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• W2531285849 abstract "Albuterol has been shown to improve outcomes in patients presenting with bronchospasm in the prehospital setting. However, the administration of albuterol therapy is restricted by scope of practice to Advanced Life Support (ALS) in many Emergency Medical Services (EMS) systems throughout the country. Basic Life Support (BLS) providers have traditionally only assisted patients with using their own albuterol, but have not been granted authority to identify patients with bronchospasm and administer albuterol to patients who may benefit from bronchodilator therapy. In Delaware's two-tiered EMS system, BLS often arrives on scene prior to ALS. To date, very few studies have evaluated the efficacy of independent BLS administration of albuterol. This study sought to evaluate the recognition of need, application, use, and monitoring of albuterol use by BLS prior to ALS arrival. This is a retrospective observational study using data collected between July 2015 and January 2016 throughout a State BLS albuterol pilot program. BLS companies that were previously trained to use and administer CPAP were invited to participate in the study. Pilot BLS agencies attended a training session on the recognition of need and administration of albuterol, and the assessment of patients presenting with bronchospasm. We examined the use of oxygen, albuterol, and CPAP in the bronchospastic patient, and the appropriateness of administration by BLS providers when compared to ALS. The “appropriateness” of BLS deciding to administer albuterol was determined by a higher trained provider (paramedic, registered nurse, respiratory therapist, and/or physician) and each use by BLS included a data collection form reviewed by one of these higher trained providers. 112 patients were administered albuterol by BLS prior to the ALS arriving. All (100%; N=112/112) BLS providers administered albuterol correctly and appropriately managed respiratory conditions after review. Only two percent of the time (2/120) was an ALS responder already on site prior to the BLS responder arriving at the scene. Initial interventions included oxygen (79%; 97/123), albuterol (96%; 118/123), CPAP (6.5%; 8/123), or other (0.8%; 1/123). The more common dose was 5 mg (83%; 102/123) compared to 2.5 mg (17%; 19/123). After albuterol administration, heart rate (p <0.01) and respiratory rate (p=0.04) significantly declined whereas pulse oximetry (p< 0.01) improved. There were no significant changes in systolic or diastolic blood pressure. BLS providers were able to identify out-of-hospital patients with bronchospasm and correctly administer albuterol nebulizer treatments in absence of ALS oversight. EMS agencies should consider changing current protocols to allow BLS to administer bronchodilators as a standard of care." @default.
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• W2531285849 date "2016-10-01" @default.
• W2531285849 modified "2023-09-27" @default.
• W2531285849 title "126 An Observational Study of Albuterol Administration by Basic Life Support Providers" @default.
• W2531285849 doi "https://doi.org/10.1016/j.annemergmed.2016.08.138" @default.
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