Category Archives: Bronchoconstriction

hello when treating a pt with adenosine the contra indications are active bronchial constriction on exam, the companion document also states that adenosine can cause bronchial constriction in asthmatic pts. so may question is ... is an asthmatic pt contraindicated for adenosine tx or is more of a relative vs absolute situation

Pt with Hx of URTI and a Dx of Asthma. With all signs of croup (Barking cough, low grade fever, severe respiratory distress) on auscultation you hear stridor and whizzing in lungs. Which treatment should be prioritized? Salbutamol vs Epi (NEB)? Thank you

Can you rationalize the administration of Epi prior to salbutamol in severe asthma exacerbation Pt? I know they both have bronchodilatory properties, just curious as to the additional benefits

When dealing with an anaphylactic patient, the PCP medical directive says to administer up to 2 doses of epi at a maximum single dose of 0.5mg, whereas the bronchoconstriction AND cardiac arrest medical directives are only one dose at a maximum single dose of 0.5mg. Can some explain why?

Question in regards to the IM epi in 'less than 50 year old patients with Severe Respiratory distress, bronchoconstriction, and a history of asthma without other contributing cardiorespiratory comorbidities' Does this mean if the patients is less than 50 year old with Severe SOB and signs of bronchoconstriction and a history of asthma but also has a history of COPD or CHF, then we do not consider IM EPI?

I have two questions with regards to the Bronchoconstriction Medical Directive, under the current (February 22nd, 2021) Considerations for Paramedics Managing Patients during the COVID-19 Pandemic. 1) Are we still only administering IM epinephrine to patients who require BVM ventilations? 2) Are we only administering IM epinephrine under this medical directive to patients presenting with a cough? It was previously stated in the January 4th, 2021 update that: "Paramedics should consider administering IM epinephrine for severe respiratory distress with cough in known asthma patients..." I understand that the top of the new memo states: " This memo replaces both the May 6th, 2020 and the January 4th, 2021 considerations documents and memos." Just looking for some clarification on the current practice please. Thank you.

With the new bronchoconstriction update, saying you can’t give Epi to pt’s unless they’re <50, does this apply only to the covid guidelines where you can administer it up to 2x if conditions met (asthma, cough, severe respiratory distress) or does the age now apply to the normal bronchoconstriction directive for Epi where you can give up to 0.5mg once too?

Why was an age restriction of 50 years of age placed on utilizing IM epinephrine for the Bronchoconstrictive Medical Directive in the latest update to the COVID-19 Management considerations?

Question: Was just reviewing the SWORBHP document that came out yesterday, just hoping for a little clarification RE bronchoconstriction. In the document it states that we should consider IM administration of Epinephrine for severe respiratory distress w/ cough, hx. asthma. It also states that we should consider using MDI salbutamol only for severe respiratory distress without a cough... My understanding of it would be that we want to keep a surgical mask on the pt. to minimize risk of droplet transmission via cough which you can’t do while administering medication via MDI. I understand that if the pt. Has a cough we should use epinephrine as our first line medication same as we normally would if the pt. Is apneic but Are we to be considering these two separate cases for use of these medications and not giving them concurrently during this pandemic? Just wondering as I did not see it specify whether or not we should considering withholding ventolin if there is a cough.

Question: Who can receive IM epi under the new COVID-19 considerations?

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