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Medication Reference

Quick EMS medication reference. Always follow your local protocols and medical control.

Nitroglycerin

Cardiac / Pulmonary Edema

Indications

  • 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

Respiratory

Indications

  • 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 Arrest

Indications

  • 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.