EMT Medication Administration: Scope, Formulary & Protocols

EMT scope is defined by state EMS regulations and local medical director protocols. National EMS Scope of Practice Model (NHTSA) sets baseline; states may expand/restrict.

Typical EMT-Basic Formulary (U.S. Common Core)

*Requires specific training, medical director approval, and often EMT-Advanced/Intermediate level.

Universal Safety Steps

1. Verify patient identity, allergies, current meds.
2. Confirm indication, dose, route, expiration.
3. Assess vitals before/after.
4. Document: medication, dose, route, time, response.
5. Communicate to receiving facility.

Never exceed local protocol. When in doubt, contact medical control.

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Category	Medications	Route	Indication
Analgesia	Acetaminophen, Ibuprofen, Aspirin	PO	Mild pain, MI (ASA)
Opioid Analgesia*	Morphine, Fentanyl	IV/IN/IM	Severe pain (protocol-dependent)
Anaphylaxis	Epinephrine 1:1000 (auto-injector or vial)	IM	Anaphylaxis, severe asthma
Antihistamine	Diphenhydramine	IV/IM/PO	Allergic reaction (adjunct)
Bronchodilator	Albuterol/Ipratropium	Nebulized	Asthma/COPD exacerbation
Hypoglycemia	Oral Glucose Gel	Buccal/PO	Conscious hypoglycemia
Opioid Overdose	Naloxone (Narcan)	IN/IM/IV	Respiratory depression
Cardiac	Nitroglycerin (SL)	SL	Angina/CHF (if prescribed to pt)
Shock	MAST/PASG*	Device	Hypotensive trauma (controversial)