Fortenberry J E, Laine J, Shalit M
San Francisco/Fresno-Central San Joaquin Valley Medical Education Program, University of California.
Ann Emerg Med. 1995 Jun;25(6):785-7. doi: 10.1016/s0196-0644(95)70208-3.
To describe a case series of emergency medical technician-basic (EMT-B)-administered epinephrine for anaphylaxis in a wilderness setting.
Case series of patients in anaphylaxis who received epinephrine subcutaneously from EMT-Bs.
National park rural/wilderness emergency medical service system covering 863,000 acres and serving approximately 2 million annual visitors.
Prehospital 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.
Subcutaneous administration of epinephrine by EMT-Bs trained in recognition, understanding, and treatment of anaphylaxis.
Eight 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.
Our 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.
描述一组在野外环境中由急救医疗技术员基础水平（EMT - B）给予肾上腺素治疗过敏反应的病例。
对接受EMT - B皮下注射肾上腺素治疗过敏反应的患者进行病例系列研究。
覆盖86.3万英亩、每年服务约200万游客的国家公园农村/野外紧急医疗服务系统。
院前护理提供者为接受过EMT - B培训的国家公园管理局护林员。该系列患者为红杉树国家公园和国王峡谷国家公园因昆虫叮咬发生过敏反应的游客。
由接受过过敏反应识别、理解和治疗培训的EMT - B进行肾上腺素皮下注射。
1992年6月至1993年9月，8例因膜翅目昆虫叮咬发生过敏反应的患者接受了EMT - B给予的肾上腺素治疗。所有患者在使用肾上腺素治疗后25分钟内临床症状均有改善。未出现严重副作用。
我们的数据表明，在农村/野外环境中，在适当的医生监督下，EMT - B使用肾上腺素是安全的。需要通过大型试验进行进一步研究以证明其安全性和有效性。
