Respiratory Medications

Exam Focus Areas

On the Nremt Paramedic exam(s), questions about respiratory medications typically test:

1. Correct medication selection, dosing, and route of administration
2. Appropriate transport decisions and hospital notification criteria
3. Assessment findings that differentiate between similar presentations
4. Recognition of signs and symptoms requiring immediate intervention

Overview

Albuterol, ipratropium, magnesium sulfate, epinephrine for bronchospasm. Respiratory medication indications tested on Paramedic exam.

In prehospital assessment, ETCO2 reference range: adult 35-45 mmHg, pediatric 35-45 mmHg. Deviations from these norms guide treatment decisions in the field.

Documentation

Documentation of respiratory medications in the patient care report (PCR) must include: time of assessment, findings, interventions performed, patient response, and reassessment findings. Use objective, measurable terms like "patient reports 8/10 chest pain" rather than "patient in pain." Document pertinent negatives. All medications administered must include drug name, dose, route, time, and patient response.

Clinical Significance

In prehospital care, understanding respiratory medications can mean the difference between a positive patient outcome and a critical miss. A 65-year-old male presents with crushing substernal chest pain radiating to the left arm, diaphoresis, and nausea. 12-lead shows ST elevation in leads II, III, aVF (inferior MI).

Related pharmacology: naloxone at 0.4-2mg IV/IM/IN, titrate to respirations, indicated for Opioid overdose.

Safety Considerations

Field safety for respiratory medications includes scene assessment before patient contact. Ensure BSI (body substance isolation) precautions are in place. PPE selection depends on the mechanism and suspected pathogens. Gloves are the minimum; add mask and eye protection for splash risk, N95 for airborne pathogens.

Never approach a scene involving hazardous materials, violence, or structural instability without proper resources and clearance from incident command.