Paramedics Course – Drug Routes

Paramedics Course – Drug Routes

Micro Lecture by the Australian Paramedical College


In this micro-lecture, we discuss drug routes and the different ways Paramedics have to administer drugs to patients. Enrolled students have unlimited access to a rich library of learning materials such as this.


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In today’s session we’re going to talk about drug routes. So as a paramedic, there are many drugs that you have to administer to your patients. Take, for example, pain relief to make them feel relaxed.

Then there’s drugs like Salbutamol to help your patients breathe better, adrenaline to help them overcome life threatening allergic reactions or life threatening asthma attacks. Now at some point within that patient care interaction, you have to try and decide, where you are given a choice, you have to try and decide which is the best route to use.

Now when choosing a drug route, you have to think about a number of factors. You have to think about the condition that the patient is presenting in. So for example, are they time critical and need a drug like today, straightaway? You need to think about things such as the condition. You need to think about things like their circulation, you need to consider the presentation. You need to think about the routes available to you in your scope of practice. Because not all of these roots here on the screen will be available to you.

So when it actually gets down to choosing a route, let’s talk about the key routes which we have here on the screen. Now, here we have intravenous, interosseous, per orem, which is oral as as in something you will swallow, correctum, taken rectally, inhalations of containers, which is under the fat layer and intramuscular.

By far the fastest route of absorption are the intravenous and interosseous routes. So intravenous meaning into your vein, directly into your circulation. Takes approximately 30 seconds to absorb into your body. That’s because you’re giving a large bolus of drugs directly into the circulation, which then gets taken back up to the heart and then directly pumps to the receptor sites. So that’s approximately 30 seconds once you’ve got the line in and given the drug.

An interosseous infusion into the bone is pretty similar in terms of the absorption rates. Per orem is also pretty fast absorbing. Per orem with regards to anything you would swallow. Now, it’s certainly by no stretch of the imagination 30 seconds like intravenous and interosseous.

But just remember that with per orem anything that you take orally and then crunch and swallow has to go through your system, so it takes approximately 10 to 15 minutes, takes much longer than the IV or the IO. But in the grand scheme of things, 10 minutes is actually not that bad. With intramuscular injections, they go straight into the muscle.

That’s what IM stands for, into the muscle. Now the problem is you can’t control the volume of drug absorption and uptake because you’re given a certain volume of drug into the muscle and it just naturally absorbs. Subcutaneous is underneath the fat tissue. Sub is underneath, cutaneous fat. Per rectum is pretty fast, is probably somewhere around here. So it’s probably in between the per orem and interosseous and IV.

The word per, P-E-R, just means pertaining to. Subcutaneous is around here with inhalation probably sitting there as well. So per orem even though it’s 10 minutes, still pretty fast. So that’s probably about the the summary of how fast the absorption rates are, intravenous, interosseous being the fastest. Per orem taking the longest and then you’ve got a of others in between.

So that’s just a snapshot of the different types of of drug routes available to you as a paramedic. There are a couple of others, but this is just a short micro lecture.

For more information about paramedic/EMT/first responder/basic life support/advanced life support training courses and becoming a Medic / Paramedic Contact the Australian Paramedical College today:


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