EMT-Basic Exam: The Basics of Medical Emergencies - General Pharmacology Lesson

The medical emergencies portion of the EMT-Basic exam tests your knowledge of basic pharmacology and quizzes you on the types of situations you’ll face during a medical emergency. This guide covers basic medication information and administration routes, as well as emergencies associated with various body systems, pre-existing conditions and allergies, altered mental status, poisons, and environmental factors.
About 15 percent of the questions on the NREMT cognitive exam are related to medical emergencies. 

A. General Pharmacology Lesson
This section of the EMT-Basic exam tests your ability to identify and administer various medications in the field. In this section, you’ll review the common medications found on EMS units. You’ll also review the various medications that EMT-Basics are permitted to administer, and the medications that EMT-Basics may assist in administering. This section also reviews the various forms of medications, the difference between generic and trade names, indication and contraindication, administration routes, and reassessment of the patient after medication has been administered.

1. Medications on an EMS Unit
EMT-Basics must often administer various medications to patients while working in the field. It’s vitally important that you understand what kind of medication a patient needs, how to administer that medication, and when the medication should be administered. EMS units carry a variety of medications for the treatment of patients, including oral glucose, activated charcoal, and oxygen.

2. Medications an EMT-Basic May Administer
There are two types of medications that EMT-Basics will frequently encounter in the field. The first are those medications that EMT-Basics most commonly carry on their unit. Medications such as oral glucose, activated charcoal, and oxygen are simple forms of treatment that EMT-Basics may administer at their own discretion or after receiving permission from the medical direction physician. EMT-Intermediates and EMT-Paramedics carry a much wider variety of medications for more advanced on-scene patient treatment.

3. Medications an EMT-Basic May Assist With
Typically, EMT-Basics will also encounter physician-prescribed medications that patients have in their possession. EMT-Basics can help patients take some medications when they have permission from the medical direction physician. The types of medications that EMT-Basics may assist patients with include nitroglycerin, prescribed inhalers, and epinephrine autoinjectors.

4. Forms of Medication
There are different forms of medication that EMT-Basics use to treat patients. The form of medication an EMT-Basic uses to treat a particular patient can vary based on the onset of action and the ease of administration. The medications that EMT-Basics administer may come in the form of liquids for injection, compressed powders or tablets, gels, fine powder for inhalation, vaporized liquids, sublingual sprays, gases, or suspensions.

5. Difference Between Generic and Trade Names
Most medications have two names: a generic name and a trade name. A medication’s generic name refers to the name of the medication as listed in the United States Pharmacopeia. In most cases, the generic name is a simplified form of the chemical name. A trade name is the name given to the medication by the company that sells it. These names are usually copyrighted and will include the copyright symbol. As an example, Nitrostat is one trade name for the medication known generically as nitroglycerin.

6. Indication and Contraindication
One of the most important steps in administering any medication is identifying indications and contraindications. Indications are signals that tell you when a medication should be administered. Patient symptoms and medical histories can be potential indications for a particular form of treatment. Contraindications are signals that indicate that a medication should not be administered. Under certain conditions, the administration of some medications may have little or no positive effect or may even worsen the patient’s condition. Understanding when not to administer a certain medication is an important part of the EMT’s job.

7. Administration Routes
An administration route refers to the way in which a medication is administered to a patient. There are four primary routes of administration of medications EMT-Basics assist in administering:
- Oral medications are swallowed and absorbed into the digestive system. These medications generally require more time to take effect because they must pass through the digestive tract before entering the bloodstream.

Tip: Oral medications should only be administered to alert patients.
- Sublingual medications are dissolved under a patient’s tongue. When the medication dissolves, it’s absorbed into the capillaries under the tongue. Because this method involves direct absorption into the bloodstream, the medication takes effect quickly.
- Inhaled medications generally include gases or fine mists. These medications are inhaled directly into the respiratory system, making the onset of action almost immediate.
- Intramuscular medications are delivered with an injection into a large muscle. From there, the medication is absorbed into the bloodstream.

8. Reassessment After Medication
Before administering medications, EMTs must take note of the patient’s condition prior to receiving any treatment. After any medication is administered, it’s important to reassess the patient’s condition, noting the time, dose, and route of administration, and any changes that occur in the patient’s condition as a result of treatment. You should also take note of any possible side effects of the medication.

Related Topics You Should Review:
- Medication actions
- Side effects