Professional Documents
Culture Documents
Training Module
Dr. Danielle Campagne
Dr. Rawnie Ruegner
UCSF-Fresno
Department of Emergency Medicine
January, 2008
Objectives
Demonstration
Test
History of Epinephrine in
Wilderness Medicine
Literature review
Food examples
Drug examples
Allergic Reactions
Itching
Hives
Redness
Treatment is close observation and watching for
progression of symptoms
Respiratory Tract
Skin
Cardiovascular
Respiratory Tract
Wheezing
Upper airway noisy breathing (stridor)
Chest and throat tightness
Shortness of Breath
Nasal congestion*
Skin
Facial Swelling
Redness*
Hives*
Itching*
Cardiovascular
Treatment
Epinephrine
A catacholamine, sympathomimetic
Acts on cardiovascular system
Increases the strength of heart muscle contraction
Increases heart rate
Increases systolic blood pressure
Bronchodilatation
Epinephrine
Epinephrine
Respiratory Tract
Skin
Cardiovascular
Epinephrine Onset
Epinephrine Dosage
Allergic Reaction/Anaphylaxis
Respiratory Distress/Bronchospasm
4. Epinephrine
Auto-injector
OR epinephrine ampule
If certified. (1 ml =1 mg)
0.3 ml (mg) IM
(1 mg/ml) 0.3 ml (mg) IM x 1
5. Oxygen
High flow
6. Remove allergen
(Oxygen)
7. Transport/backup
8. Treat for shock
If present. (Shock)
9. Base Contact
1. ABCs
as needed.
2. Oxygen
Per protocol
(Oxygen)
High flow (moderate to severe distress, altered mental status).
3. Assessment
4. Epinephrine
Auto-injector
Indications:
(Epinephrine Auto-injector)
-severe distress (unable to speak, cyanotic, severe retractions, accessory muscle use)
-no history of angina or MI
Dose:
0.3 ml IM (1 ml = 1 mg)
Dose:
0.3 ml IM (1 ml = 1 mg)
Consider air transport for patients in severe distress or unstable vitals.
OR epinephrine ampule
5. Transport/
ALS backup
6. Base Contact
If patient has an albuterol or other inhaler, allow and encourage patient to use it, as they have been directed by
their physician. (Examples: Ventolin, Proventil, Bronkosol, Alupent)
Epi Ampule
Primary sites
Deltoid (shoulder)
Vastus lateralis (outer thigh)
Secondary sites
Dorsal gluteal (buttocks), *primary site for thin kids
Rectus femoris (top of thigh)
Intramuscular Injection
90
Skills Session/Test
15. During a severe allergic reaction the chemicals released by the body may cause all
the following except:
a. Blood vessel dilation causing a decreased blood pressure
b. Blood vessel leakage resulting in swelling
c. Severe muscle pain
d. Narrowing of the air passages causing shortness of breath
16. You may AMA/TAR a patient if:
a. Patient has a mild local reaction
b. Patient was observed at least 30 minutes from onset of exposure and has
normal vital signs
c. Patient has no history of severe allergic reactions
d. Patient was given no medication
e. All of the above must be met in order to AMA/TAR
17. If a patient has an epinephrine autoinjector, you should use that instead of your
anaphylaxis kit:
a. True
b. False
c. According to the NPS EMS field manual, you may use the epinephrine
autoinjector or your anaphylaxis kit
18. Which of the following patients have a low risk of complications when receiving
epinephrine for an anaphylactic reaction:
a. 70 year old patient
b. 65 year old patient on a beta blocker (ex metoprolol)
c. 55 year old patient with a history of heart attack (MI)
d. All of the above patients are at risk of having complications with
epinephrine
19. When assessing a patients history which past medical history is not concerning
regarding the administration of epinephrine:
a. Heart attack (MI)
b. Stroke (cerebral vascular accident)
c. Recent finger amputation
d. High blood pressure (Hypertension)
20. What is the concentration of the epinephrine ampule:
a. 1 ml = 3 mg
b. 1 ml = 1 mg
c. 2 ml = 1 mg
d. 3 ml = 1 mg
21. Should you give epinephrine to this 2 year-old patient who ate strawberries for
the first time and is talking and laughing
a. Yes
b. No