Pharmacology
EMT-Basic Medication Contraindications
When protocol medications must be withheld because patient factors create unacceptable risk at the basic level.
Absolute versus relative contraindications
The FDA requires labeling that describes when drugs should not be used or require special caution.1 Absolute contraindications mean do not give—known anaphylaxis to a medication, nitroglycerin in suspected right ventricular infarction or severe hypotension per protocol, epinephrine auto-injector only when patient has no conflicting absolute rules. Relative contraindications require medical direction or protocol nuance: asthma history with beta-blocker allergy cross-reactivity questions, for example.
MedlinePlus consumer drug pages list common interactions and warnings EMS must connect to scene findings.2 “Allergy to sulfa” does not always contraindicate every sulfa-derived drug, but protocol and standing orders define what EMT-Basics can parse without physician consultation.
Scene clues that trigger withholding
Suspected stroke within nitroglycerin protocol limits, ingestion of unknown pills before glucose is checked, cocaine-associated chest pain where beta-blockade may be restricted, and pediatric patients where adult auto-injector doses exceed protocol weight bands—all are classic exam contraindication scenarios. When contraindicated, document reason and alternative care: positioning, oxygen, rapid transport.
Never withhold lifesaving medications due to incomplete history when protocol allows empiric treatment—anaphylaxis with unknown allergy history still receives epinephrine. Contraindication drills train recognition speed; wrong-route and wrong-patient errors often follow rushed “yes” answers without reading the full prompt.
Practice this skill
Apply what you read with a hands-on Pharma — Contraindications drill — instant feedback on every scenario.
