Administration of Epi-pen

Question 1

How does an anaphylactic reaction present?

Answer 1

Sudden onset and rapid progression of symptoms
Airway and/or Breathing and/or Circulation problems
Skin and mucosal changes may be evident (flushing, urticaria, angioedema)
The initial manifestation of anaphylaxis may be a loss of consciousness
Patients often describe “a sense of doom”
Anaphylaxis is a systemic event and in the vast majority of people two or more systems are involved

Question 2

What is the treatment of anaphylaxis?

Answer 2

IM Adrenaline given early (into the lateral thigh)

IM adrenaline can be repeated every 5 minutes if the airway, breathing and circulation problems persist

If it is possible, the allergen (trigger), should be removed from the patient i.e. the infusion of contrast should be stopped immediately

Question 3

Why is an IM injection used?

Answer 3

Its a faster absorption rate than subcutaneous (SC) or intra-dermal (ID) routes, but slower absorption than the intra-venous (IV route)

Less risk of tissue damage but higher risk of inadvertent injection into blood vessels or damaging underlying structures

Question 4

Which other sites can be used for an IM injection? Other than the lateral thigh
and what are the risks of these?

Answer 4

The following sites are viable but should only be used if the lateral aspect of the thigh is not an option.

Upper Outer Quadrant of Buttock
riskof injecting sciatic nerve, greater trochanter or major bloodvessels.​

Deltoid Area of the Arm​
poorly developed muscle​
risk of injecting axillary nerve​
least comfortable site

Question 5

What are the doses of epi-pen available?

Answer 5

150 micrograms (0.15 mg)
300 micrograms (0.3 mg)
500 micrograms (0.5 mg)

Question 6

How is a dose of epi prescribed?

Answer 6

The dose depends on the weight and age of the patient

Question 7

How to use a Auto-injector?

Answer 7

Grasp theEpiPenin your dominant hand with thumb closest tothe safety cap​
Pull off the safety cap
HoldEpiPen10 cm from the patient’s outer thigh,
tippointing towards the thigh
Jab firmly into the thigh so that theEpiPenis at right angles tothe skin. This may be done through clothing if necessary​
Hold in place for 10 seconds
Massage injection area for a further 10 seconds​