Non-Auto-Injector Epinephrine Administration by Basic Life Support Providers: A Literature Review and Consensus...

Area of Science:

• Emergency Medicine
• Pharmacology

Background:

• Anaphylaxis is a severe allergic reaction requiring immediate treatment with epinephrine.
• Current limitations exist in epinephrine auto-injector (EAI) availability and cost for some emergency medical services (EMS).

Purpose of the Study:

• To review literature and discuss practical/policy issues of non-EAI epinephrine administration for anaphylaxis by EMS.
• To support revised National Association of EMS Physicians (NAEMSP) guidelines on out-of-hospital anaphylaxis treatment.

Main Methods:

• Literature review and consensus report.
• Analysis of practical and policy considerations for epinephrine administration.

Main Results:

• Evidence suggests intramuscular injection of epinephrine from vials/ampules by trained EMS providers is safe.
• Non-EAI administration facilitates timely anaphylaxis treatment.
• This method is associated with reduced costs for EMS agencies.

Conclusions:

• Non-EAI epinephrine administration by trained EMS personnel is a viable and safe option for anaphylaxis.
• Expanding administration methods beyond EAIs can improve patient care and agency resources.
• Policy adjustments may be needed to support broader epinephrine access for anaphylaxis treatment.