Medication Reference
Quick EMS medication reference. Always follow your local protocols and medical control.
Nitroglycerin
Cardiac / Pulmonary EdemaIndications
- Chest pain suspected cardiac origin
- Acute pulmonary edema with hypertension
- CHF with respiratory distress
Contraindications / Cautions
- Hypotension
- Recent erectile dysfunction medication use
- Right-sided/inferior MI concern
- Severe bradycardia or tachycardia with instability
Dose
Follow local protocol. Common EMS use: SL nitro 0.4 mg, repeat as allowed with BP monitoring.
Field Pearls
- Check blood pressure before each dose.
- CPAP and nitro work well together in severe pulmonary edema.
- Monitor for sudden hypotension.
Albuterol
RespiratoryIndications
- Bronchospasm
- Asthma
- COPD exacerbation
- Wheezing with respiratory distress
Contraindications / Cautions
- Known hypersensitivity
- Use caution with significant tachycardia
Dose
Follow local protocol. Common neb dose: 2.5 mg by nebulizer.
Field Pearls
- Wheezing is not the same as pulmonary edema.
- Assess lung sounds before and after treatment.
- Can increase heart rate.
Epinephrine
Anaphylaxis / Cardiac ArrestIndications
- Anaphylaxis
- Cardiac arrest
- Severe asthma per protocol
Contraindications / Cautions
- No absolute contraindication in life-threatening anaphylaxis
- Use caution in cardiac patients when not in arrest
Dose
Follow local protocol. Dose depends on indication and concentration.
Field Pearls
- Confirm concentration before administration.
- IM epi is first-line for anaphylaxis.
- Do not delay epi in true anaphylaxis.