Allergic reaction: epi yay or nay

[EpiEMS]

Then why carry them on the ambulance?

Other use cases — reactive airway disease, croup, bronchiolitis, adrenal crisis/adrenal insufficiency

 

[E tank]

Then why carry them on the ambulance?

It's been kind of dogma for a while to use them. Takes time for practice to catch up?

 

[Tigger]

It take me about a minute to give some dex, if there’s a benefit to patients getting it then we should be doing that. But I agree, the evidence is mixed.

Decadron can also be given PO from the vial if you feel that needles are going to be an issue. Both medical direction and many of the physicians themselves encourage us to give it given the potential wait for orders etc. Is that the most clinical justification? No.

 

[johnrsemt]

You carry and use steroids on the ambulance because it does help the patient; maybe not during the transport, but it helps in an hour or 2. But why wait until you get to the hospital for the clock on it to start? Then you are just making the patient wait longer for it to start helping.
Also great for areas who have long transport times

 

[DesertMedic66]

You carry and use steroids on the ambulance because it does help the patient; maybe not during the transport, but it helps in an hour or 2. But why wait until you get to the hospital for the clock on it to start? Then you are just making the patient wait longer for it to start helping.
Also great for areas who have long transport times

However there are no solid studies that support this claim.

 

[HardKnocks]

What was the exposure and/or onset times? Last intake? Mother Breastfeeding/recent change in vape/ food/intoxicants? Existing condition?
Home Environment? BG?

There's a ton of toxins in today's home environments that we, as kids weren't exposed to.

 

[RescueRicky]

Just a EMT, but no. No episode needed. Just Benadryl and monitor.

 

[bdoss2006]

I’d also go with Benadryl Unless things went sideways. Think about what the epi does and why you’d need it. Vasoconstriction and bronchodilator. Neither of those are indicated in this instance.

Out of curiosity, since epi only causes vasoconstriction and bronchodilation, why is it indicated when there are GI symptoms?

 

[FiremanMike]

GI symptoms indicate the histamine response has gone beyond a single organ system.

Prior to working in the ED, I was much more reserved about my use of epi, but now that I've given it multiple times and spoken to the physicians about the entirety of the situation, I'm much more apt to give epi earlier rather than waiting for decompensation.

 

[bdoss2006]

GI symptoms indicate the histamine response has gone beyond a single organ system.

Prior to working in the ED, I was much more reserved about my use of epi, but now that I've given it multiple times and spoken to the physicians about the entirety of the situation, I'm much more apt to give epi earlier rather than waiting for decompensation.

That makes sense. Like you said GI symptoms means it’s extended beyond just the integumentary system, meaning you should give Epi due to the fact it will very possibly extend to other systems. The sooner you do it to stop that the better.