Prehospital Academy Lesson 12.4
AEMT Medications
Introduction
As an Advanced EMT (AEMT), your scope of practice expands to include the administration of several medications beyond the EMT level. This lecture provides an overview of common AEMT medications. Remember that your ability to administer these medications is governed by your state's regulations and your local medical director's protocols. Always adhere to your local guidelines.
Key AEMT Medications
Epinephrine 1:1,000
Indication: Anaphylaxis.
Contraindications: Known cardiovascular disease (relative).
Side Effects: Tachycardia, hypertension, anxiety, cardiac dysrhythmias, tremors, and dyspnea.
Dosing: 0.3 to 0.5 mg administered subcutaneously or intramuscularly.
Naloxone (Narcan)
Indication: Opiate toxicity with respiratory insufficiency.
Contraindications: Hypersensitivity. Use with caution in narcotic-dependent patients.
Side Effects: Withdrawal symptoms, dysrhythmias, nausea/vomiting, hypertension, tachycardia, seizures, blurred vision.
Dosing: 0.4 to 2 mg, titrated to restore respirations. The goal is not to fully reverse the opioid's effects but to ensure adequate breathing.
Albuterol
Indication: Bronchoconstriction (e.g., in asthma or COPD).
Contraindications: Hypersensitivity. Use with caution in patients with cardiac dysrhythmias.
Side Effects: Tremors, tachycardia, hypertension, anxiety, nausea, headache, palpitations, cough, dizziness.
Dosing: 2.5 mg diluted in 3 mL of normal saline, administered via nebulizer.
Normal Saline and Lactated Ringers
Indication: Hypovolemia (fluid resuscitation).
Contraindications: Fluid overload, pulmonary edema.
Side Effects: Hypertension, pulmonary edema.
Dosing: 20 mL/kg bolus for fluid resuscitation.
Dextrose (50% and 10%)
Indication: Hypoglycemia.
Contraindications: Hyperglycemia.
Side Effects: Hyperglycemia, thrombophlebitis.
Dosing: 12.5 to 25 g slow IV push.
Glucagon
Indication: Hypoglycemia when IV access is not available.
Contraindications: Hypersensitivity.
Side Effects: Tachycardia, hypotension, nausea/vomiting, and urticaria.
Dosing: 1 mg intramuscularly.
Nitrous Oxide
Indication: Pain management.
Contraindications: Altered level of consciousness, hypotension, chest trauma (especially with pneumothorax), COPD, abdominal pain/injury, head injury, bowel obstruction.
Side Effects: Altered level of consciousness, apnea, dizziness, nausea/vomiting, malignant hypertension (rare).
Dosing: Self-administered by the patient until effects are felt.
Critical Thinking Questions
What are the key differences in the routes of administration for the medications an AEMT can give compared to an EMT, and why is this significant?
Explain the importance of titrating Naloxone to the patient's respiratory effort rather than their level of consciousness.
Why is it crucial to use caution when administering fluids to a patient with a history of heart failure or pulmonary edema?
Describe the difference between Dextrose and Glucagon in the treatment of hypoglycemia, including when each is indicated.
What are the primary safety considerations when allowing a patient to self-administer Nitrous Oxide for pain?