Epinephrine
What is the typical dose of epinephrine for an adult and a child?
Adult: 0.3mg
Children: 0.15mg
For the EMT to achieve the best results when assisting with epinephrine, the medication should be placed into:
a) vein
b) muscle
c) skin
d) artery
b) muscle
A 23-year old male has called EMS for swollen lips and hives. As you enter the scene, what observation would make the EMT suspicious that the patient is having an allergic reaction?
A) A bottle of expired nitroglycerin on the kitchen counter
B) A glucometer on a table in the living room
C) A new container of penicillin on a table with two pills missing
D) Other family members complaining of similar symptoms
C) A new container of penicillin on a table with two pills missing
What is the name of the chemical released by the immune system that is responsible for many fo the symptoms of anaphylaxis?
Histamine
What is the "action" of epinephrine on the body? (2 things)
Vasoconstriction and bronchodilation
Which statement indicates that the EMT understands airway management in a patient suffering from anaphylaxis?
a) "The best way to open the airway in a patient with upper airway edema is to place the patient in an upright position."
b) "Epinephrine will help the patient's blood pressure, but not the swollen tissue in the airway."
c) "If an oral or nasal airway is used, the airway will be opened and positive pressure ventilation will not be needed."
d) "When providing positive pressure ventilation, it may be difficult to pass air through the swollen tissues."
d) "When providing positive pressure ventilation, it may be difficult to pass air through the swollen tissues."
A patient states that he is allergic to poison ivy and was burning it yesterday when he accidentally inhaled some of the smoke. Today, he awoke and found a red rash to the back of his left hand and called 911. Assessment reveals him to be alert and oriented, with easy respirations, and a blood pressure of 128/70 mmHg. Your next action would be to:
A) provide immediate and rapid transport.
B) call for advanced life support (ALS) assistance.
C) assist the patient with his epinephrine auto-injector.
D) obtain a medical history.
D) obtain a medical history.
What are the 6 Rights of medication administration?
Right patient
Right medication
Right route
Right dose
Right time
Right documentation
What is the indication to use epinephrine?
Severe allergic reaction causing airway, breathing, or circulatory compromise
Anaphylaxis is defined as an allergic reaction affecting _____ or more body systems.
2
Which statement indicates that the EMT understands airway management in a patient suffering from anaphylaxis?
A) "The best way to open the airway in a patient with upper airway edema is to place the patient in an upright position."
B) "Epinephrine will help the patient's blood pressure, but not the swollen tissue in the airway."
C) "If an oral or nasal airway is used, the airway will be opened and positive pressure ventilation will not be needed."
D) "When providing positive pressure ventilation, it may be difficult to pass air through the swollen tissues."
D) "When providing positive pressure ventilation, it may be difficult to pass air through the swollen tissues."
A 48 year-old male presents with a rash and swelling of his arms and hands. He is alert and oriented with a blood pressure of 128/90 a pulse of 88 and respirations of 22 per minute. This would be an example of:
a) angioedema
b) moderate septic shock
c) uncomplicated allergic reaction
d) anaphylaxis
C) Uncomplicated allergic reaction
What are 5 side effects of epinephrine?
1. Tachycardia
2. Sweating
3. Headache
4. Dizzyness
5. Palpitations
When assessing a patient with an anaphylactic reaction, which one of the following findings would you expect?
a) Rapid and strong carotid pulse
b) Normal to slightly increased blood pressure
c) Slow and bounding radial pulse
d) Weak radial pulse
d) Weak radial pulse
A mother has called you for her 9-year-old daughter who was stung in the right hand by a bee. She states that her older daughter is allergic to bees and she is scared that the patient may also be allergic, although she has never been stung before. Assessment of the patient reveals a red, painful, and swollen area on the back of the girl's right hand. The primary assessment is unremarkable and her vital signs are normal. The mother hands you her older daughter's epinephrine pen. You would:
A) contact medical direction for permission to use the Epi-pen.
B) administer the epinephrine into the patient's thigh.
C) wash the patient's hand with soap and water.
D) ask the mother to administer the pen into the patient's thigh.
C) wash the patient's hand with soap and water.
When listening to the chest with a stethoscope the patients lower airways are likely to present with:
a) wet rhonchi type sounds
b) wet rales type sounds
c) decreased tidal volume and wheezes
d) unilateral absent lung sounds
c) decreased tidal volume and wheezes
What are the contraindications of epinephrine?
In a life threatening emergency....none!
However, consult medical control when the patient has a history of heart disease or acute coronary syndrome
After assisting a patient with the use of an epinephrine auto-injector, you note that the patient's blood pressure has improved. As a knowledgeable EMT, you realize that this has occurred due to epinephrine's ability to:
a) increase the number of circulating red blood cells
b) constrict blood vessels.
c) increase the oxygen-carrying capacity of the red blood cells.
d) relax the smooth muscle of the blood vessels.
B: Constrict blood vessels
You are staffing an information booth at the county fair when a mother and her 15-year-old son approach. The mother informs you that her son is severely allergic to bee stings and had an epinephrine auto-injector prescribed to him when he was 5 years old. She hands you the 0.15 mg auto-injector and notes that it expired several years ago. Which one of the following statements would be most appropriate for you to make?
A) "Call your doctor to get a new injector as soon as possible."
B) "We have some on the ambulance. I can get you one until you are able to get a new one from your doctor."
C) "Make sure to call the doctor since this is out of date. Also ask him if he wants to add a steroid to the injector."
D) "Administer Epi from the ambulance and monitor as needed."
A) "Call your doctor to get a new injector as soon as possible."
What is the most common cause of death from anaphylaxis?
a) Respiratory compromise
b) Cardio vascular collapse
c) Stroke
d) Hemorrhage
a) Respiratory compromise