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Intramuscular Injection
Epinephrine 1:1,000 in Anaphylaxis
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6 Rights of Medication Administration
Right person Right drug Right dose Right time Right route Right documentation
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Right person Should be self-explanatory
Are we dealing with a patient who is suffering from a moderate to severe allergic reaction, aka anaphylaxis?
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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
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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: mg Epi 1:1,000 IM Pediatric patient: mg Epi 1:1,000 IM
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Right Time Moderate Allergic Reaction Anaphylaxis
Involving 2 + body systems, i.e. wheezing and hives Anaphylaxis Involving 2 + body systems + hypotension OR isolated hypotension
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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
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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)
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