Which action is recommended when a patient has wheezes or bronchospasm and does not improve after the prescribed inhaler, assuming protocol allows the next step?

Which action is recommended when a patient has wheezes or bronchospasm and does not improve after the prescribed inhaler, assuming protocol allows the next step?

• A. Discontinue all treatment and transport.
• B. Administer a second dose of the inhaler without reassessment.
• C. Reassess, consider nebulized therapy if protocol allows, and contact medical control.
• D. Wait and reassess after 15 minutes.

Answer: (C)

When wheezes or bronchospasm don’t improve after the prescribed inhaler, the next step is to reassess and escalate therapy within your protocol. Reassess the patient’s breathing, work of breathing, oxygen saturation, and mental status, and confirm that the inhaler technique and timing were correct. If the protocol allows, administer nebulized bronchodilator therapy, which delivers a higher dose over several minutes and can produce a more substantial and longer-lasting bronchodilation than a single inhaler dose. After starting nebulization, monitor the patient closely and contact medical control to report findings and obtain any necessary orders for further treatment or adjustments. If improvement still doesn’t occur, continue monitoring and transport per protocol.

When wheezes or bronchospasm don’t improve after the prescribed inhaler, the next step is to reassess and escalate therapy within your protocol. Reassess the patient’s breathing, work of breathing, oxygen saturation, and mental status, and confirm that the inhaler technique and timing were correct. If the protocol allows, administer nebulized bronchodilator therapy, which delivers a higher dose over several minutes and can produce a more substantial and longer-lasting bronchodilation than a single inhaler dose. After starting nebulization, monitor the patient closely and contact medical control to report findings and obtain any necessary orders for further treatment or adjustments. If improvement still doesn’t occur, continue monitoring and transport per protocol.