EMERGENCY MEDICAL SERVICES PROGRAM EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO

EMERGENCY MEDICAL SERVICES PROGRAM EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR LEARNING OBJECTIVES Ø Obtain baseline understanding of the signs and symptoms of anaphylaxis Ø Understand how epinephrine works Ø Learn how to administer epinephrine (Epinephrine auto injector)

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR UNIT ONE Signs and Symptoms of Anaphylaxis

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR What is ANAPHYLAXIS? Ø Anaphylaxis is a sudden, severe allergic reaction that can occur quickly (as fast as within a couple of minutes) and involves the whole body Ø Common Allergens: ü Insect Stings ü Medication ü Foods ü Latex .

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR What is ANAPHYLAXIS? The most common food allergy reactions are caused by eight (8) foods: Ø Ø Peanuts Eggs Soy Fish Ø Ø Tree Nuts Milk Wheat Shellfish

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR What is ANAPHYLAXIS? (continued) Ø Widespread responses that cause itching, hives and swelling Ø May cause: ü Tachycardia ü Hypoperfusion (decreased blood flow through organs) ü Hypertension ü Tachycardia ü Asphyxia .

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR Symptoms of ANAPHYLAXIS Ø Trouble breathing/Wheezing Ø Hoarseness (changes in the way your voice sounds) Ø Hives (raised reddened rash) and severe itching Ø Skin rash, redness, or swelling (Fast heartbeat Ø Weak pulse Ø Anxiety/Confusion Ø Stomach pain Ø Incontinence Ø Dizziness/Unconsciousness

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR UNIT TWO Epinephrine and Effects

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR What is Epinephrine and how does it work? Definition Ø A naturally occurring hormone, also known as adrenaline or adrenalin ü 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

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR How does Epinephrine work? Airway dilation Breathing rate increases Blood pressure increases Blood flow to skeletal muscles increases EPINEPHRINE Heart rate increases Pupils dilate Blood sugar level increases

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR UNIT THREE Administration of Epinephrine

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR Epinephrine Auto Injector Administration Epinephrine can only be administered if authorized by your Local EMS Agency Medical Director

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR Epinephrine Auto Injector Administration 1. Determine patient’s history of anaphylaxis, severe allergic reaction and/or recent exposure 2. Request ALS assistance and dial 911, but do not delay treatment 3. Obtain patient’s prescribed auto injector (if available) 4. Ensure: ü Medication is not discolored or expired and injector is intact ü If patient’s Epi Pen is unusable, use stocked Epi Pen auto injector

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR Epinephrine Auto Injector Administration – Site Selection and Preparation 1. Choose intramuscular injection site: ü Deltoid, ü Lateral thigh ü Anterolateral thigh (best site for infants and toddlers)

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR Epinephrine Auto Injector Administration – Site Selection and Preparation Injection site

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR Epinephrine Auto Injector Administration – Site Selection and Preparation 2. Prepare site with alcohol wipe, scrubbing vigorously 3. Let air dry

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR Epinephrine Auto Injector Administration 1. Ensure proper auto injector for patient ü Pediatric (0. 15 mg of 1: 1, 000) <30 kg (66 lbs) ü Adult (0. 30 mg of 1: 1, 000) >30 kg (66 lbs) 2. Grasp auto injector with needle end facing downward 3. Remove safety release cap from other end of injector

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR Epinephrine Auto Injector Administration 4. Position auto injector approximately 10 cm from injection site 5. Insert auto injector into injection site at 90 degree angle (helps insure intramuscular administration) 6. Hold in place for 10 seconds 7. Remove auto injector and massage injection site for 10 seconds 8. Properly dispose of auto injector using Sharps container

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR Epinephrine Auto Injector Administration – Side Effects of Epinephrine ü Palpitations ü Tachycardia and Dysrhythmias ü Hypertension ü Headache ü Tremors, Weakness ü Pallor, Sweating ü Nausea and Vomiting ü Nervousness and Anxiety ü Pain and Redness at injection side ü Dry Mouth

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR Epinephrine Auto Injector Administration – After Administration Ø Continue to provide respiratory assistance as needed Ø Perform CPR if unresponsive or agonal breathing Ø Continue ongoing patient assessment ü Does patient require second dose (requires medical control) ü Monitor vital signs and assessment of patient response Ø Provide supportive care

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!!!!

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR Additional Training Resources – Mayo Clinic: http: //www. mayoclinic. org/drugs-supplements/epinephrine -injection-route/description/DRG-20072429 American College of Allergy, Asthma and Immunology https: //acaai. org/allergies/anaphylaxis

EPINEPHRINE ADMINISTRATION EPINEPHRINE AUTO INJECTOR QUESTIONS? ? ?