title: Retrieval of additional epinephrine from auto-injectors.
abstract: Anaphylaxis is a challenging condition for any austere environment. It is unpredictable, has sudden onset and a high fatality rate, and is responsive only to epinephrine, a prescription medication. The Wilderness Medical Society has formally recommended that non-medical providers working in austere environments be trained to administer epinephrine. Medical providers frequently prescribe auto-injectors for this purpose due to their ease of use by nonmedical providers. However, auto-injectors have limitations in the wilderness environment, particularly due to their single-dose (or at most 2-dose) design. This paper describes an austere environment technique for obtaining multiple additional doses of epinephrine from auto-injectors that have already been used as designed.
authors.affiliation: Department of Emergency Medicine, University of North Carolina-Chapel Hill School of Medicine, Chapel Hill, NC. Electronic address: hawk@aya.yale.edu.
authors.forename: Seth C
authors.initials: SC
authors.lastname: Hawkins
authors.forename: Carl
authors.initials: C
authors.lastname: Weil
authors.forename: Fred
authors.initials: F
authors.lastname: Baty
authors.forename: David
authors.initials: D
authors.lastname: Fitzpatrick
authors.forename: Bryan
authors.initials: B
authors.lastname: Rowell
mesh_terms: D000707:Anaphylaxis / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D004837:Epinephrine / Q000627:therapeutic use*; D006801:Humans; D007273:Injections, Intramuscular / Q000295:instrumentation / Q000379:methods*; D012646:Self Administration / Q000295:instrumentation / Q000379:methods*; D055813:Wilderness Medicine / Q000379:methods*
chemical_list: D001993:Bronchodilator Agents; D004837:Epinephrine
keywords: anaphylaxis; auto-injector; epinephrine; wilderness; wilderness medicine