Basic Life Support Access to Injectable Epinephrine across the United States.

Area of Science:

• Emergency Medicine
• Allergy and Immunology
• Public Health Policy

Background:

• Anaphylaxis treatment increasingly supports aggressive epinephrine use.
• Epinephrine autoinjectors (EAI) are costly, rising tenfold in a decade.
• Expanded scope of practice allows Basic Life Support (BLS) to administer injectable epinephrine.

Purpose of the Study:

• To document current epinephrine administration practices by Emergency Medical Services (EMS) in the USA.
• To identify the forms of epinephrine utilized and the scope of practice for BLS providers.

Main Methods:

• An online survey was distributed to state EMS medical directors and officials nationwide.
• Follow-up phone calls ensured survey compliance.
• Descriptive statistics were employed for data analysis.

Main Results:

• 49 states responded; Texas declined due to variability.
• 13 states train BLS providers in injectable epinephrine; 7 are considering it; 29 are not.
• 27 states mandate EAI for BLS, with no states allowing epinephrine use below EMT level.

Conclusions:

• Many states have expanded BLS training for injectable epinephrine administration.
• Despite training expansion, the majority of states continue to rely on EAI for BLS ambulances.