What should EMS do if inhaler therapy is not improving the patient’s wheeze?

What should EMS do if inhaler therapy is not improving the patient’s wheeze?

• A. Withhold all therapy and observe the patient.
• B. Reassess the patient, consider nebulized therapy if protocol allows, and contact medical control.
• C. Discontinue inhaler and discharge the patient.
• D. Give a larger dose of an oral antibiotic.

Answer: (B)

When inhaled bronchodilator therapy isn’t helping, you need to reassess and consider escalating treatment under medical control. Start by reevaluating the patient’s airway and breathing status, vitals, oxygen saturation, and work of breathing, and check that the inhaler technique and spacer use are correct. If protocol allows, move to nebulized bronchodilator therapy, which delivers a higher and often more effective dose and can provide quicker relief after a poor response to a metered-dose inhaler. Continue to monitor the patient closely and obtain guidance from medical control for repeat dosing or additional treatments. Do not discontinue therapy or discharge a patient who remains distressed, and antibiotics won’t treat bronchospasm.

When inhaled bronchodilator therapy isn’t helping, you need to reassess and consider escalating treatment under medical control. Start by reevaluating the patient’s airway and breathing status, vitals, oxygen saturation, and work of breathing, and check that the inhaler technique and spacer use are correct. If protocol allows, move to nebulized bronchodilator therapy, which delivers a higher and often more effective dose and can provide quicker relief after a poor response to a metered-dose inhaler. Continue to monitor the patient closely and obtain guidance from medical control for repeat dosing or additional treatments. Do not discontinue therapy or discharge a patient who remains distressed, and antibiotics won’t treat bronchospasm.