Assisted Medications

The following are Brighton Ski Patrol's assisted medication standing orders as of August 5, 2023.

Medication: MDI = Metered Dose Inhaler

Verify the 5 Rights
- Medication prescribed for the patient
- Correct medication
- Right route
- Right dose
- Confirm that the medication has not expired
Patient is alert enough to use the inhaler
Shake the inhaler several times or roll it between our hands to warm and mix
Help the patient take one puff from the inhaler
Note the time and dose of the administration
If no improvement in patient condition and if MDI per dose is not instructed on the inhaler, give second or third dose in 20 minutes if patient is not improving between doses (up to 3 doses)
Continue ongoing assessment of the patient
Complete all Documentation

Patient assessment
OPQRST assessment
Patient history
Call for ALS
Transport patient to the clinic or Aid room
Ensure patient is 18 or older and has no allergies to aspirin
Patient has no bleeding and no GI bleeding
Patient can chew and swallow
Patient has a Patent airway
Patient has their own aspirin in their possession
- Confirm that it’s aspirin
- Confirm that the aspirin is not expired
Confirm patient has not taken Aspirin in the last 1 hour

Verify the 4 Rights
- Confirm you are administering aspirin to the patient
- Right route
- Right dose
- Confirm that the aspirin is not expired
Brighton Ski Patrol does not provide aspirin
Brighton Ski Patrol can assist patient with the patient’s aspirin
- assist patient with one 325 mg aspirin
- or assist patient with four chewable baby aspirin 81 mg per tablet.
- allow patient a sip of water if needed
Note the time and dose
Continue ongoing patient assessment
Complete all Documentation

Patient assessment
OPQRST assessment
Patient history
Call for ALS
Blood Pressure must be taken in the clinic or aid room not on mountain
Transport patient to the clinic or Aid room
Patient must be having chest pain and patient must be awake and responsive
Check to see if the patient has already taken dose for this episode of chest pain
Do Not assist with Nitroglycerin if
- If the patient (male or female) has taken erectile dysfunction medication or altitude illness prevention (e.g., Viagra, Levitra, Cialis, etc) with in the last 24 hours
- If Chest pain is due to trauma
- If patient blood pressure is less than 100 mm/Hg Systolic. Note: Blood Pressure must be taken in the clinic or aid room not on mountain

Verify the 5 Rights
- Medication prescribed for the patient
- Correct medication
- Right route
- Right dose
- Confirm that the medication is not expired
Wait 5 min from the last dose
Ensure Blood pressure is above 100 mm/Hg Systolic
Assist patient with their prescribed nitroglycerin, one tablet under tongue. Instruct patient to let dissolve and not to chew or swallow tablet
- If Nitroglycerin is in spray form, one spray under tongue
If patient is not improving and has a blood pressure of 100 mm/Hg Systolic, repeat at 5 minute intervals (3 doses total).
Note each time and dose assisted
Continue ongoing patient assessment
Complete all Documentation

Patient assessment
Patient history - confirm they are a known diabetic
OPQRST assessment
Call for ALS
Transport patient to the clinic or Aid room
Do not attempt to give glucose to patients who are unconscious, cannot swallow or whose gag reflex is diminished
Patient must be able to swallow
Patient must have a patent airway
Confirm you are administering oral glucose to the patient
Confirm that the Glucose is not expired

Assist with oral glucose if the patient is able to protect their airway
Right route
Right dose
Administer 1 oral glucose tube between the cheek and gum
- Adult: 15-gram commercially available tube of glucose gel or chewable tablets
- Pediatric: For patients younger than 10 years old, administer half the adult dosage
Note the time and dose
Take blood glucose level
Encourage patient to eat a full meal
Continue ongoing patient assessment
Complete all Documentation

Verify the 5 Rights
- Medication prescribed for the patient
- Correct medication
- Right route
- Right dose
- Confirm Medication expiration date and that the medication is not discolored
Assist patient with their Auto-Injector
Administer Epi-Pen in the Outer Thigh Muscle, hold for 10 seconds
Once administered place epi-pen into sharps container
After ongoing assessment, assist with 2nd dose if patient is not improving after 10 minutes.
Note the time and dose
Continue ongoing patient assessment – watch for side effects including anxiety, restlessness, tremor, weakness, dizziness, sweating, palpitations, pallor, nausea, vomiting, headache, and (rare) heart rhythm irregularities.
Complete all Documentation

Cannot talk, cannot move = Non-Responsive.
Most important clue-pinpoint pupils after opening the eyelid – DOES NOT react to light.
Slow, shallow breathing or Absence.
Blue lips & skin (nailbeds are blue).

Validation Steps