contraindication).

Dosage:

  • MDI: 1-2 puffs (assist patient).

  • Nebulized: 2.5mg2.5mg in 3ml3ml Normal Saline (NS).

5. Epinephrine (Anaphylaxis - assisting)

  • Class: Sympathomimetic.

  • Action: Bronchodilation, vasoconstriction, reduces airway edema.

Indications:

  • Severe allergic reaction (anaphylaxis).

Contraindications:

  • None in cases of anaphylaxis.

Dosage:

  • Adult: 0.3extmg0.3 ext{ mg} IM (Intramuscular) at a concentration of 1:1,000.

  • Pediatric: 0.15extmg0.15 ext{ mg} IM or 0.01extmg/kg0.01 ext{ mg/kg}.

6. Naloxone (Narcan)

  • Class: Opioid antagonist.

  • Action: Reverses opioid-induced respiratory depression.

Indications:

  • Suspected opioid overdose.

  • Respiratory depression due to opioid use.

Contraindications:

  • Heart rate (HR) < 40 beats per minute.

7. Oral Glucose

  • Class: Simple carbohydrate.

  • Action: Raises blood glucose levels.

Indications:

  • Hypoglycemia with altered mental status.

  • Patient must be conscious and able to swallow.

Contraindications:

  • Unconscious patient.

  • Patient unable to swallow.

Dosage:

  • 15−30extg15-30 ext{ g}, oral or buccal.

8. Activated Charcoal (If Authorized)

  • Class: Adsorbent antidote.

  • Action: Binds toxins in the gastrointestinal (GI) tract to prevent absorption.

Indications:

  • Certain oral poisonings within 1 hour of ingestion.

Contraindications:

  • Decreased level of consciousness (LOC).

  • Ingestion of acids, alkalis, or hydrocarbons.

Dosage:

  • 0.5−1extg/kg0.5-1 ext{ g/kg} (maximum of approximately 50extg50 ext{ g}).