1 / 68

Objectives

Objectives. Overview of General Pharmacology Develop a Basic Knowledge of medications used by BLS Providers Identify situations when each medication may be indicated. General Pharmacology. For every medication you may administer, you must thoroughly understand the following:. Actions

tana-rutledge
Download Presentation

Objectives

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Objectives • Overview of General Pharmacology • Develop a Basic Knowledge of medications used by BLS Providers • Identify situations when each medication may be indicated

  2. General Pharmacology • For every medication you may administer, you must thoroughly understand the following: • Actions • Indications • Contraindications • Dosage • Route • Side effects

  3. General Pharmacology • Right Time • Right Patient • Right Drug • Right Dose • Right Route

  4. Generic name Original chemical name Trade name Brand name given by manufacturer General Pharmacology

  5. General Pharmacology Dosage Forms • Solutions • Liquid mixture of one or more substances • Nebulized Solution • Pressurized gas passed over a solution to create an aerosol mist, which is then inhaled

  6. Anaphylaxis Epinephrine for BLS Providers

  7. An exaggerated immune response to an allergen Sudden, rapid onset Systemic involvement Severe allergic reaction Anaphylaxis

  8. Common Causes of Allergic Reactions

  9. Very Common Range from mild and local to severe and systemic. Mild reactions usually affect only one area of the body Slow onset, and minor symptoms Allergic Reactions

  10. Mild Allergic Reactions A mild, local reaction caused by a bee sting

  11. A Clear History of Allergen Exposure AND Signs and Symptoms including: Shock (hypoperfusion) Respiratory Distress Wheezing, stridor, cough Chest / throat tightness Severe Allergic Reaction

  12. Severe Allergic Reaction • Itching, skin flushing • Hives and/or swelling • (esp. face, extremities)

  13. Severe Allergic Reaction • Increased Pulse • Decreased Blood Pressure • Nausea & Vomiting • Altered Mental Status • Allergen exposure with history of anaphylaxis

  14. Patient History • Determine if the patient’s history includes: • Anaphylaxis • Severe allergic reactions • Recent exposure to a known or potential allergen

  15. Focused Physical Assessment • Assess ABCs • Breath Sounds • Vital Signs • O2 Saturation • Assess Respiratory System • Assess Cardiovascular System • Assess for Signs & Symptoms of Anaphylaxis

  16. Epinephrine • Generic Name • Epinephrine • Trade Name • EpiPen • EpiPen Jr. • Also called • Adrenalin

  17. EpinephrineActions • Dilates Bronchioles • Constricts Blood Vessels

  18. EpinephrineIndications • Signs and Symptoms of Severe Allergic Reaction

  19. EpinephrineContraindications • None BUT MUST FOLLOW NYS PROTOCOLS!

  20. EpinephrineDosage • Adult • One Adult Auto-injector (0.3 mg) • Infant and Child (< 9 y/o or < 30 kg / 66 lbs.) • One Infant/Child Auto-injector (0.15 mg)

  21. EpinephrineRoute • Deep Intramuscular Injection • Lateral thigh, midway between waist and knee

  22. Increased pulse rate Pallor Dizziness Chest Pain EpinephrineSide Effects • Headache • Nausea • Vomiting • Excitability • Anxiety

  23. Epi auto-injectorProtocol • Call ALS • Administer Oxygen • Assess Respiratory Status • Assess Cardiac Status

  24. Epi auto-injectorProtocol If the patient has an epi auto-injector prescribed: • assist the patient in administering the auto-injector

  25. Epi auto-injectorProtocol • If the patient’s epi auto-injector is not available or expired: • Administer the agency’s epi auto-injector Per Protocol

  26. Epi auto-injectorProtocol If no epi auto-injector has been prescribed: • Begin transport • Contact medical control for authorization to administer the agency’s epi auto-injector

  27. Epi auto-injectorProtocol If unable to contact Medical Control, and patient isless than 35 years of age: • Administer agency supplied epi auto-injector per protocol • Contact Medical Control ASAP

  28. What IsMedical Control? • A REMO Physician • If no REMO Physician is available, contact ED Physician at the Destination Hospital • Document WHO you talked to

  29. Epi auto-injectorProtocol • Medical Control MUST be contacted to administer a second auto-injector. • Be prepared to perform CPR if patient deteriorates. • Document history, vitals, and treatment on PCR.

  30. Summary: ALS must be called Contact Medical Control If Medical Control unavailable and patient is <35 years old, administer epi auto-injector Epi auto-injectorProtocol

  31. Epi auto-injector Administration • Remove safety cap from auto-injector • Hold auto-injector from center (DoNot place thumb over either end!) • Place against patient’s thigh • Lateral portion, midway between waist and knee

  32. Epi auto-injector Administration • Push until auto-injector activates • Hold until medication injected (10 seconds). • Record Time • Record Response • Dispose of auto-injector in biohazard “sharps” container.

  33. Reassessment Strategy • Monitor A-B-Cs • Reassess Vitals • Oxygen! • Watch for changes in Patient Condition

  34. If the patient deteriorates... Oxygenate Contact Medical Control for order for second dose Prepare for resuscitation Oxygenate Treat for shock ReassessmentStrategy Oxygenate Did we mention Oxygenate?

  35. Asthma Albuterol for BLS Providers

  36. Asthma • A common but serious disease • Affects more than 10 million Americans. • Kills 4000 to 5000 Americans annually.

  37. Asthma • Reversible smooth muscle spasm of the airway (bronchospasm) associated with hypersensitivity to various stimuli

  38. Allergy Aspiration Exertion Infection Stress Temperature change Seasonal changes Bronchospasm Triggers

  39. Signs and Symptoms Dyspnea Wheezing Tachypnea Tachycardia Cyanosis Cough Asthma

  40. Signs and Symptoms (cont.) Accessory muscle use Inability to speak in complete sentences Anxiety (hypoxia) Prolonged expiratory phase Tripod positioning Asthma

  41. O P Q R S T Patient History • S • A • M • P • L • E

  42. Patient History • Confirm Asthma History • “All That Wheezes Is Not Asthma” • Hospital visits for asthma in past year? • Any previous intubations due to asthma?

  43. Position found Pursed lip breathing Vital signs Ability to speak in complete sentences Accessory muscle use Physical Exam

  44. Physical Exam • Lung Sounds • Wheezing may or may not be present • Wheezes may be audible with or without a stethoscope • Decreased breath sounds (poor air movement) • Patient’s self-assessment • (0-10 scale)

  45. Generic Name Albuterol Trade Names Proventil Ventolin Albuterol

  46. AlbuterolActions • Bronchodilation • Duration of effect is up to five hours.

  47. History of Asthma Respiratory Distress AlbuterolIndications

  48. Known hypersensitivity to albuterol Respiratory Failure AlbuterolContraindications

  49. AlbuterolDosage • Single-dose solution of 2.5 mg in 3 ml of normal saline for use in small volume nebulizer

  50. AlbuterolRoute By Mouthpiece Nebulized Medication By Mask

More Related