January 27, 2023

Welcome to continuing mobile education for emergency medical services providers this is bls medication administration nebulized albuterol after watching this video providers will understand the criteria and basic physiology for respiratory distress recognize the indications for administration of albuterol understand basic mechanisms of action for albuterol recognize

The cautions for administration of albuterol and understand how to administer albuterol via a nebulizer the criteria for respiratory distress or bronchospasm in the mel rhymes protocol includes an oxygen saturation less than ninety two percent cyanosis respiratory rate less than eight or greater than twice the normal for the patient’s age use of accessory muscles

For respiration and auscultation of adventitious breath sounds such as wheezing or strider or markedly decreased air movement it’s important to note the respiratory distress patients may present with any one or more of these symptoms but do not necessarily require all of the symptoms in order to meet this criteria the following animation gives a brief overview of

The physiology of asthma during breathing the air inhaled through the nose and mouth enters the respiratory passages then the air entering the respiratory system passes through the trachea then splits into the bronchi bronchioles and finally enters tiny sacs called alveoli where the exchange of gases takes place asthma is a disorder of obstruction to breathing due

To inflammation and narrowing of the bronchial tubes initially the bronchial tubes become inflamed and produce thick mucus later the muscle surrounding these airways tightens and air cannot move freely this is called bronchospasm the result is shortness of breath and the air moving through the tightened airways causes a whistling sound known as wheezing pollen

Pet dander weather changes tobacco smoke etc can trigger and worsen asthma symptoms in susceptible patients short-acting bronchodilator drugs which can be inhaled provide immediate dilation of the constricted bronchi one very important step in the assessment of any respiratory distress patient is to listen to lung sounds lung sounds should be listened to from the

Back whenever possible take note if the lung sounds are quieter or absent on one side listen for wheezes crackles and strider in asthma patients it’s common to hear wheezing especially during the expiratory phase a prolonged expert ori phase or severely diminished lung sounds listen now to the following example of wheezes in a patient with asthma under the mel

Rems protocol bls providers are permitted to assist patients with a metered dose inhaler if they have at present in the event that a patient does not realize any relief from their metered dose inhaler or does not have their own inhaler or nebulizer a bls provider may administer nebulized albuterol to patients between the age of 1 in 65 who have been diagnosed

With asthma and are prescribed the use of albuterol provided that the agency has been approved for albuterol use and the provider has been trained in albuterol administration so a funeral causes bronchodilation by its effects on the beta 2 receptors so by affecting the beta 2 receptors it causes bronchial smooth muscle vasodilation some of the side effects of

Albuterol are related to its effects on the beta 1 receptors in the heart so the side effects that can occur our most most often tachycardia a tachyarrhythmias or bronchospasm so if you have a patient that already has a baseline tachycardia you want to use albuterol with caution and potentially use a lower dose and someone that has tachyarrhythmia albuterol would

Be contraindicated to review albuterol causes bronchodilation and increased airflow it should be used with caution in patients with tachycardias and is contraindicated in patients with a tacky dysrhythmia such as rapid afib v-tach or an active svt additionally albuterol should not be used in patients who are experiencing respiratory failure such as those patients

With decreased level of consciousness or who require assisted ventilations also under the mel rems protocol bls providers must contact medical control prior to administering albuterol if the patient has a cardiac history in order to administer albuterol the provider first needs to assemble the nebulizer and add the appropriate dose of albuterol for adults this

Is five milligrams or two pre-measured tubes for children two point five milligrams or one pre-measured tube attached oxygen to the nebulizer and set the flow between six and ten liters per minute coach the patient to take deep breaths in through their mouth continue to monitor vitals and carefully watch the heart rate and blood pressure activate and meet als bls

May administer up to two total doses if ls is not available remember that if als is unseen they may not release to bls once albuterol administration has taken place watch now as our bls crew administers albuterol to an asthma patient in respiratory distress what the name sir my name is mikey like a hard time catching my breath ok enough of it let them do you have

Any medical problems have asthma asthma prescribed albuterol if you have your inhaler with you i wish all you’ve been taking it is bilateral wheezes brother you give them a nebulizer given the yellow these 20 medications no can get on their own puter all how much are you giving johnny 5 milligrams of opiate roll ok can hook this up for me and i want sixty eighty

Six to eight liters per minute ok ok that’s on six eight liters sister i want you to take this deep for us ok try to hold the medication in lacey for us it should start to help in a few minutes driving dispatch center hinge no als available okay we’re going to start transporting the hospital and you’re going very c z breaths let’s review the respiratory distress

Bronchospasm protocol one more time first assess the patient for signs and symptoms of respiratory distress if the patient meets the criteria listed in the protocol provide routine medical care including high flow oxygen next assess signs and symptoms and hemodynamic stability including vital signs the ability to speak in full sentences the presence of accessory

Muscle use and adventitious lung sounds such as wheezing or strider if the patient appears to have asthma and has their own inhaler or nebulizer you may assist the patient in using the device next if required determine if the patient is eligible for albuterol if the patient meets the criteria in the protocol you may administer the appropriate dose of albuterol

For the patient’s age remember medical control should be contacted first if the patient has a cardiac history such as congestive heart failure angina arrhythmias or previous heart attack lastly timely transport with als als is available remember that als cannot released a bls for transport after albuterol has been administered in summary now that you’ve watched

This video you should understand the criteria and basic physiology for respiratory distress you should recognize the indications for administration of albuterol and understand basic mechanism of action for albuterol you should also recognize the cautions for administration of albuterol and understand how to administer albuterol using a nebulizer you

Transcribed from video
BLS Medication Administration – Albuterol By Rochester Ems