Ontario Paramedic Practice Exam

Under what conditions should epinephrine be provided for suspected bronchoconstriction?

1. BVM ventilations required, and a Hx of Asthma

2. Asthmatic with no prior use

3. Suspected Ischemic Chest Pain

4. Known renal impairment

The correct answer is: BVM ventilations required, and a Hx of Asthma

The provision of epinephrine for suspected bronchoconstriction is particularly warranted in the context of acute respiratory distress, especially when the patient requires positive pressure ventilation via a bag-valve-mask (BVM). This indicates a significant compromise in the patient's respiratory function, often associated with severe asthma attacks or status asthmaticus, where bronchodilation is urgently needed. In such cases, the history of asthma further supports the necessity of epinephrine, as individuals with this condition have heightened sensitivity to bronchoconstriction. Administering epinephrine can rapidly alleviate these symptoms by relaxing the bronchial smooth muscles, thereby improving airflow and oxygenation. The other scenarios presented do not provide a clear or immediate need for epinephrine specifically for bronchoconstriction. Asthmatic patients without prior use may require bronchodilators, but their treatment may not necessarily involve epinephrine unless they present with significant respiratory distress. Suspected ischemic chest pain and known renal impairment are not direct indicators for the use of epinephrine in the context of bronchoconstriction, thus reducing their relevance in this specific situation.