Intramuscular Injection Epinephrine 1:1,000 in Anaphylaxis

6 Rights of Medication Administration Right person Right drug Right dose Right time Right route Right documentation

Right person Should be self-explanatory Are we dealing with a patient who is suffering from a moderate to severe allergic reaction, aka anaphylaxis?

Right drug Confirm you are administering Epi 1:1,000 Check for expiration date Check for clarity Check to ensure medication is clear of debris

Right dose Per NCOEMS Protocol 24 Allergic Reaction/Anaphylaxis Adult patient < 50 years of age: 0.3 mg Epi 1:1,000 IM Adult patient > 50 years of age, or has a history of cardiac disease, or takes beta- blockers/Digoxin, or patients who have heart rates >150: 0.15 mg Epi 1:1,000 IM Pediatric patient: 0.15 mg Epi 1:1,000 IM

Right Time Moderate Allergic Reaction Anaphylaxis Involving 2 + body systems, i.e. wheezing and hives Anaphylaxis Involving 2 + body systems + hypotension OR isolated hypotension

Right Route Intramuscular Injection sites: Deltoid, Lateral Thigh Insert the needle into the skin with a smooth, steady motion at a 90-degree angle with the skin flattened Aspirate for blood Inject the medication Withdraw the needle quickly and dispose of properly without recapping Apply pressure to the site

Right Documentation Monitor the patient for the desired therapeutic effects as well as any possible side effects Document the medication, dose, route, and time on/with the patient care report (PCR)