With regards to considerations for Bronchoconstriction it says that with severe resp distress and a cough (with or without need for BVM) that we can consider IM epi as per the bronchoconstriction medical directive. Does that mean they still need to have a hx of asthma?
Yes, as per the directive, the patient must have a history of asthma. The changes allow for it to be given in situations whereby the patient might not meet the updated requirements for BVM. Epinephrine use in those with cardiac disease or in congestive heart failure can result in negative side effects such as cardiac ischemia and hypertensive emergencies, thus worsening their clinical condition. There is no evidence that epinephrine has any benefit in patients with COPD and is not used in treatment of COPDE.