How to Use an EpiPen (Latest Guidelines)

By Adem Lewis / in , , , , , /

Speaker 1: Can I have a piece? Speaker 2:
Mm-hm. Try it. It’s really good. Speaker 1: Hey, Anthony, can you go get help? Speaker
2: Mm-hm. Speaker 3: In all my years as a licensed paramedic, working on the street,
not many acute illnesses are as scary as a severe allergic reaction. We have a fancy
word to call that. It’s called “anaphylaxis,” which is the body’s reaction to something
that is causing them to have a number of different symptoms that could lead to a life-threatening
emergency. In this scenario, we’re going to teach you what anaphylaxis is, what it’s doing
in the body, and then how we maybe able to treat them until emergency medical services
arrive. So what anaphylaxis? Anaphylaxis is an allergic reaction, where the body does
different things at the same exact time. While the blood vessels are dilating and becoming
leaky, allowing fluid to leak out into the tissues of the body, decreasing the blood
pressure, something else is tightening. And it’s the airways. The bronchioles, the alveoli sacs,
are filling with mucus and fluids, and basically we have these two mechanisms working together
to create a serious life-threatening problem. So the signs that this person might be showing
is not only the itchy, the hives, the scratchy, the itchy throat, the swollen tongue, the
swollen lips. Those are kind of superficial as far as the outside of the body. But what
is happening inside is what we hear, most of the time. And that’s difficultly breathing,
wheezing, gasping for breath, and not being able to get it in. This is caused by those
bronchoconstrictions, as well as well as the fact that she might be headed into looking
pale, because her heart rate is trying to increase and she’s also losing blood pressure.
So, these are some things that we’re going to be ware of as we’re dealing with this anaphyatic
patient. Now, in this scenario though, she was wise. She understands that she’s having
a problem and she told somebody who was a bystander to get help. In this training
scenario, she’s already been prescribed epinephrine for these types of emergencies. But in the
case, didn’t know she had a food allergy. So her brother shared the candy bar with her,
it might have had an allergen in it, obviously it did. And now she’s reacting to it. So,
as soon as we could, we got to her EpiPen. A few points to think about here is we need
to make sure that the date is still within the expiration range so that it, it’s good.
We’re going to pull the cap off, the safety cap, and it’s important to remember that we
grip it firmly in our hand. But, we do not put a thumb over the needle area, or over
the back of the EpiPen. Now that this has been readied, I’m going to hand it to this victim,
whose now going to auto-inject. She puts it into her big muscle in her thigh,
and holds it there for three seconds. She now takes it out of her leg and lays
it beside her. While she does that, she massages the leg and tries to get the, the medicine
to absorb into that deep inner muscular injection. This training is based on the EpiPen brand, so if
you use a different brand, make sure you follow that manufacturer’s directions. Now, while we’re letting that get into the
system, if we have not already called 911, we should be. So, if you have a phone, dial
911, and get emergency medical services on the way. If you don’t have a phone, send somebody
to go call 911 immediately. If there’s a delay in emergency medical services of greater than
5 to 10 minutes, and the patient actually has a second auto-injector available, we can
actually deliver a second auto-injector if the signs and symptoms of her anaphylaxis
have not improved. Now, we’re always going to be monitoring this patient for an increased
problem. Maybe a loss of consciousness, increased difficulty of breathing, or respiratory arrest,
and then eventually cardiac arrest. And we’re going to treat them accordingly while we wait for
EMS to arrive.

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