Bedside Snapshot

Use It For: Moderate to severe asthma exacerbation, added to albuterol; COPD exacerbation with albuterol; maintenance bronchodilator in COPD
Adult Dose: Asthma: 0.5 mg nebulized with albuterol, every 20 min ×3 (max 3 doses)
COPD exacerbation: 0.5 mg nebulized with albuterol; EMS up to 3 doses
Combination: 1 vial (0.5 mg/2.5 mg) per dose
Pediatric Dose: Age 2 yr+: 0.5 mg nebulized with albuterol, up to 3 doses. Under 2 yr or bronchiolitis: do not give. Differs: GINA 2026 gives 0.25 mg (4 puffs) at age 5 yr and under, up to 3 doses. Not established under 12 yr (label).
Onset / Duration: Nebulized: 15–30 min / 4–5 hr (peak 1–2 hr). MDI: ~15 min / 2–4 hr
Do Not Give / Hold If: Allergy to ipratropium, atropine or derivatives; bronchiolitis; worse wheeze right after a dose; eye pain, halos or a dilated pupil
Watch For: Paradoxical bronchospasm (worse wheeze after dose); angle-closure glaucoma (eye pain, halos, red eye); urinary retention (cannot void); angioedema or anaphylaxis
Reversal / Rescue: No antidote: stop and support. Bronchospasm: switch bronchodilator. Anaphylaxis: IM epinephrine. Combination overdose is albuterol toxicity
Must Remember: Add-on to a SABA, not first-line alone: slower than albuterol. Asthma: give with the first 3 albuterol doses, stop after 1–2 hr. COPD: may continue with albuterol. Use a mouthpiece to keep mist out of the eyes.

Indications

Emergency & Prehospital

Moderate to severe asthma exacerbation: add it to albuterol for the first 1–3 doses. Admissions fall compared with albuterol alone (off-label, guideline-supported). The evidence is strongest in adults. In children the drop is clearest with nebulized ipratropium. Once the patient is admitted, there is no benefit.
Chronic obstructive pulmonary disease (COPD) exacerbation: an optional add-on to the first short-acting β₂-agonist (SABA). GOLD recommends a SABA with or without a short-acting anticholinergic.
Wheeze with respiratory distress: given with albuterol under EMS bronchospasm protocols, up to 3 doses.

ED / ICU / Transport

Severe asthma in the first hour: give it alongside albuterol, systemic corticosteroids and IV magnesium. Stop once the patient is admitted.
Hospitalized COPD exacerbation: use it with albuterol, alone or as the ipratropium-albuterol vial. Long-acting bronchodilators continue, or start before discharge.

Other Uses

Maintenance bronchodilator in COPD: the labeled indication for the nebulizer solution and the inhaler
Rhinorrhea: these are separate nasal spray products. 0.03% covers perennial rhinitis. 0.06% covers the common cold or seasonal allergic rhinitis.

Not for bronchiolitis: Skip it in infants with bronchiolitis. The National Model EMS Clinical Guidelines advise against ipratropium and other anticholinergics there. And it can't stand in for epinephrine in anaphylaxis.

Dosing & Administration

The doses below come from the cited guidelines. Your local protocols may differ, so check them.

Available Forms

Nebulizer solution 0.02%: 0.2 mg/mL; 0.5 mg (500 mcg) in 2.5 mL unit-dose vial, preservative-free, ready to use. The form EMS and EDs carry.
Ipratropium-albuterol nebulizer solution: ipratropium 0.5 mg + albuterol 2.5 mg in 3 mL (see the combination section below).
Metered-dose inhaler (Atrovent HFA): 17 mcg per actuation from the mouthpiece; 200 actuations.
Soft-mist inhaler (Combivent Respimat): ipratropium 20 mcg + albuterol 100 mcg per actuation.
Nasal spray: 0.03% (21 mcg/spray) and 0.06% (42 mcg/spray), for rhinorrhea only.

