December 3rd, 2011 by Paul Auerbach, M.D. in Health Tips, Research
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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
Healthine.com by Paul Auerbach, M.D..
October 5th, 2011 by ChristopherChangMD in Research
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Though one should always use an EpiPen that is not expired, it is better to use an expired EpiPen to treat anaphylaxis than to do nothing at all.
Some Canadian researchers studied expired EpiPen auto-injectors 1 to 90 months past the expiration date.
What they found was that the older the EpiPen, Read more »
*This blog post was originally published at Fauquier ENT Blog*
June 29th, 2011 by Edwin Leap, M.D. in Humor, True Stories
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A physician friend of mine recently bragged that, while driving along a rural South Carolina road, he had stopped, chased a timber-rattler into the bushes, located said rattler, then urinated on it.
‘I wanted to say I had peed on a rattlesnake!’ He beat a hasty retreat (and I imagine a hasty zip-up) when the snake rattled and struck at the air. Who can blame Mr. Snake?
You can take the redneck to medical school, but you’ll just get a redneck with a medical degree.
Which brings me to me. I have to work on our tool-shed/work-shop in the morning. The tool-shed/work-shop is, however, over-run with red-wasps. I counted no less than ten nests inside. These are irritable, contentious creatures with no love of humanity. If they were humans, they would be Read more »
*This blog post was originally published at edwinleap.com*
June 25th, 2011 by Paul Auerbach, M.D. in Health Tips
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An allergic reaction in an outdoor setting can rapidly become a life-threatening emergency. While most of us think of food allergies as annoyances, they can be quite serious or even life threatening. Itchy skin rashes can progress to breathing difficulty, swollen soft tissues (e.g., lips, tongue, throat) that compromise the airway, and low blood pressure or even shock. Therefore, it’s important to be familiar with the signs and symptoms of severe allergy and to be prepared to respond rapidly in the event of an emergency.
An EpiPen (an epinephrine auto-injector)
The National Institute of Allergy and Infectious Diseases has released Food Allergy Guidelines for healthcare professionals to help guide the care of patients with life-threatening food allergies. The full guidelines can be found at http://www.niaid.nih.gov/topics/foodallergy/clinical/Pages/default.aspx. Here are some key points: Read more »
This post, Food Allergies: Treating Severe Allergic Reactions, was originally published on
Healthine.com by Paul Auerbach, M.D..