Paramedics doctors nurses...what drugs can be pushed down the ET tube?
Answer:
NAVEL is the way I learned many years ago. Narcan, Atropine, Valium Epi and Lidocaine.
The purpose of ETT administration was to have an avenue of medication administration in the event of failure to obtain IV access, with the introduction of the more popular IO (introsseous) equipment, i.e. BIG, EZ-IO etc, the ETT administration is fading away in some parts of the country. I have not pushed an ETT med in well over a 2 years. I have however, used the BIG and EZ-IO to get access faster than most people can start an IV.
I have seen epinephrine go down the ETT.
Lidocaine, Epinephrine 1:1000, Atropine, Narcan, atrovent, albuterol, nitrous oxide. Giving epinephrine via ET tube anymore is being done away with.. does your lungs routinely have 5 or 10 cc of fluid floating around it them? hell no. although cardiac resucitation meds can be given down et tube, it is better for the pt's outcome to administer them intravenous. research certainly supports this. narcan can also be administered intra muscular, so why ever give it via et tube?
We learned it as the acronym LEAN
Lidocaine
Epinephrine
Atropine
Narcan
Albuterol can also be given via ET tube.
This is, of course, going to vary according to the various state protocols, and as new research comes out. However, that's what I learned in paramedic training, and that's what my state protocols recommend.
All medications given via ET tube are doubled in dose, and followed with a 10cc flush, so there's going to be an extra amount of fluid in there. Meds are only given via ET tube in dire situations (cardiac arrest, can't get an IV line). It's always preferable to push the medication via IV line if possible.
I don't know if IM Narcan would work fast enough in a cardiac arrest situation, especially since the body's not going to be pumping blood effectively.
Hope this helps, and have a fantastic day!
Use the old NAVEL acronym/mnemonic: Narcan, atropine, Valium, epinephrine, lidocaine.
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