EPINEPHRINE (AUTO INJECTORS)
Indications: Signs and symptoms of a severe allergic reaction (e.g. facial/neck/tongue swelling, wheezing, shortness of breath, hypotension, loss of consciousness)
Contraindications (Do Not Give): Chest pain of suspected cardiac origin
Procedure: ensure ALS unit is enroute
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Examine pts own epinephrine auto-injector to ensure that is prescribed for pt, has not expired and visible medication is clear, auto-injector is correct dose for pt (Adult: 0.3 mg epi, Peds < 15 years: 0.15 mg Epi Pen Jr.)
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Remove safety cap from auto-injector and place tip of auto-Injector on the mid-anterior lateral area of pts thigh, midway between groin area and knee (may place over clothing if necessary)
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Push auto-injector against thigh until you hear an audible “click”, Hold auto-injector in place until all med is administered (about 10 seconds), dispose of auto-injector in sharps container
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Reassess pt for improvement of symptoms, repeat vital signs
Documentation: Time of administration of auto-injector, dose given, response to treatment and repeat V/S, route (IM)
NERVE ADENT ANTIDOTE AUTO-INJECTOR
Indications: Possible or known exposure to a nerve agent
Signs/Symptoms: SLUDGEM - Salivation, Lacrimation, Urination, Defecation, GI Upset, Emesis, Miosis (pupil constriction)
Contraindications (Do Not Give):
Pts > 65 yrs (must weigh at least 80 kg) - 1 Auto-Injector or 2-PAM
Pts < 12 yrs (must weigh at least 30 kg) - To receive auto-injector IM
Procedure: Use red instructions in Epi Auto-Injector procedure instructions above in Epi Auto-Injector
Mark 1: Grasp injector and hold it like a pen - do NOT handle or grasp GREEN tip. Repeat with both injectors.
Duodote: Grasp center of injector with green tip (needle end) pointing down. Do not handle GREEN tip.
Document: Time, Site, and Name of antidote kit administered (PCR, triage tag or on back of patient’s hand in MCI)
Dosing: Authorized to give to self or under ALS direction
Signs/Symptoms
Duo-Dotes
Mark 1 Atropine Dose
Mark 1 2 Pam Dose
Severe respiratory distress, agitation, SLUDGEM
3 Auto-Injectors
3 Auto-Injectors
3 Auto-Injectors (6mg)
Respiratory distress, SLUDGEM
2 Auto-Injectors
2 Auto-Injectors
2 Auto-Injectors (4mg)
None
Monitor for respiratory distress/SLUDGEM every 15 minutes