Ganti Arun, Pilkerton Rebecca, Falsgraf Erika, Vanwert Elizabeth, Brouwer Nathan, Beyer Alexander, Byrne Brendan
Department of Emergency Medicine, UCSF Fresno, Fresno, CA.
Department of Emergency Medicine, University of Utah, Salt Lake City, UT.
Wilderness Environ Med. 2021 Mar;32(1):55-58. doi: 10.1016/j.wem.2020.09.004. Epub 2021 Jan 27.
Anaphylaxis is a life-threatening allergic reaction involving multiple organ systems that can result in significant morbidity and mortality if left untreated. Epinephrine is the mainstay of treatment. Most episodes of anaphylaxis resolve after a single dose of epinephrine, but biphasic and protracted courses of anaphylaxis are well described. The need for additional doses of epinephrine poses a significant challenge in the wilderness setting, because patients and providers may only carry a single autoinjector. Prior work has demonstrated successful disassembly of various brands of epinephrine autoinjectors to retrieve additional drug product for repeat dosing. We describe 2 techniques to retrieve additional doses of epinephrine from Adrenaclick-style epinephrine autoinjectors. The techniques described are off-label and are not approved by the manufacturer or the Food and Drug Administration. Wilderness providers should familiarize themselves with techniques for retrieval of additional epinephrine from various autoinjectors in light of significant differences in product design.
过敏反应是一种危及生命的涉及多个器官系统的过敏反应，如果不治疗，可能会导致严重的发病率和死亡率。肾上腺素是治疗的主要药物。大多数过敏反应发作在注射一剂肾上腺素后即可缓解，但双相和迁延性过敏反应病程也屡有报道。在野外环境中，需要额外剂量的肾上腺素是一个重大挑战，因为患者和施救者可能只携带一支自动注射器。先前的研究表明，成功拆解各种品牌的肾上腺素自动注射器可获取额外的药品用于重复给药。我们描述了两种从Adrenaclick式肾上腺素自动注射器中获取额外剂量肾上腺素的技术。所描述的技术属于超说明书用药，未得到制造商或美国食品药品监督管理局的批准。鉴于产品设计存在显著差异，野外施救者应熟悉从各种自动注射器中获取额外肾上腺素的技术。
