I rank Solu-Medrol 21 of the 33 drugs we carry.
Solu-Medrol is a systemic steroid that works as an anti-inflamatory.
We used to carry 1 gram vials of Solu-Medrol to give to head injured patients until studies showed that it wasn’t the best thing for them to be getting. Now we give 125 mg Solu-Medrol slow IV to patients having asthma and COPD exacerbations, and those having allergic reactions.
The drug has a funny little mechanism on the vial, where we push down on the top and it releases the rubber chamber divider enabling you to shake the bottle and mix the powered drug with the solution so you can draw it up. I always enjoy watching my preceptees try to figure out how it works the first time they have to give it. “Like this,” I always end up saying as I demonstrate.
It is my understanding that Solu-Medrol doesn’t reach its peak effect for 6-12 hours after we give it, but that studies have shown the earlier it is given, the less likely the patient will have to be admitted to the hospital.
I had a hard time remembering to give the drug when we first got it for these indications, but now I am getting better and am fairly used to giving it and do it routinely now, perhaps not on all calls I should, but certainly on the more serious ones.
You could say we go without carrying the drug without much harm to the patients, but the question is how quickly does the hospital jump to give the drug if EMS has failed to. I would say our giving the drug right away may save the patient an hour (from when we can give the drug to when he would otherwise get it in the hospital), which may make a difference.
Action: Thought to stabilize cellular and intracellular membranes
Indication: Asthma attack of greater than 2 hour’s duration,
Contraindication: none for emergency field use
Dose: Reactive airway disease – 40 to 125mg
Pedi dose: Reactive airway disease – 2 mg/kg (max 125 mg)
Route: IV push – slow