If your program does not carry epinephrine but is considering it, here are some issues to
take into account.
• Are you up to date on what your state law says regarding epinephrine?
◊ Curtis’s study indicated that 40% of respondents did not know the epinephrine laws
in their own states.
◊ Understanding what is taking place in K-12 institutions regarding epinephrine is a
helpful place to begin.
• Create operating procedures and a training curriculum for epinephrine.
◊ Do not reinvent the wheel. Ask a peer institution that currently carries epinephrine
to share its resources.
• Do you have a program medical director or physician who assists your program?
◊ Reach out to your college/university’s health center. Ask them to review your epinephrine operating procedures.
Programmatic Questions
Here are some questions to consider if your program carries epinephrine.
• Are you screening participants and staff?
◊ Are you conducting thorough medical screenings?
»» Are people with a history of anaphylaxis carrying their own unexpired epinephrine?
◊ Are you conducting thorough dietary screenings?
»» Consider that people with food allergies who also have asthma may be at increased risk for anaphylaxis reactions (Hawkins & Yacubian).
»» If you are providing food on your trips, what is your plan of action for people
with food allergies?
• How much medication are you carrying?
◊ Are you carrying multiple doses of epinephrine?
»» 25% to 35% of anaphylaxis victims may require a second dose (Gaudio et al.).
◊ Consider including this physician in an upcoming wilderness medical certification
near your area to help familiarize him or her with wilderness medicine.
• Have you checked with your college/university’s legal department regarding institutional authorization?
◊ Have them review your program’s epinephrine operating procedures, participant
waivers/releases, and medical forms.
• What method of administration would you use?
◊ Vials of epinephrine and syringes are far less expensive than EpiPens, but they are
more prone to operator error (Gaudio et al.).
• How can you ensure that your staff feels comfortable and confident in carrying and
administering epinephrine?
◊ Ongoing staff training is important and should include anaphylaxis and epinephrine
definitions, signs/symptoms, and treatment--hands-on practice with your preferred
administration method is a must.
◊ Do you have antihistamines available and packed in the same location as your epinephrine?
»» Early intervention with epinephrine and antihistamines reduces the likelihood
that a victim may need an additional dose of epinephrine (Gaudio et al.).
• Are you storing your epinephrine properly?
◊ Below 90°F and above 32°F are the proper storage temperatures.
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AORE Outdoor Insider | Winter 2015-2016
aore.org | [email protected]
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