Adult Dosing

Indication	Dose & Route	Repeat / Max	Notes
Asthma exacerbation: nebulizer	0.5 mg nebulized, mixed with albuterol	Every 20 min for 3 doses (max 1.5 mg in the first hour); no benefit after the first 1–2 hr	Moderate to severe attacks. Do not continue once the patient is admitted.
Asthma exacerbation: MDI	8 puffs (17 mcg/puff) INH (MDI with spacer)	Every 20 min for 3 doses, with each albuterol dose; no benefit after the first 1–2 hr	EPR-3 (2007) allowed MDI doses for up to 3 hr; GINA 2026 finds no benefit after the first 1–2 hr. A mouthpiece spacer keeps drug out of the eyes.
COPD exacerbation	0.5 mg nebulized with albuterol (air-driven)	EMS: up to 3 doses. Hospital, per GOLD 2026: short-acting bronchodilators hourly for 2–3 doses, then every 2–4 hr by response. Combination vial label max: 6 vials/24 hr; give further doses as albuterol alone	GOLD advises continuing long-acting bronchodilators during the exacerbation. If a LAMA (e.g., tiotropium) continues, avoid scheduled ipratropium on top of it: the labels advise against other anticholinergics. Label: adding ipratropium to a β-agonist has not been shown to reverse bronchospasm in acute COPD exacerbation better than either drug alone. GOLD 2026 still lists a SABA with or without a short-acting anticholinergic as the initial bronchodilator.
COPD maintenance: nebulizer	0.5 mg nebulized	3–4 times daily, 6–8 hr apart	Labeled regimen. Daily totals ≥2,000 mcg: more headache, dry mouth and aggravation of COPD symptoms.
COPD maintenance: inhalers	Atrovent HFA 2 puffs INH; or Combivent Respimat 1 inhalation INH	Four times daily; max 12 puffs (HFA) or 6 inhalations (Respimat) per 24 hr	Long-acting bronchodilators are preferred for maintenance; not a rescue inhaler.

Pediatric Dosing

Indication	Dose & Route	Max Single / Max Total	Notes
Asthma exacerbation: age 2 yr and older	0.5 mg nebulized with albuterol (not weight-based)	Max 0.5 mg/dose; up to 3 doses with albuterol, about every 20 min (EPR-3 interval); no benefit after the first 1–2 hr	Moderate to severe attacks (NASEMSO respiratory guideline, p. 191, up to 3 doses). Differs from FDA label: nebulizer solution not established under 12 yr. GINA 2026 gives 0.25 mg (4 puffs INH, MDI with spacer and mask) at age 5 yr and under, up to 3 doses. EPR-3 MDI route (Figure 5-5): 4–8 puffs INH (MDI with spacer; mask under 4 yr) with each albuterol dose, up to 3 doses (off-label).
After hospital admission	Not recommended	Not applicable	No added benefit once a child is admitted for asthma.
Under 2 yr or bronchiolitis	Do not give	Not applicable	Not recommended; suction, oxygen and supportive care.
Neonates	Not established in neonates	Specialist use only	Neonatal ICU decision.

The labels do not establish safety and effectiveness in children. Safety is not established for the nebulizer solution under 12 yr, or for the inhaler and combination products in any child. So every pediatric dose on this page is off-label. Doses come from AHA/AAP 2025 when it states one, then the NASEMSO National Model EMS Clinical Guidelines v3.0 (2022), then the US label. If none gives a dose, none is shown. A pediatric maximum never exceeds the adult maximum dose (NASEMSO Universal Care Guideline, p. 13). Check your dose against pediatric weight-based dosing.

Ipratropium-Albuterol Combination (DuoNeb)

One 3 mL vial holds ipratropium 0.5 mg and albuterol 2.5 mg (as 3 mg albuterol sulfate). It comes ready to use with no dilution. Generics sell it, and "DuoNeb" is the name most people use.

Setting	Dose	Repeat / Max	Notes
Adult asthma exacerbation	3 mL (1 vial) nebulized	Every 20 min for 3 doses, then albuterol alone	Holds only 2.5 mg albuterol. Where protocol calls for albuterol 5 mg, give ipratropium 0.5 mg with plain albuterol 5 mg instead.
Adult COPD exacerbation	3 mL (1 vial) nebulized	EMS: up to 3 doses, interval per local protocol. Hospital, per GOLD 2026: hourly for 2–3 doses, then every 2–4 hr by response. Label max 6 vials/24 hr; give further doses as albuterol alone	Same albuterol caution as above. Avoid scheduled doses on top of a continued LAMA.
EMS repeat limit	Ipratropium 0.5 mg per dose	Max 3 ipratropium doses; albuterol may be repeated without a set limit for ongoing distress	National Model EMS Clinical Guidelines; local limits vary.
Pediatric asthma exacerbation: age 2 yr and older	3 mL (1 vial) nebulized, as in adults	Up to 3 doses, then albuterol alone (interval per EPR-3: every 20 min)	Ipratropium 0.5 mg per dose (NASEMSO p. 191). Differs from FDA label: not labeled under 18 yr. GINA 2026 caps ipratropium at 0.25 mg for age 5 yr and under (1.5 mL of this vial gives 0.25 mg with albuterol 1.25 mg).
COPD (labeled)	3 mL nebulized	Four times daily plus up to 2 extra doses (max 6 vials/24 hr)	For patients who need more than one bronchodilator.

