Route of Epi Admin

[nwhitney]

Has anyone heard of administering an Epi-Pen straight into the pt's cheek? Anyone currently do this?

 

[Carlos Danger]

In the cheek? No. Sublingually, yes.

 

[teedubbyaw]

Are you referring to buccal?

 

[broken stretcher]

I hope were not administering an Epi-Pen to the cheek lol thats a good way to get a piercing and a mouth full of epi!

 

[Medic Tim]

we can give it via the Intralingual route

 

[nwhitney]

I bring this up because I have a friend in dental hygiene school and this is taught during their emergency care course. They were taught to administer an Epi-pen straight into the pt's cheek or buccal. I had never heard this before.

 

[medicdan]

Is it possible because many of the dental injections contain some epinephrine (especially the anesthetics), to decrease bleeding, your friend may have confused this, or the concentration/dose of epinephrine needed?

 

[chaz90]

I bring this up because I have a friend in dental hygiene school and this is taught during their emergency care course. They were taught to administer an Epi-pen straight into the pt's cheek or buccal. I had never heard this before.

This is likely referring to the many local anesthetics that contain small concentrations of Epinephrine to promote vasoconstriction and reduce bleeding.

 

[chaz90]

Oops. Sorry for repeating Medicdan's point.

 

[nwhitney]

Is it possible because many of the dental injections contain some epinephrine (especially the anesthetics), to decrease bleeding, your friend may have confused this, or the concentration/dose of epinephrine needed?

I suppose this could be the case but she was pretty clear that this was for anaphylaxis and not anything else.

 

[NomadicMedic]

Ask to see the textbook where this procedure is described.

 

[nwhitney]

Ask to see the textbook where this procedure is described.

Good idea I'll do that.

 

[Christopher]

In the cheek? No. Sublingually, yes.

This was news to me until I read a case report from the late 90's and then saw a Cook County critical care blog which stated it was a "common administration route" for epi for peds in cardiac arrest.

we can give it via the Intralingual route

So, exactly how common is this?

 

[Medic Tim]

So, exactly how common is this?

I don't think it is used all that often. I only know a handful of medics that have done it.

 

[chaz90]

we can give it via the Intralingual route

Do you use this for localized airway swelling or an alternative route for peds during arrests as was mentioned?

 

[Medic Tim]

Do you use this for localized airway swelling or an alternative route for peds during arrests as was mentioned?

I have not seen it used in Ped cardiac arrest. I have only heard of it being used in anaphylaxis.

 

[alexandermpd]

That's so weird

 

[alexandermpd]

Never heard of anything like that lol

 

[Handsome Robb]

I have not seen it used in Ped cardiac arrest. I have only heard of it being used in anaphylaxis.

Samsies

 

[Carlos Danger]

This was news to me until I read a case report from the late 90's and then saw a Cook County critical care blog which stated it was a "common administration route" for epi for peds in cardiac arrest.

I never heard of it either until my anesthesia training.

Pediatrics are often put to sleep with gas alone without an IV in place. If epi or sux or atropine are needed before the IV is started, they can be given IM or SL.

But I suppose it could be used for anyone, anytime you need to give an IM med.