Nasal Atomizer - Nasal Drug Administration
Slideshow to the use of Nasal Atomizers for drug administration, mainly in EMS. This slideshow follows our county protocol, so it may have different information than what is required per your local protocol.
Published on: Mar 3, 2016
Transcripts - Nasal Atomizer - Nasal Drug Administration
Nasal Administration of Medications
Intranasal Mucosal Atomization Device
1. Using a 1ml or 3ml syringe and needle, draw the appropriate amount of
medication into the syringe.
2. Remove the needle and place nasal atomizer onto syringe. Devices are Luer
Lock and twist into place.
3. Use your free hand to hold the crown of the head stable.
4. Place the tip of the atomizer snugly against the nostril slightly up and
5. Briskly compress the syringe plunger and deliver approximately half of the
6. Move the device over to the opposite nostril and administer the remainder
of the medication, as before.
7. If an amount greater than 1ml per nostril is needed, wait 2-3 minutes and
administer the remaining medication.
● Atomized nasal medications absorb into the
bloodstream, avoiding first-pass metabolism.
● Atomized nasal medications offer rapid absorption
across mucosal membranes to the bloodstream into the
brain and cerebrospinal fluid via olfactory mucosa to
Needle Free Administration
● No pain caused by needle stick.
● Reduced risk of needlestick injuries,
especially when dealing with combative
● Beware of abnormal mucosal characteristics.
● Mucous, blood and vasoconstrictors reduce
● Suction nostrils or consider alternate drug delivery
method in these situations.
● While sterile precautions are not necessary, it may
become possible to spread bacteria if device is not clean.
Intranasal Drug Administration
Many medications can be administered intranasally:
● Opiate Analgesics
● Opiate Antagonists
● Adults over 50kg: 10mg (2ml) of Versed.
○ 5mg per nostril (1ml).
● Pediatric dose: Total kg wt X 0.2 mg = total mg dose of
Midazolam (maximum of 10 mg).
● Can be safely administered to help avoid needlestick
Intranasal Opiate Analgesics
● No current pain management medications
available to Sanilac County Emergency
Medical providers is able to be administered
through intranasal injection.
● Fentanyl and Ketamine are both able to be
administered IN, but not available currently.
● Morphine and Nubain not IN compatible.
Intranasal Opiate Antagonist
• Use the concentrated form of naloxone: 1
mg/ml. 1ml per nostril.
• Deliver immediately to allow absorption to
occur while you support airway.
● Standard Narcon precautions should be observed
(withdrawal symptoms, vomiting, combative pt, etc).
● 2mg dose.
● May be beneficial when IM/SQ route not ideal (reduces
risk of needlestick injury with combative patients)
● IM/SQ route yields faster results as compared to IN
route, although IN route is still effective.
● D50 is not compatible intranasally.
Always follow local protocols with
administration of any medications or
performance of any procedure.
Croswell EMS Education
Presentation developed by David Phetteplace, CCEMT-P for Croswell EMS.
11 Wells St.
Croswell, MI 48422
©Croswell EMS 2014