If a patient with a severe allergic reaction has an epi-pen prescribed but did not carry it today, what should you do?

If a patient with a severe allergic reaction has an epi-pen prescribed but did not carry it today, what should you do?

• A. Wait for medical control before giving epinephrine.
• B. Administer only oxygen and transport.
• C. Call for a paramedic to administer epinephrine.
• D. Administer epinephrine to the patient, begin immediate transport, and contact medical control en route.

Answer: (D)

Anaphylaxis requires rapid epinephrine because it reverses the life-threatening changes of the reaction—airway swelling, bronchospasm, and shock. If the patient has a prescription but isn’t carrying the auto-injector, you should still give epinephrine from your EMS supplies under protocol or medical control. Delaying treatment to wait for authorization or for the patient to provide their medication can be fatal, so administer the medication promptly, then begin transport. Transport should start immediately, and you should contact medical control en route for confirmation, to report the patient’s response, and to obtain any additional orders if symptoms persist. Provide oxygen as needed and monitor the patient closely, staying prepared to manage the airway if symptoms worsen.

Anaphylaxis requires rapid epinephrine because it reverses the life-threatening changes of the reaction—airway swelling, bronchospasm, and shock. If the patient has a prescription but isn’t carrying the auto-injector, you should still give epinephrine from your EMS supplies under protocol or medical control. Delaying treatment to wait for authorization or for the patient to provide their medication can be fatal, so administer the medication promptly, then begin transport.

Transport should start immediately, and you should contact medical control en route for confirmation, to report the patient’s response, and to obtain any additional orders if symptoms persist. Provide oxygen as needed and monitor the patient closely, staying prepared to manage the airway if symptoms worsen.