epinephrine auto-injector annual refresher
DESCRIPTION
EMT-B Expanded Practice. Epinephrine Auto-injector Annual Refresher. Shock (Hypo-perfusion). Inadequate perfusion of the body’s organs Caused by three general processes. Organ failure Hypovolemia Vasodilation. Assessment based on signs & symptoms. A. LLERGIC REACTIONS. - PowerPoint PPT PresentationTRANSCRIPT
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Epinephrine Auto-injectorAnnual Refresher
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Shock (Hypo-perfusion)Shock (Hypo-perfusion)
Inadequate perfusion of the body’s organs
Caused by three general processes
1. Organ failure2. Hypovolemia3. Vasodilation
Assessment based on signs & symptoms
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AAAALLERGIC REACTIONSLLERGIC REACTIONSLLERGIC REACTIONSLLERGIC REACTIONS Some substances known as allergens set off an exaggerated response in the body’s immunesystem. Histamine is released causing capillaries and arterioles to dilate. Fluid contained in the cells leak into the vascular spaces decreasing blood volume. Bronchioles constrict during this process.
A severe allergic reaction is commonly referred to as anaphylactic shock.
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Common Sources of AllergensCommon Sources of Allergens
Insect stings (Bees, wasps, hornets)
Foods (Nuts, shellfish, peanuts, eggs)
Plants (Poison ivy, ragweed, grasses)
Medications (Penicillin, “Caine derivatives,
antibiotics, aspirin)
Other causes (Dust, latex, glue, soaps,
pollen, makeup)
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Patients with Allergic ReactionSIGNS SYMPTOMS
Skin Swelling, itching, hives, red skin
Cardiovascular Increased pulse, decreased BP,signs of shock
Respiratory Cough, rapid breathing, laboredbreathing, noisy breathing, hoarseness, stridor, wheezing
AssessingAssessing
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VVITAL SIGNSITAL SIGNS
PulsePulse
RespirationsRespirations
Blood PressureBlood Pressure
Mental StatusMental Status
PupilsPupils
Skin ConditionSkin Condition
PulsePulse
RespirationsRespirations
Blood PressureBlood Pressure
Mental StatusMental Status
PupilsPupils
Skin ConditionSkin Condition
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Allergic Reaction…MildAllergic Reaction…Mild
Itching, tearing and swelling around
eyes Dizziness Hives, welts localized on certain areas
of the skin Nausea, vomiting, abdominal pain
Epinephrine is not indicated
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Allergic Reaction…SevereAllergic Reaction…Severe
Wide spread hives Feeling of constriction in the throat or
chest Difficulty breathing, wheezing Difficulty swallowing Sense of impending doom Tachycardia
Epinephrine may be indicated
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Allergic Reaction…AcuteAllergic Reaction…Acute
Reduced blood pressure Cyanosis, difficulty in breathing or absence
of breathing Vascular collapse Incontinence Unconsciousness or death may occur if
anaphylactic shock not treated
Epinephrine is indicated
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EpinephrineEpinephrine
Medication Profile
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EpinephrineEpinephrine
Contraindications
Actions
Side-effects Anxiety, palpitations, chest pain(rare) irregular heart beat (dysrhythmias)
Names: Generic (brand) Epinephrine (Adrenalin ; names of auto-injectors (Epi-Pen , EpiPen Jr. )
None in life-threatening situation
Dilates bronchioles; constrictsblood vessels
Dosage Adult: 0.3 mg injected subcutaneouslyChild: 0.15 mg injected subcutaneously
Severe allergic reactionsIndications
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Indications…EpinephrineIndications…Epinephrine
Patients is in obvious shock after an insect sting(most common) or other allergen contact.
Patients who develop signs of anaphylaxis after ingestion of food or medication.
Signs including significant lowering of blood pressure, airway compromise (stridor, tongue swelling, facial swelling and/or significant difficulty breathing.
AED or SAED must be at the patients side.
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ContraindicationsContraindications
Known heart disease, Epinephrine use prior to EMS arrival, Ages < 5 yrs. & >55
yrs., AED or SAED unavailable at patient’s side
Circumstances in which you should NOT administer epinephrine
to a patient
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ActionsActions
INTENDED EFFECTS of epinephrine
EpinephrineProduced by the adrenal gland
(Dilates Bronchioles, Constricts Blood Vessels)
Example...
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Side-EffectsSide-Effects
UNINTENDED EFFECTS of epinephrine
Epinephrine(Anxiety, Palpitations, Chest Pain)
Example...
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Administering Epinephrine via an Auto-injectorAdministering Epinephrine via an Auto-injector
Infant/child0.15 mg.
>30 lbs. <60 lbs.
Adult0.3 mg. >60 lbs.
Auto-injectorsDose
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If the patient has a“Prescribed” Auto-Injector:If the patient has a“Prescribed” Auto-Injector:
Administer high-flow O2.
Verify ALS response. Have AED at patients side. Determine if patient has prescribed auto-injector. If present, check date, administer. Document administration; transport. Remove constricting clothing from fingers, wrists, or
neck.
Emergency care (off-line medical control)
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Administer high-flow O2.
Verify ALS response. Have AED at patients side. Obtain on-line medical control. Provide findings and request administration
of EMS service supplied epinephrine. Administer epinephrine
Emergency care (on-line medical control)
If the patient hasNo “Prescribed” Auto-Injector:If the patient hasNo “Prescribed” Auto-Injector:
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Transport immediately. Remove constricting clothing from
fingers, wrists, or neck. Perform ongoing assessment.
Document changes in condition.
No “Prescribed” Auto-injector(continued)No “Prescribed” Auto-injector(continued)
Emergency care
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If condition worsens: Contact medical control Treat for hypo-perfusion (shock) Prepare for initial life support (ventilation,
CPR, application of AED for cardiac arrest)
Document changes in condition.
Ongoing AssessmentOngoing Assessment
Emergency care
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Transition of CareTransition of Care
Substance patient was exposed to. Time of exposure. Symptoms patient reported. Assessment & care provided. Name of physician ordering injector. Time & dosage(s) of epinephrine. Response to treatment.
Relay to Paramedic or ED Staff:
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