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When should you use an EpiPen?

You are eating at a seafood restaurant in Southeast Asia when you begin not to feel well. You are concerned about the possibility of allergic reaction — or worse, anaphylaxis. You prepare your epinephrine (EpiPen). In which of the following situations would it be appropriate to use epinephrine in suspected allergic reaction?
(B) Shortness of breath
(C) Severe rash
(D) Feeling faint with a low blood pressure

Anaphylaxis is a severe, life-threatening form of allergic reaction. Whereas a minor allergic reaction may present with a rash or mild “hay fever” symptoms, anaphylaxis is characterized by severe symptoms or involvement of multiple organ systems of the body.

The treatment for anaphylaxis is epinephrine, also known as adrenaline, injected into a muscle. EpiPen-brand autoinjectors provide a convenient way to treat anaphylaxis by allowing anyone to inject epinephrine without having to carry or prepare a syringe of the medication. The name of this medication is sometimes written as "EPINEPHrine", with mixed case, to visually distinguish it from other similar-sounding medications.

To use an EpiPen, pull the blue plastic protector piece from the top, and jab the orange end of the device into the upper outer thigh of the person experiencing anaphylaxis. Hold it there for 3 seconds, then pull it out and discard the device. An EpiPen can be injected through clothes in an emergency. The victim must always be immediately transported to a hospital after receiving an EpiPen, because the effects of the epinephrine can wear off, and anaphylaxis symptoms can return.

Why are the other answers incorrect?

A) Lip, tongue or face swelling
Lip, tongue or face swelling are the skin manifestations of anaphylaxis, however the other answers are also correct.

Throat swelling and uvular swelling (the uvula is the thing that hangs down in the middle in the back of the throat) can also occur. Some patients report feeling like their throat is “closing” or feels “scratchy”.

Closing of the throat can lead to obstruction of the airway, inability to breathe, and death.

B) Shortness of breath
Shortness of breath is a manifestation of anaphylaxis, however the other answers are also correct. Some patients with anaphylaxis will develop stridor, which is a high-pitched noise while breathing that results from a narrowed airway.

C) Severe rash
Severe rash is a manifestation of anaphylaxis, however the other answers are also correct.

D) Feeling faint with a low blood pressure
Anaphylaxis can cause a drop in blood pressure, however the other answers are also correct.

This drop in blood pressure can cause someone to feel lightheaded or dizzy. Anaphylaxis can also cause vomiting.

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