February 8, 2023

Hello and welcome to inhaled bronchodilators this is the fourth section of chapter 11 which is emergency medications as always this is keith wood meijer with wayne county ems c we’re gonna start off talking about the prescribed metered dose inhaler metered dose inhaler is used to deliver inhaled wrestler medications patient who has a prescribed metered dose

Inhaler is reversible country constriction of is airway an mdi which is metered dose inhaler is small and consists of two parts the medication canister and plastic dispenser with a mouthpiece because some patients find it hard to coordinate breathing in a in and pressing the inhaler at the same time a physician will often prescribe a spacer squeeze with the mdi the

Spacer increases the amount of medication delivered into the respiratory tract patient squeezes the mdi into the plastic holding chamber and then inhales the medication from the chamber the use of spacers is very common in children and older adults medications contained in an mdi are usually beta-2 agonists this means that the drug stimulates the beta 2 receptor

Sites and lungs when these receptor sites are stimulated and in the bronchioles the smooth muscle tissues relax and look violating producing airway resistance this makes it easier for the patient to move air in the mouth this term is known as bronchial dilation excuse me an emt can assist a patient in taking a prescribed inhaler if all of the following criteria

Are met patient has signs and symptoms of respiratory emergency patients physician prescribed handheld inhaler no contraindications to giving the medication and specific authorization by a medical direction some places in kentucky actually utilize what’s known as nebulized albuterol and which means that they have the ability to administer it without the patient

Being prescribed that medication we’ll go over that a little more in class assisting a patient within the use of an mdi is contra mutated in e as following conditions the patient if the patient is unable to use the device the inhaler is not prescribed to the patient permissions not received from the medical direction where the patient has already met the maximum

Prescribed doses prior to your arrival and that will vary system by system adverse effects of inhaled bronchodilators include increased heart rate shaking or tremors restlessness nervousness nausea headache and dizziness an mdi automatically delivers a specific dose of medication each time it’s activated the usual dosage is two puffs every three to four hours as

Needed for shortness of breath associated with asthma or chronic obstructive pulmonary disease copd the number of inhalations is based on medical directions orders on or the patient’s physicians orders and the consideration of utilizing nebulized albuterol like so many nuances do in kentucky the dosage is 2.5 milligrams of albuterol in two point five milligrams

Of sailing from sterile water excuse me special considerations include using the appropriate ppe practicing the six rights of medication administration assisting the patient in finding his mdi is not readily available assess the patient’s lungs before administration of an mdi to establish baseline assess lung sounds after administration of the mdi and compare your

Findings wait at least three minutes before assisting with another dose from the mdi and recess vital signs and patients degree of breathing difficulty all right start out with step 1 contact medical direction for in order to assist with giving this medication make sure that you have the right medication right patient right administration and the patient is alert

Enough to use this medication check the expiration date of the inhaler check to see when the last dose was taken but a patient make sure the inhaler is at room temperature or warmer shake the inhaler vigorously in several times if the patient is wearing an oxygen mask remove it now step 2 have the patient exhale deeply and then have them put his lips around the

Mouthpiece of the inhaler step 3 if the patient has a space of device for you with the inhaler and it should be used if spacer is used to have patient press the inhaler to inject the dose into the chamber of the space this is done before placing the mouth around of the spacer i’m sorry this is done before placing the mouthpiece of the spacer in the mouth step 4

Have the patient depress the mdi and as he begins to inhale deeply help the patient direct the spray into his mouth as he attempts to take a breath instruct the patient to hold his breath as long as you comfortably can this helps with medication absorption the five the patient is using a spacer have them to press the inhaler breathe in and hold his breath breathe

Out and then take another deep breath through the mouthpiece of the spacer head and hold his breath patient who is using the spacer should try to take two deep breaths from the spacer and hold them for each puff of from his inhaler step six replace the previously removed oxygen mask recheck the patient’s lung sounds metal signs and degree of breathing difficulty

Repeat the dose after one to three minutes per instruction for medical direction when finished with the inhaler wipe off the mouthpiece mouthpiece with an alcohol swab and replace the cap after using an mdi have the patient rinses map that with water this will decrease the possibility of adverse effects from the medication

Transcribed from video
Albuterol By WCEMSTraining