Reality Training: Allergic reaction recognition and treatment with epinephrine

Review of allergic reaction signs and symptoms; practice prehospital epinephrine administration routes

Patient case: Pediatric anaphylaxis secondary to fish ingestion

A child with a known history of fish allergy accidentally consumed some fish. His mother observed signs of an allergic reaction and administered the child's prescribed EpiPen®. The child moved or jerked during the injection attempt and sustained a small laceration to his upper, medial thigh.

In the below video, filmed at the hospital, the wound is shown and signs and symptoms of anaphylaxis are discussed. The proper administration of an EpiPen auto injector is also demonstrated.  

Equipment prepared for an intramuscular injection skill and competency check station
Equipment prepared for an intramuscular injection skill and competency check station

Discussion questions: Allergic reaction recognition and treatment

Answer these questions on your own or as part of a group training activity.

  • What are common causes of anaphylaxis?
  • What are the signs and symptoms of a local allergic reaction and anaphylaxis?
  • In addition to epinephrine, what are additional BLS and ALS treatments for anaphylaxis you are authorized to provide?
  • Review the administration methods – auto-injector, intramuscular, and intravenous – for epinephrine that are within your scope of practice.  

Skill station: Epinephrine injection

After viewing the video and discussing the above questions, complete a hands-on practice station that includes one or more of the following components.

  • Use of an auto-injector for epinephrine administration
  • Drawing up and administering an intramuscular medication

Video: EpiPen accidental injury

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