Emergency Medicine Matters - Use of Adrenaline in Anaphylaxis

Image Credit: Backpacking Mastery

Anaphylaxis is a life-threatening emergency and is one of the most stressful medical conditions that an expedition medic could face. Fortunately, the condition is reversible with prompt administration of adrenaline by intramuscular injection.

Because the onset of anaphylaxis can be very fast, an adrenaline auto-injector can be very useful upon witnessing the first signs of a severe reaction.

Signs of a severe reaction include:

• Swelling in the throat (altered voice, difficulty swallowing or breathing) and extremities (if stung).

• Wheezing

• Dizziness, feeling faint, tiredness (symptoms of low blood pressure)

The most commonly seen auto-injectors are still EpiPen®. Certainly, this brand is most commonly carried by children and adults in the UK setting. Therefore it may be that some participants on expeditions may carry these.

Figure 1 - EpiPen® Auto-Injector

All auto-injectors should be injected into the muscle of the outer thigh.

There has been a recent slight change in the guidance for administration for EpiPen®.

There is no change to the device or the drug (adrenaline); the change is in the instructions for use as outlined below:

    • Reduced injection time from 10 seconds down to 3 seconds – this is based on research confirming the delivery of adrenaline for 3 seconds is sufficient.

    • Removal of the massage step after the injection – this step has been removed to simplify the process of administering EpiPen®.

The changes above are aimed to improve patient compliance.

Image Credit: Backpacking Mastery

Remember that anyone who uses an auto-injector must have had training in its use (as they are all slightly different). However, it is a drug that can be administered by a non-health care professional in the UK setting if required to treat a patient with anaphylaxis.

It is hoped that the manufacturers of the other auto-injectors (Jext and Emerade) available in the UK will also change their guidelines to match those of EpiPen®.

Wilderness Medical Training recommends the use of Emerade as the autoinjector of choice as each one contains 0.5mg adrenaline (Resus Council UK guideline dose) rather than the 0.3mg adrenaline dose in the EpiPen®.

The guidance for the Emerade auto-injector remains to hold the autoinjector against the thigh for 5 seconds.

Figure 2 - Technique for use of the Emerade Auto-injector

#BasicLifeSupport #FirstAid #EmergencyMedicine

AHA Stay Safe In The Water Campaign

Drowning is the third-leading cause of unintentional injury death worldwide, accounting for 7 percent of all injury-related deaths, according to the World Health Organization. The agency estimates there are 360,000 annual drowning deaths worldwide.

Go to: American Heart Association

Leadership Development - Nurturing a Growth Mindset

Scholars are deeply gratified when their ideas catch on. And they are even more gratified when their ideas make a difference (Carol Dweck, 2016). The growth mindset concept is spreading and being embraced in a number of sectors as part of their curriculum.

But popularity has a price and people begin to distort ideas, and therefore fail to reap their benefits (Carol Dweck, 2016). For instance, some believe a growth mindset is just about praising and rewarding effort. This isn’t true for students in schools, and it’s not true for employees in organizations. In both settings, outcomes matter.

Furthermore, some organizations espouse an ambitious "adopt a growth mindset, and good things will happen" philosophy. Such mission statements are wonderful things, aren't they? You can’t argue with lofty values like growth, empowerment, or innovation. But what do they mean to employees if the company doesn’t implement policies that make them real and attainable?

Organizations that embody a growth mindset encourage appropriate risk-taking, knowing that some risks won’t work out (Carol Dweck, 2016). They reward employees for important and useful lessons learned, even if a project does not meet its original goals.

However, the following infographic serves a purpose in that it emphasizes a relational dynamic between the individual and the growth mindset concept (Steve Wood, 2018). In that, no matter what stage of your career you are in, nurturing and preserving your own growth is absolutely essential, rather than devolve that responsibility to the organization you are part of. In that way, you are more likely to be an agent of change as a leader as well as be better invested as an active follower within your team.

Such are my thoughts on the matter, for now...

#Leadership #GrowthMindset #Development