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What are the five steps for preparing to administer medications?
- Complete a primary assessment - administer high-flow O2
- Verbalize the criteria for assisting patients with medications
- Verbalize the indications
- Verbalize the contraindications
What three things should be part of the primary assessment when preparing to administer an MDI?
- administer high-flow O2
- assess rate, rhythm, and quality of breathing
- auscultate breath sounds
What are the four criteria for assisting patients with medication?
- prescribed by a doctor
- prescribed for the patient
- meets indication
- no contraindications
What are the four indications for assisting a patient with an MDI?
- shortness of breath
- difficulty speaking
What are the two contraindications for assisting a patient with an MDI?
- patient has taken the maximum dose
- patient is unable to follow instructions
What are the key steps for assisting a patient with an MDI?
- Treat with high-flow O2 before and after administration of the MDI
- DICE the medication
- Remove the mouthpiece cover and shake inhaler vigorously
- Instruct the patient to breath out normally
- Position the inhaler
- Instruct patient to take a slow, deep breath on command
- Depress inhaler and instruct patient to continue inhaling
- Instruct patient to hold breath as long as comfortable up to 10 seconds and breath out slowing through pursed lips
- Reassess after three minutes
Are EMTs allowed to assist with all inhalers?
No. Only brochodilaters.
What does DICE mean?
- Expiration date
How long does it take for an brochodilator to take effect? How long does it last?
What is involved with reassessment of a patient after administration of an MDI?
- Rate, rhythm, and quality of breathing
- Auscultate breath sounds
- Check pulse
What is the maximum amount of time a patient should be reassessed after administration of an MDI?
What are the indications for assisting a patient with an epinephrine auto-injector?
Severe anaphylaxis with symptoms of either shock and/or respiratory distress
What are the contraindications for administration of epinephrine?
Patient does not meet indication or criteria for administration. There are no absolute contraindications.
What are the key steps for assisting a patient with an an epinephrine auto-injector?
- DICE the medication
- Remove clothing from the injection site - upper outer thigh
- Swab injection site with alcohol
- Remove cap and push pen into injection site
- Hold in place for 10 seconds
- Remove pen and place in biohazard
- Massage injection site with alcohol swab for 10 seconds
How long does epinephrine take to start working and how long does it last?
- 5-10 minutes
- up to 20 minutes
What is an additional step that must be taken before administering nitroglycerin?
secondary assessment being sure to take a BP
At what BP do you not administer nitroglycerin?
What are the two indications for assisting a patient with nitroglycerin?
- Chest pain/discomfort
- Systolic BP >100
What are the five contraindications for administration of nitroglycerin?
- Patient does not meet the indications
- Patient has already taken three doses
- Last dose was < 5 minutes ago
- Systolic BP < 100
- ED drugs withing 48-72 hours
Do you shake the container before administering nitroglycerin?
Where should nitroglycerin be placed in the mouth?
What are the key steps in administering nitroglycerin?
- DICE the drug
- Be sure to wear gloves
- Place tablet under tongue and allow to dissolve - do not swallow until 10 seconds after it dissolves
- Deliver one spray under tongue if it's a spray
How long after administration of nitroglycerin should another BP be taken?
What should the patient not do with the spray form of nitroglycerin?
Where should glucose paste be administered?
between cheek and gum