Obtain medication/incident history before Dexamethasone​ administration to avoid error and the need to self-report.

Prescribed PO/IV/IM Steroid Medications​

PREDNISONE – Potent anti-inflammatory steroid used to treat many conditions ie: inflammation in different parts of the body.

METHYLPREDNISOLONE (Medrol) Potent anti-inflammatory steroid used to treat many conditions ie: Arthritis, intestinal disorders, etc…​

DEXAMETHASONE – Potent anti-inflammatory steroid used to treat severe allergies, asthma, COPD, croup etc.

Dexamethasone administration may alter the
intended dosing of already prescribed steroid medications. THEREFORE Patients actively taking these medications​ are CONTRAINDICATED for prehospital Dexamethasone administration​

Other Commonly Prescribed Steroid Medications ​

CORTISONE – Joint injections ​

FLUCTICASONE (Advair), SYMBICORT – Inhalers commonly used in Asthma and COPD patients​

ANADROL (testosterone therapy) – Anabolic steroids​

HYDRICORTISONE – Topical Steroid Cream

Patients actively taking these kinds of steroids are NOT CONTRAINDICATED​ with Dexamethasone administration

Croup Case ​​

You are dispatched Code 4 to a residence for a 5 yr old SOB. Upon entering the residence, you hear a barking cough. Caregivers tell you the child was seen in the ER approx. 28 hours ago. They are concerned the patients SOB and cough have worsened and are requesting you treat their child with medicine like the DR did. They tell you it seemed to help before. You perform a thorough assessment. ​


Medical History Unwell for 2 days fever, runny nose, seal like cough ​

Allergies – None​

MedicationsNone prescribed, Tylenol as needed for fever, Dexamethasone admin at ER approx. 28 hours ago ​

 patent, audible stridor B- rapid & shallow, nasal flaring C- strong radial pulses​

unaltered GCS- 15 RR- 36 SPO2 – 94% HR- 128 BP-108/64​

SKIN cyanosis to lips, pink warm and dry TEMP- 38.0 PUPILS- 3 PEARL​

General Patient sitting upright, in obvious distress​

H/N barking cough, nasal flaring noted, cyanosis to lips​

Chest inspiratory and expiratory stridor​

Abdomen noted belly breathing, no nausea/ vomiting​

Extremities unremarkable, cap refill normal

Does your patient qualify for Dexamethasone administration?​

First line treatment for this patient will be nebulized Epi.

NO, this patient does not qualify for Dexamethasone administration. Even though they are less than 8 yrs, HR is <200 and stridor is present with a Hx of URTI and barking cough. Through your medication/incident history taking you discovered this patient received steroids within the last 48 hours and therefore administration would be contraindicated.