The albuterol in the combination brings its cardiac, potassium and overdose risks. The albuterol page covers those cautions.

Preparation & Administration

Nebulizer: Empty the vial into the cup. Don't dilute it. It can share the cup with albuterol if used within 1 hr. Stability with other drugs is not established. Expect a treatment to take about 5–15 min.
Mouthpiece over mask: The mouthpiece keeps mist out of the eyes. A mask is sometimes needed, for a young child or in severe distress. Fit it snugly and protect the eyes.
GINA pediatric 0.25 mg dose (age 5 yr and under): 1.25 mL of the 0.02% (0.2 mg/mL) solution; make up to the nebulizer fill volume with the albuterol.
MDI (Atrovent HFA): No shaking needed. Prime with 2 sprays before first use or after more than 3 days unused. Use only its own actuator; discard when the counter reads 0. Use a spacer, with a mask under 4 yr.
COPD: Drive the nebulizer with air and give oxygen separately by nasal cannula. Driving it with oxygen can push PaCO₂ up.

Dosing Notes:

Add it to a SABA. It is not a first-line agent alone, and it starts working more slowly than albuterol.
EPR-3 makes two exceptions. It is an alternative when a SABA is not tolerated, and the preferred bronchodilator for bronchospasm caused by a β-blocker.
In asthma, the benefit comes early, in the first 1–3 doses within the first 1–2 hr.
For renal and hepatic impairment, see Special Populations.

Contraindications & Precautions

Contraindications

Hypersensitivity to ipratropium, atropine or its derivatives, or any product component
Combination products: hypersensitivity to albuterol

Precautions

Narrow-angle glaucoma: The anticholinergic effect and mist in the eyes can trigger or worsen angle closure.
Prostatic hyperplasia or bladder-neck obstruction: may cause urinary retention.
Acute bronchospasm as a single agent: not adequately studied as monotherapy in acute COPD exacerbation. Faster drugs should come first.
Acute COPD exacerbation with a β-agonist: the label says the combination has not been shown to reverse bronchospasm better than either drug alone. GOLD 2026 still lists a SABA with or without a short-acting anticholinergic as initial therapy.
Hepatic or renal impairment: not studied. Use with caution.
Cardiovascular disease (combination products): the albuterol in the combination can cause tachycardia, ischemia and ECG changes.

Hold / Reassess If

Wheeze or dyspnea worsens right after a dose: suspect paradoxical bronchospasm, stop it and switch therapy
Eye pain, blurred vision, halos, red eye or a dilated pupil: stop, protect the eyes, assess for angle closure
Cannot void, or suprapubic fullness: check for urinary retention
Urticaria, angioedema or stridor: stop; treat as hypersensitivity
Three asthma doses given: stop ipratropium and continue albuterol

Adverse Effects & Toxicity

Common

Headache: about 6%
Dry mouth: about 2–4%; bitter or metallic taste in some
Nausea: about 4%; dizziness about 2–3%
Bronchitis, dyspnea, bronchospasm: these lower respiratory events were the main reason people stopped it in the 12-week trials.

