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Article Details The Best Uses Of Epinephrine For Severe Allergic Reactions

For management of a serious (even life-threatening) allergic reaction, I have been teaching adults to administer epinephrine (adrenaline) by injection for years. This can be a lifesaving intervention. The Emergency Medical Services (EMS) community now concurs that EMS personnel should be trained to recognize a serious allergic reaction and be allowed to administer epinephrine. In a recent issue of the journal Prehospital Emergency Care (2011;15:570-576), there is an article by Jacobsen and Millin entitled “The Use of Epinephrine for Out-of-Hospital Treatment of Anaphylaxis: Resource Document for the National Association of EMS Physicians Position Statement” that details the use of epinephrine for this purpose.

The major new thrust of this document is to highlight the fact that the intramuscular (IM, directly into the muscle) injection route of administration is preferred, rather than the traditional primary recommendation to inject into the tissue space just under the skin layers (“subcutaneous”). This is because injection into the muscle tissue results in smoother and more reliable drug absorption, with higher peak therapeutic levels of the drug achieved sooner than with subcutaneous injection. The lateral thigh is often used for the IM injection; the outer upper arm is most commonly used for the subcutaneous injection. In an “autoinjector pen” used to administer epinephrine (often referred to by the brand name “EpiPen”), the needle may not be long enough to reach the muscle tissue of a large and/or obese person. However, if the epinephrine is injected into the subcutaneous tissue, it will in all likelihood still be effective, albeit perhaps not as quickly following the injection.

Here is advice about how to give epinephrine for a severe allergic reaction: Read more »

This post, Article Details The Best Uses Of Epinephrine For Severe Allergic Reactions, was originally published on by Paul Auerbach, M.D..

Paramedic Rap

The Sudden Cardiac Arrest Foundation has held a “You Can Save a Life” video awareness contest, in which participants were invited to submit videos that raise awareness of cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs). The 2010 grand prize winner is ”Paramedic Rap” by 911 Emergency ROCKsponse, a college team that uses humor to get your attention about sudden cardiac arrest:

For more videos of contestants and previous competition winners, head over to the foundation’s YouTube channel.

*This blog post was originally published at Medgadget*

Unease About Blogging And Social Media In Medicine

Although it happened a few weeks ago, I only recently learned of the “retirement” of the blog called “Medic999” by EMS social media superstar Mark Glencourse who works in the United Kingdom. I only learned of Mark and his blog (which was recognized as the 2009 Fire/EMS Blog of the Year) in the past few months in association with the hugely popular Chronicles of EMS project (see the first episode on video here).

In stating why he was stopping his blog, unfortunately, I find similar thoughts being shared by the medical colleagues I know about why people either stop blogging or don’t ever start in the first place:

I find it a shame that the reason for this blog ending is the general lack of understanding of blogging and social media. I feel that I have promoted best practice, shared my passion for the job that I do, and hopefully have shown all readers what it is that makes EMS and those that devote their lives to it so special.

However, there still remains a general unease about social media and blogging in the health service. Read more »

*This blog post was originally published at Doctor Anonymous*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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