Microsoft word - nys bls albuterol protocol 19-nov-03.doc

H u d s o n V a l l e y R e g i o n a l E m e r g e n c y M e d i c a l A d v i s o r y C o m m i t t e e M e m o r a n d u m
To: All Regional BLS Nebulized Albuterol EMS Agencies
From: Regional Medical Advisory Committee (REMAC)
Subject: BLS Nebulized Albuterol Protocol
Date: November 23, 2003
As a result of the New York State Department of Health’s inclusion of the Special Considerations Protocol
for Nebulized Albuterol (SC-4) into the 2003 Statewide Basic Life Support Adult and Pediatric Treatment
Protocols, the Hudson Valley Regional Emergency Medical Advisory Committee (REMAC) has elected to
replace the current Regional Protocol entitled “EMT-Basic Nebulized Albuterol Treatment Protocol” with
the State’s version. Therefore, effective immediately please inform all of your personnel of the protocol
substitution. It should be noted that the current Regional and new State protocols for BLS Nebulized
Albuterol are very similar with the following exceptions:
On the new State Protocol for Nebulized Albuterol:
1. Prior to step one, there is a reminder to request Advanced Life Support and not delay 2. Step one is a prompt for the EMT to perform an initial assessment; 3. The EMT is prompted to administer high concentration oxygen after assessing the patient’s 4. The EMT is prompted to not allow physical activity or exertion after placing the patient in the 5. Transportation initiation is listed prior to the reminder to contact Medical Control for authorization to administer Albuterol to patients with a history of Angina, Myocardial Infarction, Arrhythmia or Congestive Heart Failure; 6. The medication dosage is listed as Albuterol 0.83%, one (1) unit dose in a nebulizer at a flow 7. The EMT is prompted to perform an ongoing assessment and record the patient’s vital signs 8. The EMT is prompted to record all patient care information, including the patient’s medical history and all treatment provided on a Pre-hospital Care Report (PCR). As a reminder, the New York State EMT-B Basic Life Support Protocol (SC-4) entitled “Nebulized Albuterol” is only to be used by EMS agencies who have received written authorization from the Hudson Valley Regional Medical Advisory to participate in the Regional BLS Nebulized Albuterol Program. If you have any questions in this regard, please contact the Regional Office at 845-567-6740. Issued and Authorized by: Craig van Roekens, M.D. REMAC Chairperson SERVING DUTCHESS, ORANGE, PUTNAM, ROCKLAND, SULLIVAN, AND ULSTER COUNTIES Nebulized Albuterol
This protocol is for patients between one and sixty-five years of age, who
are experiencing an exacerbation of their previously diagnosed asthma.
Request Advanced Life Support if available.
Do not delay transport to the appropriate hospital.
II. Assure that the patient’s airway is open and that the breathing and circulation are adequate.
If patient exhibits signs of imminent respiratory failure,
refer to the Adult or Pediatric Respiratory Arrest Protocol.
III. Administer high concentration oxygen.
IV. Place the patient in the Fowler’s or Semi Fowler’s position.
V. Do not allow physical activity or exertion.
VI. Assess vital signs, ability to speak in complete sentences, accessory muscle use, wheezing, patient’s assessment of breathing difficulties and through the use of a peak flow meter, BorgScale, or other method.
For patients with a history of Angina, Myocardial
Infarction, Arrhythmia or Congestive Heart Failure,
medical control MUST be contacted prior to administration
of Albuterol!
NYS EMT-B Basic Life Support Protocols
SC – 4 Page 1
Nebulized Albuterol, continued
VIII. Administer Abluterol Sulfate 0.83%, one (1) unit dose in a nebulizer at a flow rate of 4 – 6 LPM. DO NOT delay transport to complete medication!
IX. Re-assess vital signs, ability to speak in complete sentences, accessory muscle use, wheezing, patient’s assessment of breathing difficulties and through the use of a peak flow meter, BorgScale, or other method.
X. If patient’s symptoms persist, a second administration of nebulized Albuterol may be administered. A maximum of two (2) total doses may be given.
XI. Ongoing assessment. Obtain and record the patient’s vital signs enroute as often as the XII. Record all patient care information, including the patient’s medical history and all treatment provided on a Prehospital Care Report (PCR).
NYS EMT-B Basic Life Support Protocols
SC – 4 Page 2

Source: http://wordpress.hvremsco.org/wp-content/uploads/2013/05/NYS-BLS-Albuterol-Protocol-letter-19-Nov-03.pdf