• J E Fortenberry, J Laine, and M Shalit.
• San Francisco/Fresno-Central San Joaquin Valley Medical Education Program, University of California.
• Ann Emerg Med. 1995 Jun 1;25(6):785-7.

Study ObjectiveTo describe a case series of emergency medical technician-basic (EMT-B)-administered epinephrine for anaphylaxis in a wilderness setting.DesignCase series of patients in anaphylaxis who received epinephrine subcutaneously from EMT-Bs.SettingNational park rural/wilderness emergency medical service system covering 863,000 acres and serving approximately 2 million annual visitors.ParticipantsPrehospital care providers were National Park Service rangers with EMT-B training. Patients in the series were visitors to Sequoia and Kings Canyon National Parks with anaphylaxis resulting from insect stings.InterventionSubcutaneous administration of epinephrine by EMT-Bs trained in recognition, understanding, and treatment of anaphylaxis.ResultsEight patients with anaphylaxis resulting from Hymenoptera stings, from June 1992 through September 1993, received EMT-B-administered epinephrine. All patients improved clinically after treatment with epinephrine within 25 minutes. No major side effects occurred.ConclusionOur data suggest that EMT-B-administered epinephrine is safe when used by EMT-Bs in the rural/wilderness setting, with appropriate physician supervision. Further study in large trials will be required to demonstrate safety and efficacy.

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