Serious / Life-Threatening

Effect	Recognition	Management
Paradoxical bronchospasm	Worse wheeze or dyspnea right after a dose	Stop; switch bronchodilator; can be life-threatening
Hypersensitivity, anaphylaxis	Urticaria, angioedema of tongue, lips or face, laryngospasm, hypotension	Stop; IM epinephrine for anaphylaxis; do not rechallenge
Acute angle-closure glaucoma	Eye pain, halos, red eye, blurred vision, dilated pupil after mask nebulization	Stop; urgent ophthalmology assessment
Urinary retention	Inability to void, bladder distension	Stop; bladder scan or catheter
Tachyarrhythmia	Supraventricular tachycardia (SVT) or atrial fibrillation (AF) on the monitor	12-lead ECG; treat the rhythm; with the combination, consider albuterol toxicity

Overdose & Toxicity Management

Ipratropium alone: systemic overdose by inhalation is unlikely. The drug is poorly absorbed, even at up to 4 times the recommended dose inhaled, or up to 40 times the recommended dose taken orally.
Combination products: an overdose is albuterol toxicity. Watch for tachycardia up to 200/min, arrhythmia, angina, tremor, seizures and hypokalemia.
Immediate management: stop the drug. Run a continuous ECG and check K⁺ and glucose. Treat the symptoms. A cardioselective β-blocker may be considered cautiously for dangerous tachyarrhythmia, though it can trigger bronchospasm.
Antidote: nothing specific. Dialysis benefit is not established.

Monitoring

Parameter	When / How Often	Target / Act If
Clinical: work of breathing, air entry, speech	Before and after each dose; formal review at 1 hr	Drowsy, confused or silent chest: escalate (IV magnesium, ventilatory support)
Clinical: SpO₂	Continuous	Asthma: 92–95% at age 6 yr and older (no higher than 96% in adults); ≥92% at age 5 yr and under, per GINA 2026. Differs from NASEMSO, which uses 94 to 98%. COPD: lower targets, commonly 88–92% pending a blood gas (BTS 2017; NASEMSO accepts about 90%); avoid hyperoxia, which can raise PaCO₂.
Clinical: EtCO₂	Continuous in severe distress	Normal EtCO₂ (35–45 mmHg) with tachypnea and distress signals impending respiratory failure
Clinical: peak flow (PEF) or FEV₁	Before treatment and at 1 hr if the patient can perform it	Little improvement after 3 doses: escalate therapy, do not add more ipratropium
Clinical: HR and rhythm	Continuous ECG with combination or repeated doses	New SVT, AF or ST change: 12-lead ECG; review albuterol dose
Clinical: eyes	After each mask treatment	Pain, halos or a dilated pupil: stop, assess for angle closure
Clinical: urine output	Older men, prostatic hyperplasia, repeated dosing	Retention: bladder scan, catheter if needed
Laboratory: blood gas, potassium	Severe exacerbation; continuous or high-dose albuterol	Rising PaCO₂ or acidosis: ventilatory support. Low K⁺: albuterol effect, replace if needed

Interactions & Compatibility

Clinically Significant Interactions

Drug / Class	Effect	What To Do
Other anticholinergics (atropine, glycopyrrolate, tiotropium and other long-acting muscarinic antagonists (LAMAs), diphenhydramine, tricyclics)	Additive anticholinergic effects: urinary retention, raised intraocular pressure, dry mouth	Avoid combining where possible; if combined, watch voiding and eye symptoms
β₂-agonists (albuterol, levalbuterol)	Additive bronchodilation; no harmful interaction	Intended combination; monitor HR for the albuterol component
β-blockers, loop or thiazide diuretics, MAOIs, tricyclics	Interact with the albuterol in combination products (blocked bronchodilation, hypokalemia, cardiovascular effects)	See albuterol interactions
Methylxanthines, corticosteroids	Used together without adverse interaction	No adjustment

Nebulizer Compatibility

It is inhaled, so IV compatibility issues do not apply.
Label: mix it only with albuterol (or metaproterenol) in the same cup, and give it within 1 hr. Stability with other drugs is not established.
EPR-3 lists budesonide suspension as compatible with ipratropium in a jet nebulizer. The label does not say so, so follow institutional policy.
Verify with an institutional compatibility resource.

