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HEMS EPIPEN PROTOCOL

HEMS EPIPEN PROTOCOL. Michael Calice MD. Epipen Auto Injectors. BLS and LALS providers by Dec 22, 2004. MCA approved MFR providers, based upon need/ not required for ALS. Treat life-threatening anaphylaxis PA 233 of 2003 all BLS and LALS will carry 2 epinephrine auto injectors

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HEMS EPIPEN PROTOCOL

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  1. HEMS EPIPEN PROTOCOL Michael Calice MD

  2. Epipen Auto Injectors • BLS and LALS providers by Dec 22, 2004. • MCA approved MFR providers, based upon need/ not required for ALS. • Treat life-threatening anaphylaxis • PA 233 of 2003 all BLS and LALS will carry 2 epinephrine auto injectors • Adult------------- over age 11 • Jr.----------------- age 2 to 11

  3. Agency Responsibility • A. Obtain a signed legend and pharmaceutical auth form from medical director for each purchase of medication. • B. Ensure medication is securely stored in a locked compartment of the EMS vehicle. • C. Design a tracking system to ensure that expired medication is not being used. • D. Provide initial and ongoing training in the use of epinephrine auto injectors.

  4. Assessment for allergic reaction Resp– DIB, wheezing, stridor, retractions. Swelling- facial, tongue, upper airway VS- hypotension, tachycardia, thready or unobtainable pulse Skin-itching, hives, swelling, flushing, rash Assessment cont’d General- nausea, weakness, apprehension, convulsions, vomiting, diarrhea, and abdominal cramps, involuntary voiding, dyspnea due to laryngeal spasm, pruritis, urticaria,or angioedema Medication Pre-RadioIndications: Specific objective findings in the setting of a LIFE THREATENING allergic/anaphylactic reaction, which may include:

  5. Contraindications Use caution in patients with heart disease, high blood pressure, and stroke: a. EMT and Specialist: contact medical control b. MFR: do not administer

  6. Pre-radio Management • Establish and maintain airway. • Provide oxygenation • Support ventilation as needed • Upright position if not hypotensive • Consider early intubation before laryngeal swelling becomes severe. • Determine substance or source of exposure, remove patient from source if known.

  7. EMT/Specialist • Administration of epipen • Determine which Epipen to administer • Adult Dose (0.3mg/0.3ml) • Age over 11 and less than 50 • Patient over 32 kg • Pediatric Dose (0.15mg/0.3ml) • Age 2 to 11 • Under 32 kg • Consult med control for anyone outside these parameters or h/o CAD, Stroke, high BP

  8. Administration • Follow packet insert for administration procedures specific for brand of epipenephrine auto injector. • Monitor for reactions • Closely monitor the patient’s condition. • Record all patient condition information and medication administration on run record.

  9. Post-radio • Patients over 50 yo administer adult dose • (0.3mg/0.3ml).

  10. QUALITY REVIEW • EVERY USE OF THE EPINEPHRINE AUTO INJECTOR SHALL BE SUBMITTED TO THE HEMS FOR REVIEW BY THE PHYSICIAN QUALITY REVIEW COMMITTEE, WITHIN 72 HOURS • (PSRO – PROFESSIONAL STANDARDS REVIEW ORGANIZATION) REVIEW REQUIRED BY MDCH

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