Where should an EpiPen to treat anaphylactic shock be administered?

Epinephrine should be injected IM into the mid-outer aspect of the thigh (table 1 and table 2) [10,17-21,28,29]. If symptoms are severe, an IV epinephrine infusion should be prepared in case it is needed.

Why is epinephrine injected in the thigh?

This fast uptake of epinephrine is critical in the treatment of anaphylaxis. As opposed to the upper arm, the thigh muscle is one of the body’s largest muscles with more blood supply, so it allows much faster absorption of the medication.

Which position is given in anaphylactic shock?

After administration of epinephrine, patients with anaphylaxis should be placed supine with their lower limbs elevated. They should not be placed seated, standing, or in the upright position. In cases of vomiting or dyspnoea, the patient should be placed in a comfortable position with the lower limbs elevated.

How do you administer epinephrine for anaphylaxis?

Epinephrine 1:1,000 dilution, 0.2 to 0.5 mL (0.2 to 0.5 mg) in adults, or 0.01 mg per kg in children, should be injected subcutaneously or intramuscularly, usually into the upper arm. The site may be gently massaged to facilitate absorption. The dose may be repeated two or three times at 10 to 15 minutes intervals.

Where do you administer a second EpiPen?

An allergist testified that it would have been better to inject the second dose into the opposite thigh. (She received both in the same leg.) The suggestion was that this allows for maximum absorption of epinephrine.

Is Epi given IM or SQ?

The product label of EpiPen, the only autoinjection epinephrine product approved in the US for anaphylaxis, recommends IM intramuscular injection into the anterolateral aspect of the thigh, but it also states that epinephrine, when given intramuscularly or subcutaneously, has a rapid onset of action, which supports …

Where is the best place to inject an EpiPen?

This medicine is injected under the skin or into the muscle of your outer thigh only. Do not inject this medicine into a vein, into the muscle of your buttocks, or into your fingers, toes, hands, or feet. To do so, may increase the chance of having serious side effects.

How long do you hold EpiPen in thigh?

Place the orange tip against the middle of the outer thigh (upper leg) at a right angle (perpendicular) to the thigh. Swing and push the auto-injector firmly until it “clicks.” The click signals that the injection has started. Hold firmly in place for 3 seconds (count slowly 1, 2, 3).

Should you go to ER after using EpiPen?

You should always be checked out at the ER after using your EpiPen. That is not because of the epinephrine, but because the allergic reaction probably requires further monitoring. Many patients also need more than one dose of epinephrine or other emergency treatments.

When should I take an EpiPen for an allergic reaction?

Epinephrine should be used immediately if you experience severe symptoms such as shortness of breath, repetitive coughing, weak pulse, generalized hives, tightness in the throat, trouble breathing/swallowing, or a combination of symptoms from different body areas such as hives, rashes, or swelling on the skin coupled …

Do you have to go to ER after EpiPen?

Should epinephrine be administered immediately after anaphylaxis?

The answer is yes. Epinephrine should be administered without delay if there is any concern or suspicion of anaphylaxis, because the risk of an untreated severe allergic reaction outweighs the risk of inappropriately receiving epinephrine.

Which medications are used in the treatment of anaphylactic shock?

Barach EM, Nowak RM, Lee TG, Tomlanovich MC. Epinephrine for treatment of anaphylactic shock. JAMA. 1984;251:2118–2122.

Do antihistamines or glucocorticoids work as well as epinephrine for anaphylaxis?

Neither antihistamines nor glucocorticoids work as quickly as epinephrine, and neither can effectively treat the severe symptoms associated with anaphylaxis.

What is the evidence for the management of anaphylaxis?

In general, the certainty of evidence underpinning anaphylaxis management is low or very low. The GRADE-ADOLOPMENT process provides a robust and transparent mechanism to assess the current evidence for treatment of anaphylaxis, to inform the 2021 RCUK Anaphylaxis Guideline update.