Special Populations

Pediatrics: Not labeled in children, though guidelines support short courses in moderate to severe asthma during the emergency phase only. Do not give it in bronchiolitis. For doses, see the Pediatric Dosing table.
Neonates: Not established.
Pregnancy: Very little ipratropium is absorbed after inhalation, so fetal exposure is not expected. Decades of published data have not shown a risk of birth defects, miscarriage or adverse outcomes. Uncontrolled asthma is the bigger danger, so treat exacerbations fully.
Lactation: There are no milk data. Plasma levels after inhaled doses are low, so milk levels are expected to be low too. Don't withhold treatment.
Older Adults: The dose does not change. Trials over 65 yr showed similar efficacy and safety. Watch for urinary retention and angle-closure glaucoma.
Renal Impairment: Not studied. About half of an IV dose leaves unchanged in urine, but little reaches the circulation after inhalation. No specific adjustment is established, so use with caution.
Hepatic Impairment: Not studied. No specific adjustment is established.
Obesity / Dosing Weight: Doses are fixed. Weight does not change the dose.
Glaucoma or prostatic hyperplasia: Use a mouthpiece, or an MDI with a mouthpiece spacer, and monitor the eyes and voiding.

Field & Transport Considerations

Scope: EMT and above may give inhaled ipratropium, alone or as the combination vial, for dyspnea and wheezing. It is a medical-director-approved medication in the National EMS Scope of Practice Model. RN and critical-care transport (CCT) give it in all settings. Scope varies by state and agency protocol.
Storage & Stability: Keep vials in the foil pouch and protect them from light. Plain vials: 15–30°C (59–86°F). Combination vials: 20–25°C (68–77°F), with excursions to 15–30°C (59–86°F). Inhaler canisters can burst above 49°C (120°F), so don't leave them in a hot vehicle.
Carried Concentration: The plain vial is 0.5 mg in 2.5 mL. The combination vial is 3 mL with 2.5 mg albuterol. Read the label, so albuterol is neither doubled nor left out.
Device Choice: Nebulize when the patient is too dyspneic to use an inhaler. An MDI with spacer keeps aerosol out of a closed cabin. Inline nebulization with a bag-valve mask or noninvasive ventilation depends on protocol.
Oxygen-Only Nebulizer in COPD: Air-driven nebulization is preferred, but many ambulances can drive a nebulizer only with oxygen. Follow local protocol, go back to controlled oxygen after the treatment, and watch mental status and EtCO₂ for rising CO₂.
Ventilated Patients: Give it inline. Choose an MDI with an inline spacer or adapter (off-label; the label specifies its own actuator) or a nebulizer in the circuit, per respiratory therapy and institutional protocol. Check peak and plateau pressures and auto-PEEP before and after. Avoid scheduled doses on top of a scheduled LAMA.
Dose Count: Count ipratropium doses apart from albuterol. After 3, continue albuterol alone.
Handoff Essentials: number and times of ipratropium and albuterol doses (plain or combination), magnesium, steroid and epinephrine given, response (work of breathing, SpO₂, EtCO₂, PEF), HR trend, any eye or urinary symptoms.

Clinical Pearls

The blown pupil that is not a bleed: Mist leaking from a face mask can dilate one pupil. Alert, normal neuro exam, ipratropium given? Suspect drug effect. Any drop in mental status changes the picture. Treat it as a neurologic emergency until proven otherwise.

Front-load it, then stop: In asthma, the benefit comes early: the first three doses, in the first hour or two. After that, or once a child is admitted, extra ipratropium adds nothing. Keep albuterol going.

Exam discriminator: SAMA vs SABA:

Albuterol: a β₂-agonist. Onset about 5 min. First-line rescue.
Ipratropium: a muscarinic antagonist. Onset 15–30 min. An add-on, not first-line.
Unlike atropine, ipratropium is quaternary and does not cross the blood-brain barrier.
It won't thicken secretions or slow mucociliary clearance.

Heart-rate neutral: At recommended doses, ipratropium causes no clinically significant change in pulse or blood pressure. When tachycardia, ischemia or a tachyarrhythmia from the β-agonist limits albuterol, ipratropium still adds bronchodilation. The combination vial still carries albuterol's cardiac load.

Fewer albuterol side effects: In emergency asthma, adding ipratropium to albuterol lowered nausea and tremor compared with albuterol alone. Lung function improved too.

Mouthpiece for glaucoma and older men: A mouthpiece nebulizer, or an MDI with a mouthpiece spacer, limits eye exposure. On repeated doses, check voiding in men with prostatic symptoms.

Do not count on it in anaphylaxis or bronchiolitis: Wheeze with hives or hypotension means IM epinephrine comes first. Anticholinergics are not recommended for infant bronchiolitis.

