NYC REMSCO BLS Protocols state that Albuterol via Nebulizer is indicated in patients over 1 year of age presenting with exacerbation of asthma/wheezing. Albuterol is the only medicine EMT-B's in NYC can give via Nebulizer. Refer to the 2010 protocols if you want more details.
This is how you do it, for those of you who didn't learn in tech school.
1. Gather the necessary equipment.
2. Assemble the nebulizer kit.
3. Instill the premixed drug (such as Albuterol or other approved drug) into the reservoir well ofthe nebulizer.
4. Connect the nebulizer device to oxygen at 4 - 6 liters per minute or adequate flow to produce asteady, visible mist.
5. Instruct the patient to inhale normally through the mouthpiece of the nebulizer. The patientneeds to have a good lip seal around the mouthpiece.
6. The treatment should last until the solution is depleted. Tapping the reservoir well near theend of the treatment will assist in utilizing all of the solution.
7. Monitor the patient for medication effects. This should include the patient’s assessment of his/her response to the treatment and reassessment of vital signs, ECG, and breath sounds.
8. Assess and document peak flows before and after nebulizer treatments.
9. Document the treatment, dose, and route on/with the patient care report (PCR).
(Randolph County, NC, EMS System Standards Procedure - Because really, I couldn't have said it better myself.)
Here are some video links if you're a visual learner like me. The narrator is using an actual Nebulizer machine rather than an O2 tank, but it's the same concept. It's a series if you want to see every last detail (and how to use Nebulizer masks), but these are the parts relevant to what I carry on my ambulance.
How to Get Nebulizer Ready for Use
How to Load Medicine in Nebulizer
How to Use Nebulizer Wand With a Child