Medications EMTs Can Administer
The EMT scope of practice includes a limited number of medications. While the specific medications may vary by state protocol, the NREMT tests the following core medications: aspirin, oral glucose, epinephrine auto-injector, and naloxone. EMTs may also assist patients with their own prescribed medications such as metered-dose inhalers and nitroglycerin, with medical direction authorization.
Aspirin
Aspirin (acetylsalicylic acid) is administered for suspected acute coronary syndrome (ACS). The standard dose is 324 mg (four baby aspirin) chewed for rapid absorption. Contraindications include known aspirin allergy, active GI bleeding, and recent aspirin use. Ask the patient about allergies before administering. Aspirin inhibits platelet aggregation, which can limit the growth of a coronary artery clot. The NREMT expects you to administer aspirin early in any suspected cardiac event.
Oral Glucose
Oral glucose is administered for suspected hypoglycemia in patients who are conscious and able to swallow. One tube of glucose gel (approximately 15 grams) is placed between the cheek and gum. The patient must be able to protect their own airway. Never administer oral glucose to an unresponsive patient or a patient who cannot swallow. Reassess blood glucose and mental status after administration. Repeat administration may be needed.
Epinephrine Auto-Injector
The epinephrine auto-injector (EpiPen) is used for severe allergic reactions (anaphylaxis). Administer into the lateral (outer) thigh, through clothing if necessary. Hold in place for 10 seconds. The adult dose is 0.3 mg; the pediatric dose is 0.15 mg. Epinephrine reverses bronchospasm, improves blood pressure, and reduces swelling. A second dose may be administered if symptoms do not improve or recur. Monitor the patient closely after administration.
Naloxone (Narcan)
Naloxone is an opioid antagonist used for suspected opioid overdose. It can be administered intranasally (IN) or intramuscularly (IM) depending on the form available. Signs of opioid overdose include unresponsiveness, pinpoint pupils, and respiratory depression or arrest. Administer naloxone, provide ventilatory support, and monitor for return of respiratory depression as naloxone may wear off before the opioid does. Be prepared for the patient to become combative upon waking.