Asthma - Magnesium vs. Epi.

[Akulahawk]

A medic I learned from (way back when) used to somewhat regularly transport a patient that was allergic (or some similar deal) to albuterol. It was a known contraindication for that patient. Instead of using neb albuterol, they would have to call for an order to nebulize terbutaline. They were never refused once the base doc understood the issue. Yes, this patient was an asthmatic and pretty much always had their own terbutaline 'bullets' available for the Paramedics to put into their nebulizer.

Upon reviewing Sacramento Protocols, it appears that Mag sulfate is no longer available for anything. Then again, most of the time, our transport times are short enough that even if it were in our protocols, we're rarely use it.

 

[Handsome Robb]

A medic I learned from (way back when) used to somewhat regularly transport a patient that was allergic (or some similar deal) to albuterol.

Don't even get me started.

We have a "patient" here who's "allergic" to albuterol but can somehow tolerate duonebs...so she got her own protocol written for her.

Not saying it isn't real but hearing those two words in the same sentence strikes a nerve haha.

 

[Akulahawk]

Don't even get me started.

We have a "patient" here who's "allergic" to albuterol but can somehow tolerate duonebs...so she got her own protocol written for her.

Not saying it isn't real but hearing those two words in the same sentence strikes a nerve haha.

This patient actually was/is allergic to it... I just don't remember the specifics about the "why" behind it. This patient couldn't tolerate duoneb. I don't recall if they had Atrovent available, if they did, they may have started the patient on that while getting the order for nebulized terbutaline. That was one reason we were educated about other meds (Beta-adrenergic agonists (albuterol, epinephrine, isoproterenol, metaproterenol, and terbutaline), though we concentrated mostly on albuterol as that was what was in all the local protocols, and therefore was what was carried on all the ALS units.

 

[Handsome Robb]

This patient actually was/is allergic to it... I just don't remember the specifics about the "why" behind it. This patient couldn't tolerate duoneb. I don't recall if they had Atrovent available, if they did, they may have started the patient on that while getting the order for nebulized terbutaline. That was one reason we were educated about other meds (Beta-adrenergic agonists (albuterol, epinephrine, isoproterenol, metaproterenol, and terbutaline), though we concentrated mostly on albuterol as that was what was in all the local protocols, and therefore was what was carried on all the ALS units.

I'm sure she was. It's absolutely possible. Sorry that was me ranting about a specific frequent flyer in our system who pretty much burned her bridge with every medic in our system when she pulled a handgun on a crew.

I'll admit that while we covered beta agonists other than albuterol in school I definitely need to put more time in on learning them to be more familiar. I hate hearing a med and it ringing a bell but not remembering what it is.