1. GFR Medication Training

2. What Medications Can GFR Give?
Epinephrine
Narcan/Naloxone
Albuterol
Oxygen
Oral Glucose
Aspirin
Nitroglycerin (WE DO NOT CARRY THIS IN OUR BAG)

3. Epinephrine

4. Epinephrine Indications:
Option 1: Exposure to known allergen: Hypotension and/ or Respiratory Distress
Option 2: Exposure and true history of anaphylaxis: Hypotension and/or Respiratory Distress and/or RASH
Contraindications: No true contraindications, but be aware of patients who have cardiac issues
Dosage: 0.3 mg for adults, 0.15 mg for pediatric patients
Route: IM (check and inject)
How many times can we administer in the field: ONE TIME (then call medical control)
Asthma

5. Auto Injector Epi Pens

6. Narcan

7. Narcan
Indications: Respirations <8, pinpoint pupils, altered level of consciousness, suspected opioid overdose
Contraindications: none if the indications are present, it won’t hurt the patient if it was not an opioid overdose. However, be aware that if the patient has done opioids that are laced with things like Molly, if you give narcan they might go into spontaneous cardiac arrest.   
Dosage: 4mg Nasal Spray in one nostril- both adult and pediatric
Route: Intranasal
How many times We can give 2 doses total (repeat in 5 minutes if no improvement)  keep in mind UPD has extra doses

8. Narcan Training Video
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9. Albuterol

10. Albuterol
Indications: Pt. has a known history of asthma and is prescribed albuterol and is wheezing
Contraindications: no prescriptions for albuterol/ diagnosis of asthma (can call med control for orders), allergy, if you have already given 3 doses
Dosage: 2.5 mg in 3 ml (one tube) for adult + pediatric patients
Route: Via Nebulizer
How many times three times- every five minutes
Consider calling medical control for epi if asthma is not getting better, also be sure to consider anaphylaxis even if the patient has a history of asthma

11. Nebulizer

12. Oxygen Indications: SPO2 < 92% CO poisoning Smoke inhalation
Patients who are having difficulty breathing should first be “coached” with their breathing as long as SPO2 is above 92%.

13. Oxygen Flow Rates Non Rebreather: 12-15 LPM Nasal Cannula 2-6 LPM
Nebulizer 4-8 LPM
BVM 15+ LPM

14. Oral Glucose

15. Oral Glucose
Indications: BG less than 60, altered mental status, patient is cool and clammy
Contraindications: Patient can not maintain their own airway
Dosage: grams for adult and pediatric patients
Route: Buccally (between tongue and cheek)
How many times Have the patient suck on the tube as needed
Be aware that oral glucose lasts for ~30 minute time periods. Be ready for patient crashes. This is the only time that food would be appropriate during an EMS call

16. Aspirin

17. Aspirin Indications: Chest Pain
Contraindications: recent surgery, major internal/external bleeding, allergy, they already took it in the past 6 hours
Dosage: mg tablets: 324 mg total
Route: chewable
How many times One in 6 hours, unless you suspect the full dose was not delivered (i.e. vomiting right after administration)
You can not give Aspirin to patients under 18 years of age. Call medical control if you are concerned about patients between 18 and 21

18. Nitroglycerin

19. Nitroglycerin Indications: Chest pain with prescription for Nitro!
Contraindications: Systolic BP < 120, ED medications within the past 72 hours, they already took 3 doses
Dosage: 1 tablet
Route: Sub-Lingual
How many times We can give one tablet every 5 minutes up to 3 times! Check BP every single time- systolic must be above 120. If the patient already took 2 doses before you got there, then you only have one dose left to give