Travel Reference
In-Depth Information
Slide the yellow collar off the plunger without pulling on the plunger.
Insert the needle into the skin of the thigh and push the plunger down as far as it will
go.
Remove the needle.
Bothtypesofdevicesshouldbestoredatroomtemperature.Theyshouldnotbeexposed
tosunlight,refrigerated,orexposedtoexcessiveheat,aswouldoccurintheglovecompart-
ment of a motor vehicle. They should be replaced by the expiration date or if the solution
becomes discolored. Both should be disposed of as hazardous waste and should not be dis-
carded in ordinary trash.
Epinephrine is made by several pharmaceutical manufacturers. It comes in glass vials
that must be opened, and the solution must be aspirated into a syringe, which is time con-
suming. However, for individuals who know how to use them and can obtain the needles
and syringes, the vials are cheaper, smaller, and lighter in weight.
Someinhalersforasthmaticscontainepinephrine.Suchpreparationsarenotrecommen-
ded for anaphylactic shock because the response to them is inconsistent. Although they are
cheaper than the injectable preparations and undoubtedly better than nothing, they are not
totallyreliableforthetreatment ofsevereanaphylactic reactions—the typethatmostneeds
reliable therapy.
Injections of epinephrine should be repeated every five minutes if needed. In fact, indi-
viduals must be closely watched because many relapse in a very few minutes as the epi-
nephrine wears off.
Antihistamines help control the itching of hives and other symptoms but should be ad-
ministered only after anaphylaxis has been controlled. Any H 1 blocker would be effective,
butdiphenhydramine (Benadryl®, Dramamine®, andothers)administered orallyiswidely
recommended.
An albuterol inhaler can be used to relieve residual respiratory obstruction if wheezes
are heard in the chest.
The administration of corticosteroids to reduce the possibility of late reactions is widely
recommended. The standard therapy is oral prednisone for several days.
Respiratoryobstructionduetolaryngealedemausuallyrespondstoepinephrinebutmay
require tracheostomy or cricothyrotomy.
Other steps can help an individual with anaphylaxis, but none can substitute for epi-
nephrine. Following insect stings on an extremity, placing a venous tourniquet above the
site can provide more time for the individual to be transported to a medical facility where
epinephrine is available. Oxygen should be administered during the period of respiratory
difficulty regardless of altitude. Other forms of treatment for shock should be instituted.
Appropriate care should be given if the person is unconscious.
Individuals who have had a mild to moderate anaphylactic reaction to a known allergen
that can be avoided do not need to be evacuated, particularly if additional supplies of epi-
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