How many times can EMTs give epinephrine auto-injector or assist with albuterol MDI before BH contact is required?

• A. Once
• B. Twice
• C. Three times
• D. Four times

Answer: (A)

The idea here is that EMS standing orders typically allow one initial intervention with these medications before you must obtain base hospital input for anything further. A single dose of an epinephrine auto-injector to treat suspected anaphylaxis can be life-saving, but repeating doses without physician oversight carries increased risks like tachycardia, hypertension, and arrhythmias. Similarly, assisting with albuterol via a metered-dose inhaler is intended as an initial measure; additional doses without base hospital approval can lead to excess beta-agonist effects, including tachycardia and tremors, and may indicate a need for a different treatment plan or advanced care.

After giving that first dose or assisting with the inhaler, you should reassess the patient. If symptoms persist or hemodynamics worsen, you contact the base hospital for further instructions before proceeding with additional dosing. That’s why the correct approach is to perform the intervention one time before BH contact is required.