Prehospital Academy Lesson 12.3
EMT Medications
Introduction
As an EMT, you are responsible for the safe and effective administration of a select group of medications. This lecture will cover the common medications within the EMT scope of practice. It's crucial to remember that your local protocols and medical director ultimately define which medications you can administer. Always follow your local guidelines.
The Six Rights of Medication Administration
Before administering any medication, you must follow the "Six Rights" to ensure patient safety:
Right Patient: Confirm you are treating the correct person.
Right Medication: Verify the medication is the one you intend to give.
Right Dose: Ensure the dosage is correct for the patient and their condition.
Right Route: Administer the medication via the correct route (e.g., oral, sublingual, intramuscular).
Right Time: Administer the medication at the appropriate time.
Right Documentation: Document the medication administration accurately and thoroughly.
Common EMT Medications
Oral Medications
These medications are swallowed and absorbed through the digestive system.
Oral Glucose: A sugar used to treat hypoglycemia (low blood sugar). The patient must be conscious and able to protect their own airway.
Aspirin: Used for patients with chest pain of a suspected cardiac origin. It works by preventing platelets from clumping together, which can help prevent a clot from getting larger.
Sublingual Medications
These medications are placed under the tongue for rapid absorption into the bloodstream.
Nitroglycerin: Used to treat chest pain (angina). It relaxes blood vessels, which increases blood flow to the heart. It can be given as a tablet or a spray. Check the patient's blood pressure before administration, as it can cause a significant drop.
Intramuscular Medications
These medications are injected into a muscle.
Epinephrine (Adrenaline): Used to treat severe allergic reactions (anaphylaxis). It's a sympathomimetic drug that helps to constrict blood vessels and open up the airways. It is often administered via an auto-injector (like an EpiPen).
Naloxone (Narcan): Used to reverse the effects of an opioid overdose. It is an opioid receptor antagonist. It can be given intramuscularly or intranasally. The goal of administration is to restore adequate breathing, not to fully wake the patient.
Inhaled Medications
These medications are breathed in and absorbed through the lungs.
Oxygen: A fundamental medication in EMS for treating hypoxia. It is administered via various devices, such as a non-rebreather mask or nasal cannula.
Metered-Dose Inhaler (MDI) and Nebulizers: Used to administer medications like Albuterol for patients with respiratory distress from conditions like asthma or COPD. These medications help to relax the muscles around the airways, making it easier to breathe.
Medication Errors
Medication errors can have serious consequences. To prevent them, always follow the Six Rights, work in a well-lit environment, and double-check medications with your partner. If an error does occur, your priority is the patient's well-being. Immediately notify medical control, follow your agency's protocols, and document the error honestly and thoroughly.
Critical Thinking Questions
Why is it important for an EMT to check a patient's blood pressure before and after administering nitroglycerin?
What are the key differences in the administration and goals of treatment when using epinephrine for anaphylaxis versus naloxone for an opioid overdose?
Explain the importance of each of the "Six Rights" of medication administration.
Describe a situation where you would administer oral glucose. What are the essential patient assessment findings required before administration?
What are the potential complications of administering too much naloxone to a patient with an opioid overdose, and how can this be avoided?