What is required before administering epinephrine to a patient in respiratory distress over 55 years old?

In cases involving the administration of epinephrine for respiratory distress in patients over 55 years old, obtaining the medical director's permission is crucial due to the potential for underlying health complications that could arise in older patients. This age group often presents with various comorbidities, which necessitate a more cautious approach to medication administration.

The involvement of the medical director ensures that the decision to administer epinephrine is not only based on immediate symptoms but also takes into account the patient’s overall health status and any protocols specific to older adults. Medical directors typically provide guidelines that reflect evidence-based practice and patient safety considerations, which is particularly important when administering potent medications like epinephrine that can have significant cardiovascular effects.

In contrast, options such as doctor's consent or patient's written consent may not necessarily align with established protocols, as the medical director is the designated authority overseeing EMS protocols and medication administration. Confirmation of symptoms, while important, is typically a prerequisite for treatment but does not address the additional layer of oversight required for an older population. Therefore, obtaining the medical director's permission is the appropriate step to ensure compliance with EMS guidelines and to prioritize patient safety.