Medication Administration

This page is the take-off page for other topics related to medication administration such as intravenous medication administration and medication preparation (such as suspension or reconstitution). Additionally, this page covers the Five Rights of drug administration that should be used prior to each and every administration of a drug to a patient.

General Medication Administration[edit | edit source]

While paramedics administer many medications that perform a variety of functions, there are some general rules which apply to any time a paramedic administers a medication to a patient. These are known as the Five Rights of drug administration. These are true for any medication and can be expanded upon, if needed (some hospitals will increase this up to 10 Rights).

The Five Rights of Drug Administration[edit | edit source]

1. Right Patient
   • Is this the correct patient? In the hospital setting where nurses and doctors treat multiple patients simultaneously, this Right asks "Is this drug supposed to go to this patient?". In the prehospital setting, this Right can be viewed as a question as to whether or not the drug is indicated for the patient presentation (e.g. a patient in SVT is not the right patient for atropine administration).
2. Right Medication
   • Is the medication you are holding the same one you are meaning to give/that was ordered? Many medications are stored in color coded vials, some of which can look and feel quite similar in a stressful emergency situation (or in low light conditions). Additionally, some medications are quite similar in name (e.g. 1:1,000, 1:10,000, 1:100,000 epinephrine*) and can and will be easily confused, misread, or misheard.
3. Right Dose
   • Is this the correct dosage of medication? Not all medication indications require the full contents of a vial be drawn up while other indications may require multiple vials drawn to reach the correct dosage. Not paying attention to the correct dosage of a medication can easily lead to overdosing or under-dosing the patient.
4. Right Route
   • Is this the right route of administration for this medication with this dosage? Some medications such as fentanyl may be given by multiple routes. For example, fentanyl may be given intravenously, intranasally, intramuscularly, sublingually (as a tablet/lozenge) and dermally (via patch). Route of administration will frequently affect the time of onset and time until maximal serum concentration has been reached; using fentanyl as an example, intravenous fentanyl administration will lead to a faster onset of pain relief than a dermal fentanyl patch (and will similarly have a shorter duration of action).
5. Right Time
   • Is this the right time to give the drug? Is the drug expired? Have I exhausted all other options that I should perform prior to administration of this drug?

*These names for the different epinephrine concentrations are becoming less common due to the possibility for medication error. Instead, epinephrine is now commonly referred to by its concentration per mL (e.g. 1 mg/mL, 0.1 mg/mL, 10 mcg/mL).

Medication Administration Routes[edit | edit source]

• Intravenous Medication Administration
• Intranasal Medication Administration
• Intramuscular Medication Administration
• Oral Medication Administration

Medication Use and Management[edit | edit source]

• Medication Preparation