Use of epinephrine for anaphylaxis by emergency medical technicians in a wilderness setting.
OBJECTIVE
To describe a case series of emergency medical technician-basic (EMT-B)-administered epinephrine for anaphylaxis in a wilderness setting.


METHODS
Case series of patients in anaphylaxis who received epinephrine subcutaneously from EMT-Bs.


METHODS
National park rural/wilderness emergency medical service system covering 863,000 acres and serving approximately 2 million annual visitors.


METHODS
Prehospital care providers were National Park Service rangers with EMT-B training. Patients in the series were visitors to Sequoia and Kings Canyon National Parks with anaphylaxis resulting from insect stings.


METHODS
Subcutaneous administration of epinephrine by EMT-Bs trained in recognition, understanding, and treatment of anaphylaxis.


RESULTS
Eight patients with anaphylaxis resulting from Hymenoptera stings, from June 1992 through September 1993, received EMT-B-administered epinephrine. All patients improved clinically after treatment with epinephrine within 25 minutes. No major side effects occurred.


CONCLUSIONS
Our data suggest that EMT-B-administered epinephrine is safe when used by EMT-Bs in the rural/wilderness setting, with appropriate physician supervision. Further study in large trials will be required to demonstrate safety and efficacy.
Fortenberry
J E
JE
San Francisco/Fresno-Central San Joaquin Valley Medical Education Program, University of California.
Laine
J
J
Shalit
M
M
D000293:Adolescent; D000328:Adult; D000707:Anaphylaxis / Q000188:drug therapy* / Q000209:etiology; D000818:Animals; D002648:Child; D004634:Emergency Medical Technicians / Q000193:education; D004777:Environment; D004837:Epinephrine / Q000008:administration & dosage*; D006801:Humans; D006927:Hymenoptera; D007279:Injections, Subcutaneous; D007299:Insect Bites and Stings / Q000150:complications*
D004837:Epinephrine