NREMT EMT 4: Patient Treatment and Transport - Pharmacology Basics, Drug Calculations, Medication Safety, Rights of Medication Administration

Pharmacology Basics: Drug Calculations, Medication Safety, and "Rights" of Medication Administration

Pharmacology is the study of how medications work and how to use them safely. In an emergency, medications can save lives, but they can also cause harm if not used correctly. Think of medication administration like cooking a recipe: you need the right ingredients (medications), the right amounts, and the right instructions to get the desired result.

Key Steps / Core Facts

• Medication Administration Rights (MR): A checklist to ensure safe medication administration: Read the label, Identify the patient, Check the medication, Have the patient sign for it, and Explain the medication. (MR)
• Dosage Calculation: To calculate medication doses, use the ratio of the medication to the patient's weight (e.g., 1 mg/kg). (e.g., 10 mg for a 10 kg patient)
• Conversion Factors: To convert between units (e.g., milligrams to grams), use conversion factors (e.g., 1 g = 1000 mg). (e.g., 10 mg = 0.01 g)
• Medication Safety: Always check the patient's medical history for allergies and interactions with other medications. (e.g., penicillin allergy)
• Medication Expiration: Check the expiration date on medication labels to ensure they are still safe to use. (e.g., "Use by" date)
• Medication Storage: Store medications in a cool, dry place, away from children and pets. (e.g., locked cabinet)
• Medication Labeling: Always read the medication label carefully, including the name, dose, and instructions. (e.g., "Take 1 tablet by mouth")
• Medication Administration Routes: Medications can be administered through different routes (e.g., oral, IV, IM). (e.g., "Take 1 tablet orally")
• Common Medication Doses: Familiarize yourself with common medication doses (e.g., acetaminophen 325 mg).
• Red Flags: Be aware of red flags (danger signs) that indicate a medication is not safe to use (e.g., patient's medical history, allergies).
• Conversion Factors for Common Medications: Familiarize yourself with common conversion factors for medications (e.g., 1 mg of fentanyl = 100 mcg).

What Laypeople Can Do

• If someone is experiencing an allergic reaction, call 911 and try to identify the allergen (e.g., bee sting).
• If someone is taking medication, ask them to show you the label and instructions.
• If you are unsure about medication administration, do not attempt to administer medication – wait for EMS to arrive.

Common Mistakes

• Mistake: Not checking the patient's medical history for allergies and interactions.
• Fix: Always check the patient's medical history before administering medication.
• Mistake: Not reading the medication label carefully.
• Fix: Always read the medication label carefully, including the name, dose, and instructions.
• Mistake: Administering medication through the wrong route (e.g., oral instead of IV).
• Fix: Always follow the medication instructions and administration route.

Quick Practice Scenarios

• A patient is experiencing chest pain and is prescribed nitroglycerin. What should you do first?
• Answer: Administer the nitroglycerin as directed by the patient's medical history and the medication label.

• Reason: Nitroglycerin can help relieve chest pain, but it can also cause hypotension if not used correctly.

• A patient is taking medication for high blood pressure and is experiencing dizziness. What should you do first?

• Answer: Check the patient's medication label and medical history to ensure the medication is not causing the dizziness.

• Reason: Certain medications can cause dizziness as a side effect.

• A patient is experiencing a severe allergic reaction and is administered epinephrine. What should you do first?

• Answer: Monitor the patient's vital signs and administer additional epinephrine as directed by the patient's medical history and the medication label.
• Reason: Epinephrine can help relieve an allergic reaction, but it can also cause cardiac arrhythmias if not used correctly.

Last-Minute Exam Cram

• Normal vital sign ranges: HR 60-100 bpm, BP 90-140/60-90 mmHg, RR 12-20 breaths/min, SpO2 95-100%.
• Common medication doses: acetaminophen 325 mg, fentanyl 50 mcg.
• Medication administration routes: oral, IV, IM.
• Assessment sequence: SAMPLE (S - Signs and symptoms, A - Allergies, M - Medications, P - Past medical history, L - Last meal, E - Events leading up to the emergency).
• Agonal breathing is NOT normal breathing – start CPR.
• Always check the patient's medical history for allergies and interactions before administering medication.
• Never administer medication through the wrong route (e.g., oral instead of IV).
• Always read the medication label carefully, including the name, dose, and instructions.
• Familiarize yourself with common medication conversion factors (e.g., 1 mg of fentanyl = 100 mcg).