# Albuterol

Nebulized treatment for bronchospasm, with adult and pediatric protocol distinctions.

Population: Adult & pediatric guidance. Scope: ALS.
Status: published. Source-linked OCEMS summary.
Summary updated: 2026-09-16.
Source checked: 2026-09-16.
Source version: I-15 revised March 31, 2026; I-20 revised March 26, 2026. Both implemented April 1, 2026. See linked condition-specific sources..
Canonical page: https://www.ocmedic.com/guides/albuterol/
Official source: [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf)

Independent OC Medic summary. Does not replace the complete policy, current system notices, or clinical judgment.

## Check before giving

- Anaphylaxis requires epinephrine; albuterol is an adjunct for bronchospasm.
- If pediatric respiratory status worsens or treatment fails, contact base; a pediatric-capable base is preferred.

## Source documents

- [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf#page=1)
- [I-20 — Pediatric Medication Volume Dose by Weight](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-20%20Peds%20Drug%20Guide%2004-2026.pdf)
- [SO-M-035 — Respiratory Distress](https://www.ochealthinfo.com/sites/healthcare/files/2025-10/SO-M-35%20Respiratory%2010-2025.pdf)
- [SO-P-035 — Acute Respiratory Distress - Pediatric](https://www.ochealthinfo.com/sites/healthcare/files/2025-10/SO-P-35%20Respiratory%2010-2025.pdf)
- [SO-P-060 — Allergic Reaction / Anaphylaxis - Pediatric](https://www.ochealthinfo.com/sites/healthcare/files/2023-04/SO-P-60%20Allergic%20Rxn%204-2023.pdf)
- [PR-900 — State of Emergency - Use of Spacer-Metered Dose Inhaler in Place of Nebulizer for Administration of Albuterol](https://www.ochealthinfo.com/sites/hca/files/import/data/files/114647.pdf)

## Use in OCEMS

- Used for wheezing/bronchospasm, including asthma or COPD, and selected smoke-inhalation and crush-injury pathways.
- Persistent severe bronchospasm may require additional base-directed treatment; bronchodilator delivery does not replace ventilatory support.

## Adult / adolescent

| Indication / route | Dose & limits |
| --- | --- |
| Nebulized solution | 5 mg in 6 mL by continuous nebulization, as tolerated, under the relevant standing order. |
| Metered-dose inhaler listed in I-15 | 90 mcg per actuation: 2 puffs every 2 hours until symptoms resolve. Check that the applicable MDI procedure and agency authorization apply. |

## Pediatric

- SO-P-035 specifies 5 mg in 6 mL by continuous nebulization for wheezing/suspected asthma. SO-P-060 also uses this regimen for anaphylaxis with wheeze or hypoxia.
- I-20 lists 2.5 mg in the 3–5 kg newborn band. This differs from the general pediatric respiratory standing-order wording: reconcile the neonatal dose with base rather than treating the table and condition order as interchangeable.

## Pediatric dose by age / weight

- SO-P-035 / SO-P-060: continuous nebulization for the specified wheezing/respiratory indication. Weight does not independently establish treatment eligibility.
| Weight / use | Pediatric dose | Volume / route |
| --- | --- | --- |
| 3–5 kg newborn band | Resolve source difference with base | I-20: 2.5 mg / 3 mL; general SO-P-035: 5 mg / 6 mL |
| Other eligible pediatric patients | 5 mg | 6 mL by continuous nebulization as tolerated |

## Preparation & reassessment

- Nebulizer stock is commonly 2.5 mg/3 mL; confirm the total medication and volume.
- Reassess air movement, work of breathing, oxygenation, and heart rate. Consider CPAP only when its separate age and clinical criteria are satisfied.