1. Emergency Medical Services Program
Epinephrine Administration
Epinephrine Auto Injector

2. Epinephrine Administration Epinephrine Auto Injector
LEARNING OBJECTIVES
Obtain baseline understanding of the signs and symptoms of anaphylaxis
Understand how epinephrine works
Learn how to administer epinephrine (Epinephrine auto injector)
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3. Epinephrine Administration Epinephrine Auto Injector
UNIT ONE Signs and Symptoms of Anaphylaxis
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4. Epinephrine Administration Epinephrine Auto Injector
What is ANAPHYLAXIS?
Anaphylaxis is a sudden, severe allergic reaction that can occur quickly (as fast as within a couple of minutes) and involves the whole body
Common Allergens:
Insect Stings
Medication
Foods
Latex .
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5. Epinephrine Administration Epinephrine Auto Injector
What is ANAPHYLAXIS?
The most common food allergy reactions are caused by eight (8) foods:
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Peanuts
Tree Nuts
Eggs
Milk
Soy
Wheat
Fish
Shellfish

6. Epinephrine Administration Epinephrine Auto Injector
What is ANAPHYLAXIS? (continued)
Widespread responses that cause itching, hives and swelling
May cause:
Tachycardia
Hypoperfusion (decreased blood flow through organs)
Hypertension
Asphyxia .
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7. Epinephrine Administration Epinephrine Auto Injector
Symptoms of ANAPHYLAXIS
Trouble breathing/Wheezing
Hoarseness (changes in the way your voice sounds)
Hives (raised reddened rash) and severe itching
Skin rash, redness, or swelling (Fast heartbeat
Weak pulse
Anxiety/Confusion
Stomach pain
Incontinence
Dizziness/Unconsciousness
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8. Epinephrine Administration Epinephrine Auto Injector
UNIT TWO Epinephrine and Effects
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9. Epinephrine Administration Epinephrine Auto Injector
What is Epinephrine and how does it work?
Definition
A naturally occurring hormone, also known as adrenaline or adrenalin
Released during “Flight or Fight” response
Effects
Relaxes muscles in airways opening trachea
Counteracts swelling (histamine blocker)
Increases blood sugar, blood pressure, heart rate and cardiac output
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10. Epinephrine Administration Epinephrine Auto Injector
How does Epinephrine work?
Airway dilation
Blood flow to skeletal muscles increases
Pupils dilate
Blood sugar level increases
Heart rate increases
Blood pressure increases
Breathing rate increases
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EPINEPHRINE

11. Epinephrine Administration Epinephrine Auto Injector
UNIT THREE Administration of Epinephrine
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12. Epinephrine Administration Epinephrine Auto Injector
Epinephrine Auto Injector Administration
Epinephrine can only be administered if authorized by your Local EMS Agency Medical Director
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13. Epinephrine Administration Epinephrine Auto Injector
Epinephrine Auto Injector Administration
Determine patient’s history of anaphylaxis, severe allergic reaction and/or recent exposure
Request ALS assistance and dial 911, but do not delay treatment
Obtain patient’s prescribed auto injector (if available)
Ensure:
Medication is not discolored or expired and injector is intact
If patient’s Epi Pen is unusable, use stocked Epi Pen auto injector
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14. Epinephrine Administration Epinephrine Auto Injector
Epinephrine Auto Injector Administration – Site Selection and Preparation
Choose intramuscular injection site:
Deltoid,
Lateral thigh
Anterolateral thigh (best site for infants and toddlers)
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15. Epinephrine Administration Epinephrine Auto Injector
Epinephrine Auto Injector Administration – Site Selection and Preparation
Injection site
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16. Epinephrine Administration Epinephrine Auto Injector
Epinephrine Auto Injector Administration – Site Selection and Preparation
Prepare site with alcohol wipe, scrubbing vigorously
Let air dry
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17. Epinephrine Administration Epinephrine Auto Injector
Epinephrine Auto Injector Administration
Ensure proper auto injector for patient
Pediatric (0.15 mg of 1:1,000) <30 kg (66 lbs)
Adult (0.30 mg of 1:1,000) >30 kg (66 lbs)
Grasp auto injector with needle end facing downward
Remove safety release cap from other end of injector
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18. Epinephrine Administration Epinephrine Auto Injector
Epinephrine Auto Injector Administration
Position auto injector approximately 10 cm from injection site
Insert auto injector into injection site at 90 degree angle (helps insure intramuscular administration)
Hold in place for 10 seconds
Remove auto injector and massage injection site for 10 seconds
Properly dispose of auto injector using Sharps container
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19. Epinephrine Administration Epinephrine Auto Injector
Epinephrine Auto Injector Administration –
Side Effects of Epinephrine
Palpitations
Tachycardia and Dysrhythmias
Hypertension
Headache
Tremors, Weakness
Pallor, Sweating
Nausea and Vomiting
Nervousness and Anxiety
Pain and Redness at injection side
Dry Mouth
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20. Epinephrine Administration Epinephrine Auto Injector
Epinephrine Auto Injector Administration –
After Administration
Continue to provide respiratory assistance as needed
Perform CPR if unresponsive or agonal breathing
Continue ongoing patient assessment
Does patient require second dose (requires medical control)
Monitor vital signs and assessment of patient response
Provide supportive care
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21. Epinephrine Administration Epinephrine Auto Injector
Epinephrine Auto Injector Administration –
After Administration
Remember
Document all information concerning patient, medication and patient response for ALS transport providers
Thorough documentation!!!!
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22. Epinephrine Administration Epinephrine Auto Injector
Additional Training Resources – Mayo Clinic: American College of Allergy, Asthma and Immunology
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23. Epinephrine Administration Epinephrine Auto Injector
QUESTIONS???
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