Pharmacology

Mechanism of Action

Blocks acetylcholine at M₃ muscarinic receptors on airway smooth muscle → less vagally mediated bronchoconstriction → bronchodilation. The effect is mainly local, in the lung.
Nonselective. It also blocks the inhibitory M₂ autoreceptor, which may blunt the effect a little.
A quaternary ammonium compound related to atropine. It is poorly absorbed and stays out of the brain.
Mucociliary clearance is unchanged, and so are the volume and viscosity of secretions.

Pharmacokinetics

Route	Onset	Peak	Duration
INH (nebulized)	15–30 min	1–2 hr	4–5 hr (7–8 hr in 25–38%)
INH (MDI)	~15 min	1–2 hr	2–4 hr
INH (combination vial)	Rapid (albuterol component)	~1.5 hr	~4.3 hr

Half-life: about 2 hr (1.6 hr after IV dosing).
Absorption: about 7% of a nebulized dose reaches the circulation. Most is swallowed and leaves in feces.
Metabolism: partial, producing inactive ester hydrolysis products.
Elimination: about half of an IV dose leaves the body unchanged in urine.
Protein binding: 0–9%.

Names & Classification

Generic Name: Ipratropium bromide (monohydrate)
Brand Names: Atrovent HFA (inhaler); combinations: Combivent Respimat (soft-mist inhaler) and DuoNeb (name in common use for the ipratropium-albuterol nebulizer solution; current US products are generic). Nebulizer solution and nasal spray are generic.
Pharmacologic Class: Short-acting muscarinic antagonist (SAMA); quaternary anticholinergic
Therapeutic Class: Bronchodilator; nasal antisecretory (spray)
Controlled Substance: Not controlled
ISMP High-Alert: No
Look-Alike / Sound-Alike: None commonly reported; the practical risk is confusing the plain 2.5 mL vial with the 3 mL combination vial

References

Nephron Pharmaceuticals Corporation. (2025). Ipratropium bromide inhalation solution, USP 0.02% [prescribing information]. DailyMed, National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=db8095db-d1fd-4099-9fb1-d1ad4e284976
Boehringer Ingelheim Pharmaceuticals. (2025). Atrovent HFA (ipratropium bromide HFA inhalation aerosol) [prescribing information]. DailyMed, National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=170e98ef-5560-4068-be7d-e649068eb884
Nephron Pharmaceuticals Corporation. (2025). Ipratropium bromide 0.5 mg and albuterol sulfate 3 mg inhalation solution, USP [prescribing information]. DailyMed, National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ae35ec1f-526a-49bf-8262-c50e40190d1f
Global Initiative for Asthma. (2026). Global strategy for asthma management and prevention, 2026 update. https://ginasthma.org/2026-gina-strategy-report/
Global Initiative for Chronic Obstructive Lung Disease. (2026). Global strategy for prevention, diagnosis and management of COPD: 2026 report. https://goldcopd.org/2026-gold-report/
National Asthma Education and Prevention Program. (2007). Expert Panel Report 3: Guidelines for the diagnosis and management of asthma (landmark guideline; source of the US exacerbation doses). National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/sites/default/files/media/docs/EPR-3_Asthma_Full_Report_2007.pdf
National Association of State EMS Officials. (2022). National model EMS clinical guidelines, version 3.0. https://nasemso.org/wp-content/uploads/National-Model-EMS-Clinical-Guidelines_2022.pdf
Hamud, A. A., Mudawi, K., Powell, C., et al. (2026). Use of inhaled/nebulised ipratropium bromide in addition to standard first-line treatment with inhaled/nebulised short-acting beta 2-agonist and systemic steroid in the management of acute asthma exacerbations: a systematic review and meta-analysis of randomised controlled trials. Archives of Disease in Childhood, 111(3), 211–218. https://doi.org/10.1136/archdischild-2024-327898
National Highway Traffic Safety Administration. (2019). National EMS Scope of Practice Model 2019 (DOT HS 812 666), Section V, Medical Director Approved Medications. https://ldh.la.gov/assets/oph/ems/2025/EMSEducation/National_EMS_Scope_of_Practice_Model_2019.pdf
O'Driscoll, B. R., Howard, L. S., Earis, J., & Mak, V. (2017). British Thoracic Society guideline for oxygen use in adults in healthcare and emergency settings. BMJ Open Respiratory Research, 4, e000170. https://doi.org/10.1136/bmjresp-2016-000170

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